By Sharon Salyer
Adults and families who don’t have health insurance and want to buy it will be able to shop for it and compare prices online through the state’s new health exchange starting on Oct. 1.
With many consumers confused about what’s being offered or what type of insurance best fits their needs, the state opened a toll-free hotline Sept. 3 to help answer their questions.
In Snohomish County, an estimated 113,000 children and adults don’t have health insurance, according to the state Insurance Commissioner’s office. That’s about 15 percent of the county’s population.
Consumers who don’t have insurance can begin signing up on Oct. 1 for coverage that begins on Jan. 1. Washington’s new health insurance marketplace, called an exchange, is part of the changes included in the federal Affordable Care Act.
“It will allow you to make an honest comparison between the plans, which we’ve never had before,” said Stephanie Marquis, a spokeswoman for the state Insurance Commissioner’s office.
The state’s call center, with a staff of 80 people, will be open 7:30 a.m. to 8 p.m. Monday through Friday.
Consumers can learn about their insurance options and if they qualify for tax credits to help pay for health insurance, said Michael Marchand, communication director for the Washington Health Benefit Exchange, where consumers can compare health insurance plans.
The online shopping center, called Health Plan Finder, “will be a new way for people to find health plans that meet their needs and budget and provide side-by-side comparisons,” Marchand said.
A family of two adults and two children can have a household income of up to $94,200 and still qualify for tax credits. “There will be a lot of people in this state who will qualify for assistance,” Marchand said.
Consumers will be able to choose from plans in three pricing groups: bronze, silver and gold.
“Cost, coverage and convenience really are what people are making their decisions on,” he said.
This includes questions on the annual costs for each plan and whether a plan will cover the costs of medications and managing chronic diseases such as diabetes and asthma. Consumers also want to know if they can keep their current doctor and how far they have to drive for medical facilities, such as hospitals or specialists, he said.
Insurance plans cover more of the costs of being treated at hospitals or by specialists that contract with the insurance plan or “in network.”
Consumers also will have choices on deductibles, the amount of money paid out of pocket before insurance begins covering medical costs, and co-pays, such as the amount paid out-of-pocket for each medical visit.
The issues to balance: As more of these costs are covered by insurance, the costs of premiums rise. Anyone who doesn’t have insurance next year will pay a fine of $95 per adult and $47.50 per child up to a maximum of $285 for a family. The goal is to encourage people who don’t have insurance to buy it.
In addition to the phone center, consumers will be able to get one-on-one help later in the fall. In Snohomish County, 10 organizations will be helping in this effort, including the hospitals in Arlington, Edmonds, Everett and Monroe, Housing Hope, the Community Health Center of Snohomish County and Sea Mar.
Sharon Salyer: 425-339-3486; firstname.lastname@example.org.
A toll-free hotline for information on buying individual health insurance plans opened Sept. 3. The number is 855-923-4633. More information on how to sign up for health insurance is available at the Washington Health Benefit Exchange, wahealthplanfinder.org, and at the state Insurance Commissioner’s Office at tinyurl.com/qzbpp4r.