This is Nefouse & Associate’s sixth open enrollment since the affordable care act has gone into effect. We are one of the last Indiana based agencies to still be active in the individual market. There has been a lot of changes, but one thing has stayed the same, costs continue to rise.

We have just two carriers offering coverage in the individual market, Ambetter & CareSource. Both companies will be offering personal coverage through the marketplace in every Indiana county. Insurance companies are required to file their rates and plan for approval with the Indiana Department of Insurance.

  • CareSource average approved rate increase is 4.90%, with an average premium of $532.95.
  • Ambetter average approved rate increase is 18.9% with an average premium of $567

Each plan design and county will have a different increase and some decrease.

  • CareSource will have a -13.8% decrease and as high as 26.9%.
  • Ambetter will have as low as 5.4% increase and as high as 30.60%.

Plan options are continuing to have a large deductible and out of pockets maxes.

Lowest Costing Plans Deductibles:
CareSource $7,700 deductible.
Ambetter $8,150 deductible.

2020 Health Saving Accounts:

CareSource: $5,300 deductible with 50% co-insurance
Ambetter: $6,750 deductible with 100% coinsurance
The Caresource H.S.A is about costs about 10% below Ambetter.

Network Access:
CareSource: Health Maintenance Organization (HMO)
Ambetter: Exclusive Provider Organization (EPO)

CareSource has increased its participating medical providers in central Indiana.
Ambetter appears to have greater network access with EPO vs. the HMO.
It is essential to research your physicians to see if they are participating in these networks. The networks can change, and physicians may not be accepting new patients.

Drug Formulary:
Both offer similar drug formularies, but cost-sharing does vary from plan. Most tier 3 brand name drugs will apply towards the deductible.

The 2020 Individual open enrollment is through November 1st -December 15th.

Use our Quote Engine to review and enroll in health insurance for 2020: https://www.healthsherpa.com/?_agent_id=tony-nefouse.