Archive for the ‘health insurance exchanges’ Category

5 New Entrants to Indiana’s Health Insurance Exchange

Sunday, July 20th, 2014

Residents of Indiana are getting some new health insurance choices in the state’s health insurance exchange.  According to The Courier-Journal’s “Indiana health insurance market to see changes,” Maureen Groppe says that five additional companies will be selling plans in the state exchange this year.  There are currently four companies offering plan choices in Indiana.  Out of the 16 states that make their information public, Indiana has the most new entrants.  There will be some rate changes by the four companies who are already selling in Indiana’s exchange.  The highest change is a 96% increase and the lowest change is an 11% decrease in plan costs.  More choices mean that Indiana residents who already have health plans could get rates that are significantly lower than their current plan rates.

More than 130,000 Indiana residents purchase health insurance outside of an employer program or Medicare.  It’s possible that number could double next year as more uninsured Americans seek health insurance plans through the government exchanges and individual companies to comply with the individual mandate.  CareSource is one of the new companies to Indiana’s exchange and plans to offer very low, competitive rates.  Their rates are so low in fact, that the state regulators questioned the insurance company’s filing.  Premium prices will not be set in stone until just before the November 15 open enrollment period.  But the state filings help the market get a feel for what is going to happen in the fall.

Overall health care costs are increasing by 5.4%.  Insurance companies have to justify increases in premiums that are much more than the increasing cost for health care.  Some insurance companies face a greater amount of claims than others.  Indiana is changing the way that their disabled residents qualify for Medicaid, so close to 7,000 people with higher medical expenses will be entering the individual health insurance market next year.  Since these Affordable Care Act rules are fairly new, insurance companies are still trying to maneuver this health insurance market where they cannot deny coverage to people with preexisting conditions.  Companies are seeking rate increases and also lowering premium costs based on regions in the state and the tier level of different plans.  It will take a few years for health insurance companies to determine exactly what premium changes need to be made based on what happens each year with costs and new members.

You Could Lose Your Health Insurance When Your Parent Dies

Sunday, July 13th, 2014

The last thing you are worried about when a parent dies is what will happen to your health insurance coverage.  But unfortunately for many young people, they also lose their health insurance coverage when their spouse dies.  This also holds true for spouses, including those with young children.  In the U.S. News & World Report Health article “What to Do When You Lose Your Health Insurance,” Geoff Williams offers up options for those who lose their health insurance unexpectedly.  The article gives the example of a 30-year old woman who lost her health insurance coverage when her father passed away in April.  She has ulcerative collitis, a bowel disease that could cause serious complications without her medication and doctor visits.  She found out that she had lost her health insurance when she tried to fill a prescription and her insurance was declined.  It cost her $200 out of pocket just to buy the four pills that she needs for one day.

It’s not common for a 30 year old to have health insurance coverage under her Dad’s plan, so the woman in the example was lucky to have such a perk.  In this particular instance, her Dad had carried individual health insurance with his carrier for so long that they allowed him to keep his daughter on his plan to age 31.  She would have had to search for health insurance soon anyways, so she was likely already researching her options.  If you don’t have health insurance coverage, you can shop for it at any time.  The Health Insurance Marketplace open enrollment period is from November 15 to February 15, but the government dates aren’t necessarily written in stone.  You can apply for a health insurance plan at any time when you have had a life change that took away your health insurance.  You can also apply for health insurance with an individual health insurance company at any time during the year.  Most companies have open enrollment periods similar to the government, but for a shorter period of time.  You can make changes to your plan during that time, unless you have a life changing event some other time during the year.

Life changing events include death, the birth of a child, marriage, divorce, a change of income, relocation, or the sudden loss of health insurance.  If any of these events happen to you, the government gives you a 60 day grace period to obtain health insurance in the exchange.  You can get health insurance quotes from multiple companies here.  You can also use an agent that works for one health insurance company or a broker that shops the health insurance marketplace for you.  The last option is similar to shopping the market for health insurance with comparehealthrates.com.  Medicaid and the Children’s Health Insurance Program are available to those with low income.  COBRA is a health insurance option for people who have just lost their jobs, and therefore their health insurance coverage.  If your parent dies and you lose your health insurance, there are options for you to find health insurance coverage.  The woman in the article was able to get her insurance plan extended until August 1 so that her daily medication is covered, so she had a couple months to search for her own health insurance plan.

