Open enrollment starts Nov. 1
Okanogan County residents who buy their own health insurance in through the state exchange will have options from three insurance companies in 2023.
People will be able to preview and compare plans on Washington Healthplanfinder starting this week. The preview period ends Oct. 29. People can choose and purchase a plan for next year starting Nov. 1, when the open-enrollment period begins.
Only policies offered through the Washington Health Benefit Exchange are eligible for subsidies. The exchange is the state marketplace for Affordable Care Act policies.
For 2003, Coordinated Care Corporation (which sells Ambetter plans) will offer eight plans. LifeWise Health Plan of Washington will offer seven plans. Community Health Plan of Washington is selling three plans in Okanogan County, according to Shawna Bruce, associate director of marketing and communications for the Washington Health Benefit Exchange.
A plan from Asuris Northwest Health, to be sold through the individual market, is still under review. If approved, the plan would be offered outside the exchange and therefore wouldn’t be eligible for subsidies.
The exchange board announced certification of 90 health insurance plans offered by 12 carriers statewide for next year in September. The board also certified 10 dental plans from five carriers. Premiums have gone up an average of nearly 9%, but some have decreased.
Higher premiums are a result of “increased utilization, including pent-up demand for elective surgeries.” Changes in the Affordable Care Act’s risk-adjustment program have also increased costs, according to the exchange.
All plans offered through Washington Healthplanfinder meet strict benefit and quality standards. Essential services, like visits to the doctor and emergency room, prescriptions, maternity care and preventive screenings, and mental health and substance-use treatment, are covered. No one will be denied coverage because they are sick or have a pre-existing condition.
The plans are rated as bronze, silver or gold. Bronze plans have the lowest premium but typically have a higher deductible and require the insured to pay more for doctor’s visits and procedures. Gold plans have the highest premium but lower deductibles and lower out-of-pocket costs.
Although premiums have increased, additional subsidies to help cover premiums have been extended for three years through the federal Inflation Reduction Act, according to the exchange. Subsidies are available to people who meet certain income thresholds.
More than 200,000 people in Washington state get their health coverage through the individual market.
Among the options for 2023 are Cascade Care plans, which were created in response to a state law that aims to make health-insurance choices and costs clearer to consumers. They are also intended to make the market more predictable for medical providers and insurers.
There are three types of Cascade Care plans. Cascade Care Standard plans are designed to have standardized benefits for each metal color — what’s covered and how much people pay for common procedures and drugs — so that consumers can compare them more easily. Consumers will find differences in the provider networks and premiums, according to Bruce.
Cascade Select plans, part of the state’s public option, cap reimbursement rates to keep premiums lower, Bruce said. Because providers had to agree to accept lower reimbursement, the networks tend to be smaller, so consumers need to confirm that their physicians are in the plan’s network.
Cascade Care Savings plans are new this year. These plans (offered at the silver and gold level) are eligible for a state subsidy, on top of the federal subsidy, for people earning up to 250% of the federal poverty level, Bruce said.
Open enrollment runs through Jan. 15, 2023, but to have insurance coverage starting Jan. 1, people must enroll by Dec. 15. Plans purchased between Dec. 15 and Jan. 15 won’t start until February.
People who qualify for Apple Health (Washington’s Medicare program) or who experience certain life changes, such as a change in income or having a baby, can sign up at other times of year.
People can get help choosing a plan and applying for coverage through free navigators and brokers. There is more information through the exchange at www.wahbexchange.org or 1-855-923-4633. Room One also has certified navigators.