Dear Sun Spots: Earlier this year, the Sun Journal ran an excellent article on the new Dirigo health insurance plan. Different incomes were used as an example to determine how much the monthly cost would be. Several members of our coffee club wondered how it would affect us. We pooled and averaged our stats in the hopes that you would be able to check out the proposed plan and give us a guesstimate based on our average ages and incomes.

Here’s our example: husband and wife are both 62 years old. Both retired. Total yearly income from Social Security is $21,600. Not eligible for Medicare until 65. No current health insurance coverage for either. As we are not employed, the cost would be ours. Also prescription coverage would be very important to all of us. Thank you in advance from our 12 members. – E. Folker, Mechanic Falls.

Answer: According to Adam Thompson of the governor’s Office of Health Policy and Finance it’s difficult to say what DirigoChoice would cost those in your example because enrollment of individuals will not occur until late this winter. But, he says, they can estimate that the couple, with an income of $21,600 would be eligible for a discount of up to 40 percent on the monthly costs of DirigoChoice, and their deductible and out-of-pocket maximum costs would be similarly reduced.

The goal of Dirigo health reform is to achieve universal access to quality and affordable health care for all Maine people. Dirigo health’s cost containment and quality improvement reforms will benefit all Maine people who pay for health care and insurance premiums.

Another component of Dirigo health is the Dirigo Health Plan, called DirigoChoice. DirigoChoice is designed to increase access to coverage for Maine’s uninsured, of which 75 percent work in small business or are sole proprietors (self-employed). DirigoChoice will be available to Maine’s small businesses (with between two and 50 eligible employees), sole proprietors and individuals.

DirigoChoice will be available for enrollment by small businesses and sole proprietors starting Oct. 4, with coverage for benefits beginning Jan. 1. Individuals will be able to enroll starting in February, with benefits to be covered starting April 1.

DirigoChoice will look and feel like other products in the market, offering:

Discounts of up to 100 percent on monthly costs. Reduced deductibles are provided to members with incomes below 300 percent of federal income levels – approximately $28,000 in income for a single household and $56,500 for a family of four, for instance.

Preventive services are covered at 100 percent. No co-pays, deductibles or other out-of-pocket expenses for preventive services, such as routine physicals, well baby care, mammograms and certain blood tests.

Mental health services are covered at the same level as physical ailments for all members and the Health Me Rewards program provides a total $100 incentive for members to complete a health risk assessment, and to choose and consult with a primary care physician.

DirigoChoice and the discount program are designed to reflect a member’s ability to pay. So costs will vary for each member and their individual income level and demographics.

There are many details available right now about DirigoChoice. The best way to learn more is to visit www.dirigohealth.maine.gov. And, to inquire about enrolling or to receive a rate quote, interested small businesses and sole proprietors should contact Anthem or an Anthem insurance producer (agent).

Dear Sun Spots: I wrote before and always got a good answer, and I hope you can help me again this time.

I’m looking for Jacklyn Smith support knee-high stockings. I seem to get them at Kmart, but lately I can’t find any. If you can give me any information, I would really appreciate it very much. – No Name, No Town.

Answer: In addition to responses from readers, Sun Spots checked with Kmart, which carries a trouser sock ($2.99) that is heavier than a regular knee-high but not as heavy as a support hose. You might want to check them out to see if they would work for you. You can reach the store on Center Street in Auburn, across the street from Shaws, at 784-2911.

This column is for you, our readers. It is for your questions and comments. There are only two rules: You must write to the column and sign your name (we won’t use it if you ask us not to). Letters will not be returned or answered by mail, and telephone calls will not be accepted. Your letters will appear as quickly as space allows. Address them to Sun Spots, P.O. Box 4400, Lewiston, ME 04243-4400. Inquiries can also be posted at www.sunjournal.com in the Advice section under Opinion on the left-hand corner of your computer screen. In addition, you can e-mail your inquiries to [email protected]


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