 

Consumers Would Like to Know Premium Increases In Advance

Saturday, June 28th, 2014

Increasing healthcare costs have been a bone of contention for years.  This was long before the Affordable Care Act became law and it’s continuing after the ACA went into effect.  One of the biggest problems that many consumers have is that it’s just not clear where the extra money they have to pay is going.  The cost of health insurance premiums is rising much faster than our incomes, so healthcare is really taking a hit on consumer budgets.  Consumer Reports’ David Butler wrote an article for Fox Business titled “Make the pricing of health insurance more transparent.”  If consumers know why they are paying more money and exactly where their money is going, people might not be so angry about paying higher premiums.  Or it might make the health insurance industry function in a better way so that money is used wisely. Health insurance companies are already getting ready to set their premium prices for next year.

The open enrollment period for signing up for health insurance in the government exchanges is less than five months from now.  It would make sense that consumers get a taste of what premium costs are going to be before searching for health insurance plans.  Health insurance increases before the Affordable Care Act were often extreme and there weren’t any safeguards in place to prevent astronomical premium increases.  This is why millions of Americans chose to avoid purchasing health insurance and take the risk that they wouldn’t get sick.  President Obama’s goal in creating the Affordable Care Act was to get more Americans insured.  One safeguard that the law put into place was an oversight of premium rates at both the state and federal level.  The Department of Health & Human Services has the ability to review premium costs and increases that they deem unreasonably high.

The government is trying to make health insurance premiums more transparent, so that consumers can see potential increases before they are hit with them.  Unfortunately the timing has not been quite right.  2013 information was recently released, although we are already paying for those premium increases.  Now would be a good time to see the potential increases for next year, before open enrollment and before health insurance decisions have to be made.  Making the information public before increases go into effect allows consumers and states to determine if the increases are justified.  Another problem is that some insurance companies say that their information is confidential, so we aren’t able to have access to any transparency.  It’s frustrating for consumers to feel in the dark and out of control when it comes to health insurance premium increases.  Consumer Reports hopes to change the system by requiring full transparency of health insurance premium increases before they come into effect.  If you are having a hard time finding affordable health insurance, search for quotes here.

Health Insurance Premiums Have Been Increasing for Years

Saturday, June 7th, 2014

A recent study done by the Commonwealth Fund found that health insurance premiums have been increasing for years.  The nonprofit group performed this study to determine what had been happening in the health insurance industry before the implementation of the Affordable Care Act changes.  They wanted to show the public the whole picture so that people aren’t blaming all of the health insurance increases on Obamacare.  This information comes from Maggie Fox’s NBC News article, “Health Insurance Premiums Have Been Increasing Since 2008.”  They studied health insurance premiums in the private health insurance markets.  Those are the individual and family health insurance plans that Americans find and pay for out of their own pocket, not through a group or employer.  The study found that health insurance premiums have been steadily increasing since 2008.

Individual insurance premiums increased by at least 10% per year from 2008-2010.  We are still waiting to see what the premium prices will be for 2015, but most experts agree that they will be higher than this year’s prices.  The study results point out that premium increases really cannot solely be attributed to mandatory changes brought about by the Affordable Care Act because premium prices were rising 10% per year before the law took effect.  Premiums almost have to increase because health insurance companies have to cover much more than they covered before the ACA took effect.  Insurers can no longer deny coverage to people with preexisting conditions either, so it costs them much more money to offer insurance plans.  They can’t exclude maternity coverage from plans or charge cancer patients more for their insurance policies, so premium prices across the board are likely to increase.

