A publication of the Kentucky Center for Public Service Journalism

Open enrollment available at Healthcare.gov through Dec. 15; subsidies keep most rates similar to 2017

By Melissa Patrick
Kentucky Health News

It’s again time to sign up for federally subsidized health insurance through Healthcare.gov. Open enrollment for coverage in 2019 runs through Dec. 15.

It’s worth taking a look, because most shoppers in the marketplace will qualify for financial help to lower their costs. About 80 percent of Kentuckians enrolled through the federal exchange qualified for tax credits or subsidies that reduced their premiums, according to a Cabinet for Health and Family Services news release.

“For most of those who qualify, the credits will offset any premium increases, so the cost of insurance in 2019 will be about the same as this year,” says the release.

In Kentucky, Anthem Health Plans of Kentucky and CareSource will offer federally subsidized plans on Healthcare.gov, with rate increases of 4.3 percent and 19.4 percent, respectively. Anthem has returned to 34 counties it formerly served, to cover a total of 93. CareSource is covering 61 of the state’s 120 counties.

While 34 counties will now have a choice between Anthem and CareSource, the only Anthem plan in 16 of those counties will be the Anthem Pathway Transition HMO, which has a very narrow provider network. The state insurance commissioner has cautioned people in these counties to look closely at provider networks.

Anyone who already has a plan on Healthcare.gov and doesn’t choose a new one will be automatically re-enrolled, but there is widespread agreement among experts that it’s best to take a look at your options each year to make sure you have the one best suited to your needs.

Margot Sanger-Katz, who writes extensively about health care for The New York Times, offered the following tips on Twitter. She is also part of a Kaiser Health News “What the Health?” podcast discussion on this topic.

• Don’t procrastinate; you’ve only got six weeks to get this done.

• Look at your options as soon as possible, even if you love your current plan.

• If you don’t qualify for Medicaid, but earn less than double the poverty level, about $24,000 for a single person, look at the silver plans. “The cheapest one that covers the doctors you care about is almost always your best option,” she writes.

• If you qualify for a subsidy, about $48,000 for a single person, look at all the plans.

• Check the deductibles! Even if you get a great premium, make sure you can afford the deductible.

• If you make too much to get a subsidy, first look on Healthcare.gov, then at plans sold directly by insurance companies — a broker can help.

• Short-term plans are cheaper, but have fewer benefits. “If a short-term plan is all you can afford, you should shop really carefully. Read the fine print. And consider discussing it with someone who has expertise,” she writes. Click here for her story on short-term plans.

• Beware of fraudulent plans.

It’s also important to take note that Healthcare.gov has scheduled possible maintenance for the program each Sunday morning during the sign-up period, except for the final Sunday, for a total of 60 hours potential of downtime.

Where can I find help?

The state-based call center is available at 855-459-6328 to help assist Kentuckians with where to go for coverage, answer questions and pre-screen for eligibility. The Healthcare.gov customer service center (800-318-2596) is also available 24 hours a day, seven days a week.

Click here to find an application assister or an insurance agent near you.

Healthcare.gov provides a shopping tool to allow you to preview 2019 plans and estimated prices before you log in.

The Kaiser Family Foundation also offers a Health Insurance Marketplace Calculator to provide estimates of health insurance premiums and subsidies for people purchasing insurance on their own on Healthcare.gov. It allows you to enter your income, age and family size to estimate your eligibility for subsidies and how much you should spend on health insurance. It will also allow you to see if you qualify for Medicaid.

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