Rate increases between 20 percent to 28 percent are on their way to folks under the age of 65 and who are paying for an individual health insurance plan in Pacific County for 2018.
Before I begin, I am grateful we continue to have two keystones of the Affordable Care Act: No one can be denied coverage due to their health and there are no waiting periods. Until you’ve personally experienced a health crisis,it is hard to genuinely understand how powerful these two keystones are.
If you have an individual policy with Regence, you’ve already received notice they are no longer offering any plans to individuals under the age of 65 in Pacific County, and nearly all counties in Washington, for 2018. If you have Regence, you must act to replace coverage before Dec. 15 to be covered as of Jan. 1, 2018.
It’s important to know that, for 2018, only two carriers, Premera and Lifewise, are offering individual health insurance in Pacific County and:
• They cover you primarily only in Washington; and
• They do not cover Providence or Swedish even inside Washington.
Both carriers are only offered through the state’s exchange. If you want any individual health insurance, you must sign up through www.WaHealthPlanFinder.org even if you are not taking tax credits. We are hoping there will be a shortcut for those not taking tax credits — fingers crossed. We will share more at our upcoming community group meetings.
A worthy concern… What if you are traveling and need immediate medical assistance? What if you live part of the year out of state? The carriers will cover your emergency visit, but only up to the “allowed amounts.” You can then be stuck with the balance of the bill. I will share with you from my personal experience: My late husband Steve’s first balance bill last year would have been $32,000, and that was just a week at Good Sam in Corvallis. In 2018, coverage applies only in Washington with in-network providers. At present, neither Providence, Swedish or Oregon Health Sciences University are in-network, so be prepared to seek treatment elsewhere. I cannot fathom what those bills would have been without the group coverage we had. Nor do I want you to have to worry about that in 2018. But there’s no other option unless you have a business and at least one employee on payroll whose premiums you can afford to pay. If you do, call our office as soon as possible for an appointment, as there’s a tight time line for coverage to start Jan. 1.
For those who qualify to receive premium tax credits — under $65,000 for a married couple — insurance can still be “affordable.” Coverage for two 64-year-old people will top $1,600 a month for the least-expensive plan if they do not qualify for tax credits. To put it in perspective, say a couple grosses $6,000 a month combined and pays $1,500 in taxes, which leaves $4,500 and 37 percent of it goes to health insurance, plus they still have their $6,350 out-of-pocket maximum to reach.
Soooo, what do you do? Enroll in group insurance if you qualify, and if not, select between Lifewise or Premera. None of the Lifewise plans pay for prescriptions or testing before deductibles are met, plus they do not use/educate brokers. Lifewise will generally be less expensive than Premera. If you want Premera and want to use us as your broker — their silver plans pay prescriptions and testing before deductible — we can help sign you up. Call Stephanie for an appointment. If you want Lifewise, then please contact the state exchange directly to enroll.
I hope you qualify for group insurance, or that you qualify for tax credits and do not plan to leave the state in 2018.
If you are already on the exchange, in preparation, log in and update your password. Update your income for 2018 after Nov. 16. Just to be sure the exchange doesn’t change your plan/premiums for 2017. We will be conducting community meetings again this year to help answer questions on Monda,y Oct. 23, at 2 p.m. and Thursday, Oct. 26, at 4 p.m. at the Adrift Hotel meeting room in Long Beach. No reservations are required — just first-come, first-serve.
Unfortunately, it just is what it is, and we will help you as much as we possibly can. Please keep us in mind for your own and your friends’ group and Medicare supplement needs. We would greatly appreciate your support and business!
Shelly Pollock is principal broker with NW Insurance & Financial, 811 Pacific Highway, South. Suite #1, Long Beach. The Chinook Observer will offer comments about Washington state’s health insurance situation next week.