Okanogan County residents who buy their own health insurance through the state exchange have five choices for coverage next year, all from LifeWise Health Plan of Washington. Individuals under age 30 have one more choice — a plan that covers catastrophic needs.
LifeWise is offering two bronze plans (one with a health-savings account), two silver (low- and high-deductible), one gold, and the catastrophic plan.
Deductibles range from $8,150 for the catastrophic plan to $4,000 for the high-deductible silver plan to $1,000 for the gold plan. A 20-year-old would pay $261 for a bronze plan but $362 for a gold plan. Premiums go up with age.
Some plans have a copayment of $30 for a doctor’s visit, while others pay a percentage of the doctor’s fee. The high-deductible silver plan offers generic drugs for $10, but the low-deductible version charges $20.
All plans must provide 10 essential benefits, including preventive screenings, mental health care and maternity care. People who earn between 138% and 400% of the federal poverty level qualify for subsidies through the Washington Health Benefit Exchange.
The open-enrollment period closes Sunday, Dec. 15.
Browse plans and sign up online at www.wahealthplanfinder.org. For assistance, call 1-855-923-4633. Trained navigators are available at Room One at 997-2050.
A new state law aims to make health-insurance options and costs clearer to consumers — and to make the market more predictable for medical providers and insurers. The new Cascade Care plans will be available in 2021.
Under Cascade Care, state agencies are designing health insurance plans that will standardize benefits — what’s covered, which providers are in a network, and what common procedures and drugs will cost, Michael Marchand, chief marketing officer with the Washington Health Benefit Exchange, said.
“Standard” plans will have set benefits so that consumers can compare costs and make sure their doctor is in a network without worrying about specific benefits, Marchand said.
Any insurance company that wants to offer a “non-standard” plan — basically the model they offer today — will also be required to offer a standard plan, which will have better overall value, Marchand said. All plans will be available through the state exchange, and all are eligible for subsidies.
Cascade Care has been called a “public option.” That refers to the fact that reimbursement rates to providers will be capped, Marchand said.
The law also requires state agencies to study the economics of providing subsidies to people who earn up to 500% of the poverty level. Their findings are due to the Legislature in November 2020.
State agencies are drafting Cascade Care plans and benefits for 2020 now. The public can submit comments until Monday (Nov. 18). For more information or to comment, visit www.wahbexchange.org and search for “Cascade Care implementation.”