State and federal run health insurance exchanges started offering plans this year.  Before these exchange plans were an option, an estimated 14 million people bought individual health insurance plans outside of the workplace.  This is either because they don’t have a job or their employer doesn’t offer them health insurance coverage.  Eight million people have bought insurance plans through the exchanges this year, according to the President’s administration.  A Gallup poll found that the number of Americans without health insurance went from 18% in December to 13.4% in May.  It’s going to take years before we know the true effect of the Affordable Care Act on the health insurance industry, especially because of the plans that have been allowed to continue offering sub-standard policies for two more years.  It will just be important to keep in mind that health insurance plans were rising before the ACA as well.  Increases in 2008, 2009 and 2010 were 9.9%, 10.8% and 11.7%, respectively.

Large Employers May Stop Offering Health Insurance Plans

Wednesday, May 21st, 2014

A lot of people who get their health insurance from their large group employers might just be searching for insurance coverage elsewhere soon.  While it certainly wasn’t the intention of the Affordable Care Act to make it more difficult for employers to offer insurance to their employees, that has been an effect of the health insurance mandate often referred to as Obamacare.  In the Forbes article, “Obamacare Increases Large Employers’ Health Costs“, Sally Pipes tells us about recent study findings.  S&P Captial IQ’s study determined that 90% of workers in America who currently have health insurance through a large employer will be searching for a policy in the government exchanges by 2020.  That figure seems extreme, but the harsh reality is that the taxes, fees, and added insurance mandates placed on large employers are hurting them.  Many of these employers simply don’t think that they can afford to offer health insurance if something doesn’t change.  They are currently mandated to offer you health insurance plans, so that is something that will have to be considered as well.

Group health plan sponsors pay a new fee to help fund the government sponsored Patient Centered Outcomes Research Institute (PCORI).  This organization tests the effectiveness of certain medical treatments and Medicare uses the results to determine what they will cover for their patients.  Some skeptics worry that results could be twisted to support lower cost treatments over more effective, but higher cost ones.  Another fee that large employers have to pay is a Temporary Reinsurance Fee.  This fee is supposed to stabilize premiums in the individual health insurance marketplace.  The American Health Policy Institute estimates that $15.3 million will be collected by this fee in just two years.  In 2018, large employers will start paying a 40% excise tax on health insurance plans that are deemed “expensive”.  Individual premiums above $10,200 and family premiums above $27,500 are considered “expensive”.  One company estimates that this excise tax will cost them $378 million over the course of five years.

In addition to the direct taxes, there are indirect tax increases for employers as well.  There is the mandate for companies to offer health insurance to full time workers within the next year or two.  If they don’t, they will pay a fine.  Companies also have to allow children to remain on their parents’ health insurance until the age of 26 now.  That last mandate alone has increased employer insurance costs between 1 and 3%.  Mandating full coverage of preventative care services, such as immunization and birth control is drastically increasing employer health care costs as well.  The AHPI survey estimates large employer health care costs to rise by 4.3% in 2016, by 5.1% in 2018, and increase by 8.4% in 2023.  This equates to hundreds of billions of dollars extra that large employers will have to shell out over the next decade or so.

Unfortunately, what this means to Americans with health insurance from their large employer is that their costs will likely increase as well.  More than 80% of large employers have already increased their employees’ deductibles, or plan to do so soon.  Some employers might stop offering health insurance altogether and pay the fine for not offering plans.  They might actually save money by doing that, although employee morale could decrease from such a move.  Companies may also offer incentives for sick employees to search for health insurance in the exchanges instead of using the company plan, saving both the employer and employee money.  But if all of the sickest employees head into the health insurance exchanges, costs within those will increase for everyone.  The potential destruction of employer health insurance plans was certainly not a goal of the Affordable Care Act, but it might just be a consequence.  If you are worried about losing your employer health insurance, you can compare health plans and rates here.

