Obama Care Starts October 1st

Health plan rates posted 

Figures released for Del. residents 

By Beth Miller 

The News Journal 

The first real “Affordable Care” numbers – the amounts Delaware residents can expect to pay for health insurance under what has come to be known as Obamacare – were released Thursday by Delaware officials. 

The state’s menu includes 19 plans and four levels of coverage, ranging in price from $193 a month for an individual basic plan to $329 for an individual “platinum” plan. Coverage ranges from 60 to 90 percent of qualifying costs, with an assortment of deductibles, co-payments, and co-insurance features that affect out-of-pocket costs. 

See HEALTH, Page A7 

AFFORDABLE CARE ACT

Those who review the charts will be glad to know that a small army of “marketplace guides” and navigators will be available starting Oct. 1 to help them find their way through the options. 

But now the specifics – under construction for months – are emerging. 

“This is what we’ve all been waiting for – the day we can finally see what the marketplace is going to be,” said Linda Nemes, assistant director of market regulation for Delaware Insurance Commissioner Karen Weldin Stewart. Three carriers will issue the medical care plans: Highmark Blue Cross Blue Shield Delaware, Coventry Health Care of Delaware, and Coventry Health and Life Insurance. Dental plans will be offered by Delta Dental of Delaware, Dentegra Insurance and Dominion Dental Services. 

Rates for small business operations also were released. The rates were set in negotiations between state actuaries and insurance carriers, with final numbers approved by state and federal officials. 
Generally speaking, the higher the percentage of coverage, the higher the monthly premium for the policy. And generally, the lower the premium, the higher the deductibles – the amount a person must pay before insurance coverage kicks in. 

Some residents will qualify for subsidies, and some young Delawareans may be eligible for “catastrophic” plans, the least expensive protection against major problems. 

State officials say about 90,000 Delaware residents have no health insurance, and thousands more are under-insured. 

About 35,000 of them will be eligible to buy coverage in the state’s insurance marketplace, according to Secretary Rita Landgraf of the state Department of Health and Social Services. Expansion of Medicaid coverage in Delaware also will provide care for some who have not previously qualified. Almost everyone now on Medicaid will remain within its coverage, Landgraf said. 

All who now qualify for Medicare – those 65 years old and older – will continue to receive Medicare. 

“This is a piece of transforming health care, health care delivery and the cost of health care,” Landgraf said. “If all we are going to do is open the doors to give uninsured insurance, it would do nothing relative to the cost of health care. But this is the first piece. This is the vehicle for them to have access to health insurance.” 

The Affordable Care Act, signed by President Barack Obama in 2010, extends health insurance to many who could not get it before and mandates coverage for all who wish to avoid penalties ranging from $95 a year to more than $600. 

The plans provide many layers of basic care. No one will be excluded because of pre-existing conditions and coverage will no longer be limited by annual or lifetime caps. 

Open enrollment begins Oct. 1 and continues through March 2014 for coverage in 2014. Those who want coverage to begin by Jan. 1 must enroll by Dec. 15. 

“This is phase 1,” Nemes said. “Going forward, there has to be a monitoring process and ongoing management of the plans and all those activities, making sure carriers are abiding by the laws and requirements. That’s the next phase we’re entering into.” 

Contact Beth Miller at 324-2784 or bmiller@delawareonline.com. Follow on Twitter @BMiller57.