Health

Healthcare.gov is open for business, and individuals looking for insurance plans on their own can now buy an Affordable Care Act-compliant plan on the site. Open enrollment in Kentucky this year ends on Dec. 15, 2018 for coverage beginning Jan. 1, 2019.

Here are a few changes that Kentucky consumers should know about:

More Insurance Options

Last year in Kentucky, there was only one insurer per county: either CareSource or Anthem. This year some consumers living around Louisville, Lexington and in northeastern Kentucky can choose between the two. Anthem is offering a limited network plan to people in these areas, mainly with doctors and hospitals within the University of Louisville and University of Kentucky health systems.

Joel Thompson, an insurance broker in eastern Kentucky, said the Anthem plans tend to be a bit cheaper than CareSource because of the more limited network of providers.

“One [of my clients] is a couple in their 40s and they have a silver plan now. And the Anthem silver plan is about $200 a month less than what they have now through CareSource, which certainly has broader choice of providers,” Thompson said. “But at the same time, that’s $200 a month.”

No Penalty For Not Having Coverage

Starting with the 2019 plan year — for which you’ll file taxes in April 2020 — people who can afford insurance but do not buy it will no longer have to pay a tax penalty because of the Republican tax plan approved by Congress late last year. That could mean that fewer consumers buy health insurance on the market. But Thompson, an insurance broker,  said he isn’t too worried about a drop in customers.

“The people that that were subject to it [the tax penalty] already know the importance of health insurance,” Thompson said.

Bob Brett, vice president of Medicare and Marketplace at CareSource, said that the Congressional Budget Office projected a five percent decrease in enrollment nationwide for the 2019 insurance year. But he said 80 percent of Kentuckians are eligible for a subsidy. CareSource expects its enrollment numbers will be close to previous years.

“The vast majority of the consumers shopping are also eligible for subsidies, which bring down the prices of the premiums for these plans significantly,” Brett said.

This Year, Short-Term Health Plans Will Be An Option

Short-term health plans have been around for decades. Until recently, they were only offered for three-month periods. But a recent move by the Trump administration changed that. In Kentucky, consumers can buy the plans to last for up to three years. These plans might be attractive to people who make too much money to qualify for a federal subsidy to help buy coverage on Healthcare.gov.

Thompson, the insurance broker, cautions that short-term plans are cheaper for a reason. They don’t offer benefits for some things, including maternity care. He said insurance brokers are also paid much more to sell these plans than Healthcare.gov plans.

“Anthem pays very little commission and CareSource pays no commission on the ACA plans. That’s why a lot of agents that are maybe less than consumer-friendly are directing people toward the plans that have more holes than Swiss cheese because they’re making more money,” Thompson said.

Lisa Gillespie is WFPL's Health and Innovation Reporter.