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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

Topic: Healthplanfinder

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July 17, 2014 at 7:43 PM

Lawmakers quiz health insurance exchange on glitches, budget

Lawmakers grilled officials from Washington’s Health Benefit Exchange Thursday, making it clear they’ve heard plenty from constituents who say they’ve paid their premiums but still don’t have health coverage — in most cases because premiums, which they paid to the exchange, aren’t getting to the insurer. “We’ve all heard a lot,” said Rep. Eileen…


Comments | Topics: Healthplanfinder, Office of the Insurance Commissioner, Washington Health Benefit Exchange

May 13, 2014 at 5:02 PM

More 2015 health plan choices likely for exchange shoppers

On average, the rate increase requested for 2015 individual health plans is 8.25 percent ­– the lowest in seven years, according to figures kept by the Office of the Insurance Commissioner. That “relatively low” weighted average increase in proposed premiums is just one of the developments that has pleased Insurance Commissioner Mike Kreidler, whose office will now be…


Comments | Topics: BridgeSpan Health Co., Healthplanfinder, individual health insurance

April 23, 2014 at 7:20 PM

Coordinated Care adds Seattle Children’s to network

Coordinated Care Health, whose “Ambetter” plans are sold through the Washington Healthplanfinder, has added Seattle Children’s to its network of providers. The insurer took a lot of heat last year for not including Seattle Children’s, which sued last year to force the insurance commissioner to require plans to include Children’s, arguing that it has unique services…


Comments | Topics: Coordinated Care, Healthplanfinder, network adequacy

March 24, 2014 at 9:01 PM

Uninsured Americans not rushing to buy health coverage

Data through March 23. Source: Washington Health Benefit Exchange.

Data through March 23. Source: Washington Health Benefit Exchange.

As the enrollment deadline draws near, more than 125,000 people have purchased health insurance through Washington’s insurance exchange. But there hasn’t been the surge of new signups that supporters were hoping for, and a national poll casts some doubt that a major rush is still to come.

Only 40 percent of uninsured Americans surveyed in a new poll were aware of the March 31 deadline for purchasing individual insurance this year.

When reminded of the date and requirement that they get insurance or pay a penalty, half said they are not planning to get coverage, according to a survey being released Wednesday by the Kaiser Family Foundation.

Four-in-10 uninsured Americans said they did plan to get insurance.

On Tuesday, the Obama administration announced an easy process for people to apply for extensions to the deadline if they were trying to buy insurance through federally-managed exchanges. Washington residents can also request extensions, but they have to meet more stringent requirements.

Washington’s insurance exchange, called Healthplanfinder, is nationally recognized as one of the more successful marketplaces. But a week before enrollment is set to close for the year, the exchange still had not met its January sales goal of 130,000 people.


Comments | Topics: Affordable Care Act, Apple Health, health insurance

January 14, 2014 at 6:04 PM

270,000 residents insured through state exchange

Richard Onizuka, chief executive officer for the Washington Health Benefit Exchange, which operates Washington Healthplanfinder.

Richard Onizuka, chief executive officer for the Washington Health Benefit Exchange, which operates Washington Healthplanfinder.

More than 270,000 Washington residents have secured health care coverage through the state’s new health insurance exchange, officials announced Tuesday.

From Oct. 1 to Jan. 9, some 73,098 residents bought insurance through Washington Healthplanfinder insurance exchange, according to new data. In addition, nearly 200,000 of the enrollees are new participants in the Medicaid program, which locally goes by the name Washington Apple Health. An additional 183,141 former Medicaid recipients have renewed their coverage.

Approximately three-quarters of those enrolling through the exchange qualified for a federal tax break to reduce the cost of their coverage, according to data through the end of the year. The subsidies are available to people earning up to 400 percent of the U.S. poverty line. That comes to approximately $45,000 for an individual.

Residents have until March 31 to enroll in an insurance plan that will provide coverage this year. Medicaid — a federal program providing free health care — offers enrollment year round.


Comments | Topics: Affordable Care Act, health insurance, Healthplanfinder

January 9, 2014 at 12:58 PM

What you need to know about health-care deadlines

Photo by Protocol Photography, from Flickr's The Commons.

Photo by Protocol Photography, from Flickr’s The Commons.

This season the holidays just kept on giving. Seemingly each day last month, our email in boxes at HealthCare Checkup were stuffed with yet another surprise in the form of new enrollment deadlines and changed rules for getting health insurance. While other folks were slugging down eggnog and making merry, we were trying to unwrap and assemble all the shiny new changes.

Here’s what you might have missed:

Folks with canceled plans

Remember all the people upset that they got letters informing them that their health-insurance plans were being discontinued? Just before Christmas, the Obama administration announced new rules that allow anyone whose plan was canceled to either buy so-called “catastrophic” plans or go uninsured but without having to pay the penalty that kicks in at the end of March.

The change potentially affects more than 227,000 Washington residents whose individual insurance plans were scuttled this fall because they  didn’t comply with rules in the Affordable Care Act.

The kicker is that there is only one catastrophic plan for sale through most of the state, and there are actually cheaper, non-catastrophic plans available, so there’s not a huge financial benefit to this announcement. The biggest change is the provision saying these people won’t be penalized for not having insurance in 2014. But again, these are people who already had insurance, so presumably they liked being covered.

