A nonprofit publication of the Kentucky Center for Public Service Journalism

Individuals who qualify for health plan tax subsidies will sign up on federal exchange starting Nov. 1


By Melissa Patrick
Kentucky Health News

Kentuckians who qualify for health plans subsidized by tax credits, called Qualified Health Plans, will sign up on HealthCare.gov instead of Kynect during the open enrollment that begins Nov. 1.

Some Kynect advocates have voiced concern that the changeover will be troublesome, but Cabinet for Health and Family Services spokesman Doug Hogan said in an e-mail, “We expect a smooth transition to HealthCare.gov. People should be aware that Kynect is not health insurance, it is a website. This transition changes the web portal people use to enroll.”

Hogan said the state has sent letters about the transition to Kentuckians who have previously applied or been enrolled in health coverage through Kynect, to guide them through the process. He said the state will continue to send informational postcards throughout open enrollment, which ends Jan. 31.

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“Only about 2 percent of Kentucky’s population purchases a QHP in a given year, so targeting resources to this group and doing it in the final month leading up to open enrollment and continuing through open enrollment is the most effective use of resources,” Hogan said.

Hogan said that starting Nov. 1, Kynect’s website will offer detailed messages about the transition and directions on when and were to apply for coverage. The HealthCare.gov website also has messages for Kentucky residents.

Where to get answers to your questions

The Kynect call center (855-459-6328) will remain available to help tell Kentuckians where to go for coverage, answer questions, pre-screen for program eligibility, and assist with Medicaid applications. The HealthCare.gov customer service call center (800-318-2596) is also available to help and is open 24 hours a day, seven days a week.

Hogan said insurers are also sending notices to their enrollees about the changes; insurance agents and application assisters have advertising tool kits for their outreach efforts; and agents and assisters have been given lists of their QHP enrollees. Also, social media campaigns, media advertising and other measures have different start times around the state in strategically placed target areas with the highest uninsured rates and QHP eligible populations, he said.

If you qualify for a QHP in 2017, which is a plan that offers a tax credit to help cover out-of-pocket costs, you must sign up for your health insurance through HealthCare.gov this year instead of Kynect, as you have in the past.

“Kentuckians can only get the tax credit, called APTC or Advanced Premium Tax Credit or a Cost Sharing Reduction that helps cover out-of-pocket costs, by enrolling through HealthCare.gov,” Hogan said.

Open enrollment for these plans is Nov. 1 through Jan. 31, but to get coverage on Jan. 1, you must enroll by Dec. 15.

Why aren’t there as many choices as last year?

In 59 of the state’s 120 counties, residents will have only one health insurance option on the exchange. Anthem Health Plans of Kentucky is the only company offering coverage on the exchange in every county for 2017. CareSource will offer plans in 61 counties, up from 46 in 2016 and Humana Health Plan will offer exchange plans in nine counties, down from 15 in 2016.

Baptist Health Plan, United HealthCare, WellCare and Aetna, which offered plans on the exchange in 2016, will not in 2017. Most have cited unsustainable losses.

“People should know that this transition to HealthCare.gov did not affect plan choice,” Hogan said. “All insurers made the same offerings regardless of the enrollment website we selected which is the same as in prior years.”

Hogan added, “Cost increases were not driven by the transition to HealthCare.gov.” He said premiums on exchange policies are increasing by more than 20 percent.

People whose current insurers are not offering a plan in 2017 on HealthCare.gov will be given more time to choose a plan for 2017 due to a “special enrollment period for loss of minimum essential coverage,” Hogan said.

Do we still have Kynectors?

The state has extended contracts with the same organizations that provided Kynectors, which are now called “application assisters,” Hogan said. Application assisters work with Kentuckians either in person or over the phone to answer questions or get assistance with the application and enrollment process.

“We are confident our assister agencies will have the ability to provide the same exceptional service,” Hogan said. “Every county in Kentucky is served by a contracted organization for in person assistance. Kynectors have a very active outreach program that includes sign up events, advertising, and education opportunities. They will continue to be very active in the communities they serve.”

You can find an Application assister in your area by using the “search” function on the Kynect website or by calling Kynect’s customer service.

Many Kynectors are still in the process of being trained to help clients on the federal marketplace, so Hogan said there isn’t a firm number of participating application assisters for 2017.

What about Medicaid?

The Medicaid program for low-income and disabled people, and its application process, will stay the same. It was moved from Kynect earlier this year.

Medicaid-eligible Kentuckians can apply anytime during the year through Benefind, a one-stop-shop website for public benefits. But if you are already enrolled, you don’t need to do anything until your renewal or recertification date.

“If a citizen believes they may be eligible for Medicaid (any type), we would recommend that they apply through Benefind,” Hogan said. “This would be the quickest route to receive Medicaid eligibility.”

Benefind also has an anonymous pre-screening tool to assist in determining if you are eligible for Medicaid or a QHP.

Consumers may ask, “What happens if I apply for the wrong type of coverage?” Hogan answered, “Consumers cannot apply in the wrong way or place.” He said if an application is started in Benefind, but the applicant is over the income limit, the application will be transferred to the federal marketplace and Benefind will send a notification letter to the participant indicating Medicaid eligibility was denied and that the client information was sent to HealthCare.gov.

If a consumer submits an application to HealthCare.gov, it will be entered, but if the applicant is deemed Medicaid-eligible, the application will be transferred to the state for final eligibility determination. If the participant is determined eligible, Benefind will notify the participant.

If more information is needed, Benefind will ask the participant for it, indicating the next steps to take.


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