Welcome to the new world of health insurance plans under the Affordable Care Act.
Some people have experienced premium joy. This has come from the Federally Facilitated Health Insurance Marketplace in Indianapolis. Hoosiers have been eligible for subsidized premiums in the marketplace. The average subsidy we are seeing is about $2,800 a year. On the high end, we have help many Hoosier in their early 60’s pick up subsidies for over $11,000 a year. The biggest subsidy I have seen so far is $15,900. This has created a lot of premium joy for Indianapolis residents. They have had to make some difficult decisions on doctors though; the networks on the exchange plans are 40% smaller than what they use to be. In some areas there is no access to primary care doctors. There has been a lot of frustration getting these policies but now the process is getting a lot better.
Guaranteed Issue in the individual market has helped a lot people. When we look at policies off of the exchange, there is no more underwriting. This has increased premiums! If you don’t qualify for a subsidized plan you may have premium shock. Many young families in the area have been content with a $700 per month premium. That is no longer the case; these young families now are looking at $1,200 a month for a similar policy. On the plus side, the new policies have more coverage and cover maternity.
One of the key benefits to these new off-the-exchange policies is the traditional PPO network. Not all of the off the exchange policies have it but a few still do. So if you do not want to have to decide between doctors at medical facilities and would rather have the ability to go to almost any doctor, you still have this option. The interesting thing is these traditional PPO plans cost about the same as narrow network plans.
Remember: there is an open enrollment season right now that ends on March 31 for both on and off the exchange plans. Get signed up now!