Health insurance exchange opens tomorrow

Written by Matt Paul, Reporter/Producer | Sep 30, 2013 3:09 AM

(Harrisburg) - Open enrollment begins tomorrow in Pennsylvania’s new federally-facilitated health insurance marketplace for the uninsured and privately insured.

But it doesn’t matter if consumers purchase insurance on October 1st or December 15th, because coverage starts in January for anyone who enrolls within that range.

So Pinnacle Health’s legal services director, John DeLorenzo, says there’s no need to panic for those who don’t pick a plan on day one.

“What I would suggest people do is gather the information, go on, follow the checklists that they have and acquire all the information that you need. Subsequent to that you can go online and start the process. I understand that you can save it, so you don’t have to do it all at once,” he says.

“If you’re finding that the website’s slow or you can’t get on, you can come back another time,” explains DeLorenzo, who says he think bugs are almost inevitable with a system of this scale.

Antoinette Kraus, director of the Pennsylvania Health Access Network, says the federal government is going to great lengths to make the various health insurance options easy to compare.

“It’ll be set up to really able to compare plans in an easy to use fashion,” she says. “As we’re talking to folks we want to encourage them to really think about their health care usage.”

The plans to be offered in the marketplace will be categorized by level, from bronze to platinum. Each level represents a different actuarial value. Those with lower values may have cheaper premiums, but Kraus says their out of pocket costs are higher.

“You know, the bronze plan is the lowest plan and that might look good because it’ll be the lowest premium amounts, but folks will have more co-pays and deductibles,” says Kraus.

Even within the four levels of coverage, which range from bronze to platinum, DeLorenzo says the plans will vary.

“The big thing I think that people need to really focus on is the network,” he notes. “What networks are out there? If you have a specific doctor that you use and you really like and you want to continue to use, make sure that doctor is in your plan.”

But details on the plans are being kept under wraps until the exchange goes live.

Figures released by the Obama administration indicate Pennsylvania’s average individual premium will be $286 per month for a mid-range plan. That ranks as the 10th lowest rate nationwide.

Tax credits will be available to households whose income falls below 400 percent of the federal poverty line, or about $44,700 for a single adult.  

Cost sharing subsidies will be available to households whose income falls below 250 percent of the poverty line, roughly $28,000 for that same individual.

Those who don’t have health insurance by the end of March may be subject to a penalty of $95 or one percent of household income, whichever is greater. The penalty for non-compliance with the individual mandate is scheduled to increase in subsequent years, under the Affordable Care Act.


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