By Suzie Wolfer LCSW, SEP
I talked with Randy Coryell about getting the best health insurance for you and your family in 2018. Randy has been helping our clients with health insurance selection for the last few years when the Affordable Care Act made insurance available to everyone.
Randy, what 3 things do our clients need to know about getting the best insurance coverage right now?
“The news seems to be scaring people that coverage is going away and there will be huge price increases, and those getting subsidies will be losing those subsidies. But here are the facts:
- “Open Enrollment happens soon: Nov 1 to Dec 15. If you want to review or change your health insurance policy, now is the time. Do it in November when your changes will go through more quickly. If your current policy rates are going up, or your needs have changed, this is time to review your policy.
“I can help you select the policy that is best for you and help process your changes quickly. And remember that if you have a new job, have changes in your marital status, have a child, the special election period is open to you at any time. But changing you current policy has to be done this November.
- “Best Pick: Kaiser is currently the best value for the money. For example, a 40 year-old non-smoker can pay $277 to $400 depending on the options you prefer. I can help you review benefits that will fit your needs and budget.
- “Rate increases. Yes there will be rate increases but the good news is that the rate increase has stabilized this year and is much less than what we have seen in the previous two years. The overall rate increase in the Oregon Individual market is under 10% whereas we have seen previous rate increases in the 20 and 30% in the last two years. Oregon insurance rates must all be approved each year.
What warnings do you have for our clients Randy?
“If you have Providence health insurance, they are making changes that will effect your coverage, so speak with your agent to see how these might effect you. Here’s a summary:
- “Providence is doing away with the nationwide doctor coverage in certain counties so you want to make sure your doctors are still in network on your plan.
- Providence has eliminated their nationwide “Signature” network of Providers in certain counties and they use 2 smaller networks of Providers. This means that the in-network providers you have had may no longer be able to see you
- With Providence, they are eliminating out of network options. Your agent can help you determine if or how you will be effected.
What types of insurance are available to our clients here in Oregon?
“There are 4 types of health insurance available in Oregon:
- “Medicaid for low income. You qualify as a single non-smoking adult if you earn under $16,000 as or $24,000 for a family of four.
- “ACA Exchange: Depending on your income, you may get a partial subsidy of your health insurance costs. Your income will determine the amount of your subsidy. Your insurance agent can help you determine your discount and the best policy for your needs.
- “ACA Off exchange: These are basically the same insurance plans, but with no subsidy. You can purchase them directly through your agent or through the ACA website.
- “Private Insurance: offered by your school or employer
What kind of rate increases will our clients see in 2018?
- Monthly Premiums – These rates are governed by the Oregon Health Commissioner. The various health insurance plans submit proposals and this year, for example were allowed an average 9.2% rate increase. So you may see slight increases in your monthly premium.
- Cost sharing reductions through the ACA – These are your deductible and copay amounts. We are seeing some plans with lower than normal deductibles and copayments if you qualify for them. Your insurance agent can help you select the best plan and benefit package for you.
“One of the biggest benefits of the ACA is making all plans offer the 10 essential benefits, such as mental health and substance abuse care. And people with pre-existing conditions are eligible for full coverage.
“We are fortunate to live in Oregon. Our legislature created laws that enable the state government to take a variety of actions to stabilize the insurance market, if federal programs try to undermine the ACA. The new administration may eliminate maternity care from the 10 essential benefits, but the Oregon legislature passed a law keeping that care for all women.”
“If you’d like to review your policy and coverage, I am here to help you. Just give me a call or email me at:
RC Insurance LLC
520 SE 15th St
Gresham OR 97080