Pregnant Women Have More Maternity Health Insurance Choices

Tuesday, May 13th, 2014

There was a time, not very long ago, that you were hard pressed to find health insurance as a pregnant woman.  This pre-existing condition was the only reason needed for a health insurance company to deny a pregnant woman’s application for coverage.  The Affordable Care Act has changed this former reality, according to “Health law gives pregnant women more options“.  In the Associated Press article, it says that Medicaid will help to supplement private insurance plans bought in health insurance exchanges.  Pregnant women who recently purchased private health insurance plans through the government exchanges will also be able to access Medicaid coverage from their state as well.  This applies to lower-income women, but the income limits vary significantly from state to state.  Some state limits are close to the poverty level, while others are more like a middle class income.

Did you know that Medicaid already pays for almost half of the births in the United States?  This new expansion of Medicaid services to pregnant women will be effective in every state, even if they have not opted to expand their overall Medicaid system under the Affordable Care Act.  Unfortunately the logistics of this Medicaid expansion are fairly complicated.  States and the federal government are trying to iron out the details, so it is still complex for consumers to navigate.  Overall though, it’s a good thing for women because they will end up paying less out of pocket.  They have the option of using only their private health insurance, only Medicaid, or a combination of both plans if that is what will be best for their pregnancy scenario.

While the cost of insuring more women is going to be higher, there are anticipated lower costs overall.  Taking care of a woman and her unborn child with good prenatal services helps to avoid the larger expense related to premature births and birth defects.  Pregnant women without health insurance often don’t seek prenatal care and can’t be treated for problems that they don’t know exist.  The Affordable Care Act made it so that health insurance companies must offer maternity coverage, even if the woman is seeking health insurance while she is already pregnant.  For those lower-income women who bought private plans in the health insurance exchanges using federal subsidies, the original law stated that they were no longer eligible for Medicare.  Then there was a ruling that said Medicare coverage did not meet the “minimum essential coverage” that the law requires because it is temporary and states can deny certain services.  Now they can use their private plan along with Medicaid coverage.  A woman might benefit from using both plans because her coverage will continue after she has the baby, but the Medicaid coverage could help with cost-sharing.

If you are looking for health insurance with maternity coverage, you can find affordable health insurance in any state.

Hard to Find Health Insurance Anywhere After March 15 Deadline

Thursday, April 24th, 2014

The deadline to sign up for health insurance and meet the Affordable Care Act requirements has come and gone.  Health insurance exchanges will not start offering plans until later this year for the next enrollment period.  But most people were not expecting some private health insurance companies to stop selling health insurance plans after March 31 as well.  According to Health Day’s Karen Pallarito, “Suddenly Health Insurance Is Not For Sale“.  One Tennessee insurance broker said that many health insurance companies in her area are not selling insurance plans until the exchanges open again later this year.  One of the main reasons that some health insurers have made this decision is because they believe they will attract healthier, younger people when the government exchanges are open as well.  Insurance companies can no longer reject sick people or those recently diagnosed with a disease.  They are hoping that they will be able to attract the young, healthy individuals that will keep their costs lower.

For coverage that will start in 2015, the next open enrollment period starts on November 15.  Penalties for not obtaining insurance coverage yet won’t be issued until tax time next year, but those who waited might just be ready to purchase insurance come November.  Healthy and young individuals are most likely to plan in advance when shopping for health insurance.  That is why it makes sense economically for health insurance companies to only offer plans during open enrollment times.  Individuals who have recently become sick or need some type of care right away are the most likely to search for health insurance at any time of the year.  Open enrollment periods were designed to deter people from waiting until they are sick to shop for health insurance.  When that happens, insurance can become unaffordable all around.

Health insurance companies offering plans outside of the exchanges can choose whether or not to sell health insurance year round or not.  One survey of 180 health insurance companies found that one or more health insurers will be offering plans after March 15 in only 14 states.  Some of those plans will only be offered through the end of April.  You will be able to find health insurance in some places though.  Arizona’s non-profit insurer Meritus plans to continue offering health insurance plans year round.  They are currently working with the Arizona Department of Insurance.  In Nevada, their Health Coop will continue offering insurance plans to consumers around Las Vegas.  There may be some states where it is difficult to find health insurance before November 15.  If you are looking for a plan, you will probably have to work a little harder than before the deadline.

