Health

Baptist Health providers will soon accept CareSource insurance offered on Healthcare.gov. That’s because starting in 2018, CareSource will be the only health insurance choice for half of the counties in Kentucky on the individual market created through the Affordable Care Act.

“Given that CareSource is going to be the only option in many of these counties, a number of patients and physicians had reached out to us and asked if we’d consider CareSource,” said Donna Ghobadi, a vice president at Baptist Health.

CareSource currently provides health insurance to around 23,000 Kentuckians with Healthcare.gov plans. That will double next year as the company expands into many more counties following Anthem’s decision to pull out of half of Kentucky’s counties in 2018. The counties are mostly in eastern and central Kentucky and had the lowest number of people enrolled.

Anthem officials said at the time they were pulling out because the Healthcare.gov market was uncertain, citing multiple attempts this past summer by Republicans to repeal and replace the individual mandate and the subsidies that allow many people to buy insurance. Last year, Anthem offered only limited-provider networks in half the counties with their plans in an effort to reduce costs.

That move leaves CareSource as the sole health insurer for Healthcare.gov buyers in Jefferson, Oldham and Bourbon counties, along with 58 other counties. Baptist Health has many hospitals and doctor offices in CareSource’s newly covered counties.

If Baptist Health didn’t accept CareSource insurance, patients with that coverage would have had to pay out-of-network prices — meaning they would be charged higher co-pays, which are fees due at the time of a visit. Deductibles are also higher with out-of-network providers, meaning a patient would have higher out-of-pocket costs before insurance kicks in.

“Without being able to access your health care benefits and have it be out-of-pocket, I don’t think that would have been financially viable for many of our patients,” Ghobadi said.

The enrollment period to buy insurance on Healthcare.gov is open until Dec. 15. After that date, people will have to wait until this time next year to purchase a plan. Some could be eligible for an extension if they’ve moved, gotten married or had a baby.

As of Nov. 25, almost 28,000 people in Kentucky had bought a Healthcare.gov plan. Last year, a little over 80,000 people bought coverage on the site.

CareSource is also a relatively new insurance company in Kentucky. In 2015, it joined Kynect, the former state-based marketplace. Also that year CareSource started selling similar health plans in Indiana.

Lisa Gillespie is WFPL's Health and Innovation Reporter.