During this year’s enrollment period for the Affordable Care Act’s (ACA) Marketplace health insurance, residents of Allen County will notice some important changes and additions.
Open enrollment began Nov. 1 and ends Jan. 15. Those who enroll by midnight on Dec. 15 get full-year coverage that starts Jan. 1. The final deadline to enroll in coverage is Monday, Jan. 15. For those who enroll from Dec. 16 through Jan. 15, coverage will not start until Feb. 1.
So what’s new this year? According to Thrive Lead Care Coordinator Greta Ingle, there are two new insurances offered this year for residents in Allen County — Oscar Health Insurance and United Healthcare. They will join the already existing Ambetter Health Insurance and Blue Cross/Blue Shield.
But, as always, buyer beware. While Oscar Health Insurance is likely to offer cheaper premiums, no health providers in Allen County quality as in-network, a significant drawback.
And as far as United Healthcare, Ingle noted that there are “limited” providers in-network in Allen County.
Unsubsidized premiums on the lowest cost plans are expected to rise in 2024, according to KFF, formerly known as the Kaiser Family Foundation.The Silver plan will increase by 5 percent, the Bronze plan by 6 percent. The increase has been attributed largely to rising prices paid to health care providers, due to inflation in the economy. Marketplace consumers may be eligible for financial help with the cost of coverage, due to the Inflation Reduction Act’s temporary enhancement of subsidies. With these subsidies, a cap is placed on how much a consumer must spend on a Silver plan premium as a share of their household income.
ALSO NEW to the Marketplace this year is an update to the automatic re-enrollment process for some consumers. To help better understand this update, it is important to know the four health plan categories that are offered in the Marketplace. They include Bronze, Silver, Gold, and Platinum plans, which offer tiered levels of insurance. Bronze plans leave individuals to cover 40% of the costs, while Platinum plans cover 90%.
This year, eligible individuals who would normally be automatically re-enrolled in a Bronze plan will now be re-enrolled into a Silver plan. No need to worry about extra costs, though. It will only apply if the Silver plan is available in the same product type, with the same provider network, and with a premium no greater than the initial Bronze plan the consumer would otherwise be enrolled in. Simply put: free upgrade. This applies for any eligible Bronze plan consumer who does not make an active plan selection prior to the Dec. 15 deadline.
ONE MORE change for young adults will take effect this year: no more loss of coverage as a (grim) birthday present. Young adults have been able to stay covered as a dependent on their parent’s policy until they are 26 on the Marketplace. In 2024, however, federal Marketplace health plans will no longer be allowed to end coverage for adult dependents mid-year, on their 26th birthday. With this change, the dependent coverage will continue through the end of the calendar year. This has already been occurring, but the measure is to codify the practice to ensure that it will continue.
This year will mark the first time that consumers can elect to answer optional demographic questions on the Marketplace application. The new demographic questions are entirely optional and consumers may choose to answer or skip them, or choose to note that they prefer not to answer. According to the Centers for Medicare & Medicaid Services, the new questions will be used to analyze health disparities in access to coverage.
ACCORDING TO the Kansas Health Institute, Marketplace enrollment reached a record high in 2023. During the open enrollment period that ended Jan. 15, 2023, there were 127,473 Kansans who selected or were automatically re-enrolled in a health insurance plan. This was a 15.5 percent increase from the prior year’s open enrollment period. All counties in Kansas had at least two insurers offering coverage through the Marketplace.
Also important to note, Marketplace coverage is not available through the Small Business Health Options Program (SHOP) exchange in Kansas. This means that businesses or entities can not provide insurance for their employees via the Marketplace in the state of Kansas.
FOR HELP enrolling in the Marketplace, contact Thrive Lead Care Coordinator Greta Ingle at (620) 365-8128.