7 Health Insurance Issues to Follow This Year

Sunday, April 6th, 2014

Kaiser Health News and USA Today collaborated on an article asking “What Happens Next On The Health Law?“.  Julie Appleby, Mary Agnes Carey, and Phil Galewitz gave us seven things to watch for between the end of enrollment on March 31 and the beginning of the next enrollment period in November.  This health care reform has been hotly debated for the length of a presidential term already and will likely continue to be a hot topic into the future.  Now that the first enrollment period has come to an end, we can finally start to measure some of the successes, failures, and changes that have actually occurred.  Before that, it was just speculation.

Everyone wants to know how many people actually signed up for health insurance plans after the law took effect.  We certainly don’t have any concrete answers yet, but President Obama says that early indications show 6 million people signed up.  This doesn’t take into account those Americans who got health insurance outside of the government agencies or with insurance companies.  The March deadline was also loosened for people who tried to sign up and had website issues.  It could be a month or so before we get concrete numbers.  For the law to work ideally, young and healthy individuals needed to sign up.  So who actually did enroll?  Around one-quarter of them were in the targeted demographic of 18 to 34.  The majority of new enrollees were aged 35 and up and were female.  Health insurance rates are based on state enrollment though, so it’s more important to determine who signed up in each state.  Those states who had more older, sicker individuals sign up might see increasing health insurance rates.

The biggest question to be answered is whether or not the law actually affected the number of uninsured Americans overall.  There are no clear statistics to answer this question just yet.  The Kaiser Family Foundation says that they are pretty sure the uninsured rate has gone down, based on a Gallup poll and McKinsey phone survey.  That last survey found that 27% of those who signed up for health insurance previously did not have any.  Everyone will be closely tracking final figures on this topic.  You will not find the same plans and prices when the next enrollment period begins on November 15.  Insurance companies will have to go over all of the costs and figures before they release their new selections next fall.  It’s too early to determine whether Medicaid participation will grow, but that is something that a lot of people are watching this year.  There has been a lot of political fighting over Medicaid expansion, so it is being closely monitored.

Many of us are wondering what might happen with employer sponsored health insurance.  Employers who already offer it will continue to do so, but will likely pass cost increases onto employees through increasing deductibles and co-pays.  Employers with less than 50 employees do not have to offer them health insurance.  Those with 50-99 employees have to offer 70% of them insurance plans by 2016.  Companies with 100 or more workers have to offer 70% of them health insurance by next year.  Look out for coverage options relatively soon if you work for one of those companies.  Congressional elections will likely be affected by these health care issues in the near future.  You’ll probably see a lot of advertising and news time dedicated to health care reform issues this year.  If you are looking for a health insurance plan, find an affordable option here.  The next enrollment period for the government exchanges begins on November 15.

 

 

Out-of-Network Insurance Costs Can Be Sky High

Tuesday, March 18th, 2014

Unless you’re made of money, it’s really important to pay attention to the health care providers you see.  In-network and out-of-network may just seem like insurance terms, but if you you make the decision to seek health care that is out of the network established by your health insurance plan, you might end up paying a lot of money out of pocket.  In the Kaiser Health News article, “Warning: Opting Out Of Your Insurance Plan’s Provider Network Is Risky,” Michelle Andrews gives us the run down on what to expect out-of-network.  There are a lot of health insurance plans, especially in the new health insurance marketplaces, that offer consumers lower premium costs if they choose a network of health care providers that is more limited.  Some people opt for these plans with the assumption that they will simply go out-of-network if necessary and pay the added costs.  They may not know just how much those added costs will be though.