Folks who had trouble enrolling

While the state’s health insurance exchange, Washington Healthplanfinder, had a better track record than most marketplaces around the nation, the site for purchasing subsidized coverage had serious challenges. Whether it was the mistakes in calculating how much of a subsidy someone qualified for, or the inability to get through to the toll free help line, many people were stymied in their efforts to get insurance through the exchange.

So last month the state bumped back some enrollment and payment deadlines. If you started — but even if you did not complete — the online enrollment process by Dec. 23, you could still have health insurance starting Jan. 1. To get that coverage, you do need to make your first insurance premium payment by Jan. 15, then the coverage is retroactive.


Comments | Topics: Apple Health, Healthplanfinder, Medicaid

December 23, 2013 at 2:56 PM

Healthplanfinder signup deadline is still midnight Monday

The Obama administration’s deadline extension for health-insurance signups does not apply to Washington residents seeking insurance coverage by Jan. 1 on Washington Healthplanfinder, the online exchange marketplace. The deadline for Washington residents is still 11:59 p.m. Monday, Dec. 23, Washington Health Benefit Exchange officials said Monday. Washington residents who start applications in Healthplanfinder by 11:59 p.m. Monday…


Comments | Topics: deadline, exchange, health insurance

December 11, 2013 at 3:42 PM

Step by step: what to know before you buy health insurance

Photo by Cristiano Betta, from Flickr's The Commons.

Photo by Cristiano Betta, from Flickr’s The Commons.

The clock is ticking folks — and no, we don’t mean the countdown to Christmas. Those people who are not insured or had their current health insurance canceled and don’t want to go with the default plan recommended by their insurance company have until Dec. 23 to enroll in a new plan, if they want it to start Jan. 1.

Luckily for those in Washington, the website used to enroll in government-subsidized insurance plans and Medicaid is working, at least most of the time. And the government exchange site isn’t the only option for buying insurance — there’s also an individual market outside of the exchange.

But even if the websites work, the truth is that buying health insurance can be overwhelming and confusing. So we’ve distilled the process down to five steps to help get you through it.

1. Figure out if you are eligible for a tax subsidy.

Depending on your income and household size, you could be eligible for a tax subsidy under the Affordable Care Act. To figure this out, go to Washington Healthplanfinder, the state’s insurance exchange, or use a calculator on a site like the Kaiser Family Foundation. The subsidies are available to those earning up to four times the federal poverty line. For an individual, that’s roughly $45,000 a year.

And be careful about what you’re using as your income. The subsidies are based on your Modified Adjusted Gross Income (MAGI), which includes wages, tips, taxable income, ordinary dividends, unemployment benefits, alimony, etc. minus a variety of deductions such as student loan interest, health savings account deductions, some self-employed expenses and other items. (Check out this great fact sheet from University of California Berkeley for more information on MAGI.)

If you are eligible for a subsidy, you should buy your insurance from the exchange because your premiums will be lower. Also, catastrophic plans are available only through the exchange, though they’re limited to people under age 30 and those with certain financial exemptions. And plans on the exchange are likely to be cheaper because they often include coverage for fewer doctors and hospitals.

If you’re not getting a subsidy and want more doctors included in your plan, you might as well buy it outside of the exchange where there are more options.

2. Find a good insurance broker.


Comments | Topics: Affordable Care Act, health insurance, Healthplanfinder

December 5, 2013 at 11:08 AM

One way Obamacare could nudge down medical costs

At the end of my daughter’s annual checkup this year, her doctor asked if we had any concerns. Almost as an afterthought I mentioned the little wart at the end of one of her toes (note to self: get my kid flip- flops for the gym pool and showers!).No problem, said the pediatrician. In a flash she pared away some of wart with a small scalpel and froze what remained with liquid nitrogen on a Q-Tip. It took five minutes.

Historically, I have been a lazy health-care shopper. My family has always had insurance through employers and we’re generally healthy. I never ask what something will cost (chances are the doc won’t know anyhow) and I rarely scrutinize doctor’s bills.

That’s before I got the wart invoice.

Our doctor’s office billed $269 for the procedure, which was coded as “DESTRUCTION EG, LASER SURGERY.” Our insurance carrier, Aetna, got that reduced to $204.40, and that’s what we’re going to have to pay. For wart removal.

The New York Times this week published two more articles on the cost of U.S. medical care in its “Paying Till It Hurts” series. The series compares the costs of various procedures at hospitals and clinics around the country, and between nations. It’s terrifying. A story Monday delved into stitches costing $500 a piece. An article yesterday documented ambulance rides lasting two blocks and costing $900.


Comments | Topics: Affordable Care Act, health insurance, Healthplanfinder

September 11, 2013 at 9:33 PM

Health insurance for smokers: the price for lighting up

By now, you may have noticed that individual health insurance rates are considerably more more expensive if you’re a smoker. But just how much more? The state’s Office of the Insurance Commissioner says companies are allowed to set smokers’ health- insurance rates as much as 50 percent higher, if they could justify such hefty increases. So far, the…


Comments | Topics: Healthplanfinder, smoking, Washington Office of the Insurance Commissioner