The Affordable Care Act has put limits on the out of pocket costs that Americans will have to pay each year.  For 2014, the limits are $6,350 for individuals and $12,700 for families.  These maximum out of pocket costs are only for in-network care though.  Most health insurance plans can charge you much more if you go out-of-network.  Some companies don’t even have a cap on your out of pocket costs when you go out-of-network.  Annual check-ups, vaccines, cancer screenings and other preventative care are now free for most Americans with health insurance plans.  But if you choose to receive these services from a provider out of your network, you will likely pay for these otherwise “free” services.  Health insurance companies often charge consumers higher co-payments and coinsurance for care that they receive out of their network.  In addition to that, doctors and hospitals can charge you what is known as “balance billing” when they are out of your insurance company’s network.  Since they aren’t in a contract with your insurer, many out of network doctors and hospitals will send you a bill for any charges that your insurance did not cover.

This in-network versus out-of-network cost structure holds true for Americans who purchased health insurance through the marketplaces, those with individual health insurance plans, and even workers who receive health insurance plans through their employer.  You would be hard pressed to find a health insurance plan that covers care at any doctor or hospital.  The four levels of plans in the health insurance marketplace are bronze, silver, gold and platinum.  They cover 60, 70, 80 and 90% of your medical services, respectively.  But those percentages only account for in-network care, something you have to keep in mind when choosing providers.  When taking a look at the silver plans specifically, 70% of them are considered narrow network, which means that 30% of the largest hospitals in your area will not be in-network.  With ultra narrow network plans, 70% of the largest hospitals in your area are out-of-network.  Emergency care will be covered because of a stipulation in the health care law, regardless of where you receive care.  Insurance companies cannot charge you higher co-payments or coinsurance if you are out-of-network, which is probably why most emergency room co-payments are so high to begin with.  But if you end up being admitted to an out-of-network hospital after your emergency room visit, you might want to seek a transfer to an in-network provider because you are no longer protected by the emergency care stipulation.

A Kaiser Family Foundation study found that more than half of people who purchase their own health insurance plan are willing to take a smaller network of providers in exchange for lower premium costs.  They also found that there is little standardization when it comes to individual and marketplace health insurance plans.  Do your research and call your insurer with every visit if you need to, just to make sure that your health care will be covered.  If you are looking for health insurance quotes, compare health rates offers quotes from multiple insurers all over the United States.

Health Insurance Is Going the Way of Retirement Plans

Sunday, February 16th, 2014

Just a couple decades ago, American retirement plans made a big shift from pensions to 401k’s.  Instead of receiving a defined benefit pension, workers started contributing to plans and making their own decisions about how they would receive their money.  A lot of people are forecasting a similar change in the health insurance industry over the next 5-10 years.  Right now many employers offer health insurance in a defined benefit way.  They choose the exact health insurance options and you can choose to pay for the plan or opt to buy your own individual health insurance.  Insurance News Net posted an article from The Pittsburgh Post-Gazette’s Bill Toland which says that “In 2020, Workers Will Decide (their own) Health Benefits.”

Many experts believe that the face of health insurance will change dramatically.  They forecast that people will shop online and choose the specific health insurance options that they want for themselves from private exchanges.  Companies will pay a certain stipend to their employees via a health account and that will go towards their health insurance plan costs.  If people choose a health insurance plan that is more than their employer stipend, they will have to pay the rest of the bill themselves.  They will shop in online private health insurance exchanges run by health insurers, like Highmark, or benefits consultants or brokers..  If an insurance company is running the exchange, all of the plans will be from them.  But if the exchange is run by benefits consultants or brokers, there will be plans from multiple insurance companies.  Plans will differ in prices and coverage.  Each exchange will likely offer around 6-10 different plans.

It was easier for large companies to make the pensions switch because they almost immediately saw huge cost savings.  It is a little different with the health insurance plans because although they will not see huge cost savings, they will see a large reduction in the amount of administration.  They are also offering better benefits to their employees, making them more competitive as employers.  But small and mid-sized employers will see even more benefits initially than the larger companies.  Experts predict that many smaller companies will make this switch to private exchanges in the next year and a half.  Larger companies will switch as well, but it will take a large employer like McDonalds or WalMart making the big move before many other make the jump as well.