By SHANNON HAUGLAND
Sentinel Staff Writer
SEARHC health benefits team members, from left, Michaela Dunlap, Susan Briles and Hillary Russom look over papers today, the last day to sign up in the health insurance marketplace. (Sentinel Photo)
If you haven’t signed up or renewed your coverage through the health insurance marketplace for 2023, you have until midnight tonight to do so, health insurance experts say.
“Today is the final day to purchase a plan that starts January 1, through the health insurance marketplace,” said Susan Briles, SEARHC patient health benefits manager.
Those uncertain about which plan they want are advised to sign up by the deadline, so they will be covered or continue coverage Jan. 1 and beyond.
“They can enroll in a plan today, and call us tomorrow,” Briles said. “If they aren’t sure they enrolled in the right plan, call us and we’ll look at it for them.”
Sign-ups have become more complicated with the increase in plan choices from five to a total of 16. Moda Health has once again joined the marketplace, along with Premera Blue Cross, but those signing up should be aware of limitations of the Moda plans. Premera has also expanded its offerings.
“Not all providers are contracting with Moda and it’s something important for people to be aware of,” she said.
Most providers (doctors and other health professionals) accept Premera insurance, but Briles said she has learned that Providence Alaska Medical Center in Anchorage does not take Moda.
SEARHC, by far the largest health care provider in Sitka, does accept Moda, the financial services office said.
Briles said Premera offers the most popular plans, with gold, silver and bronze options. Generally the bronze plan has higher deductibles and out-of-pocket maximums, and lower premiums, as compared to the silver and gold plans.
Under the Affordable Care Act, the federal government subsidizes health insurance for those not eligible for Medicare, Medicaid or employer-sponsored health insurance. Before ACA, insurance companies could deny coverage to those with high-risk health conditions or make them pay much higher premiums.
Briles said health care insurance premiums increased by up to 47 percent this year, so most people will see higher costs for 2023.
Under ACA, subsidies are based on a number of factors, including income, family size and quality of coverage.
Another change people should be aware of is that the silver plan is more expensive than the better gold plan. Silver this year has a higher deductible, premiums and out-of-pocket maximums than does gold, unless you qualify for cost-sharing reductions. This makes the gold plan the smarter and cheaper choice in most cases, Briles said.
Options can be evaluated under the sign-up page at healthcare.gov.
“The most important things for people to look at is the premium, how much is your deductible and how much is your out-of-pocket maximum,” Briles said. “Beyond that, plans are pretty much the same as last year (for gold, silver and bronze).”
A second deadline is available on January 15, but those signing up after today won’t have coverage from Jan. 1 through February 1. Briles said it’s never a good idea to be without coverage, even for a month.
“They’ll have to be really careful for the month,” she said.
Briles’ patient health benefits department of four specialists at SEARHC has helped an estimated 240 with health insurance questions since sign-up opened November 1.
Congress enacted the Affordable Care Act in 2010, making more affordable health insurance available to more people. The program provides federal subsidies on premiums to lower overall costs regardless of income, although those with lower incomes receive a higher subsidy.
The ACA also expanded the Medicaid program in participating states to cover all adults with incomes at or below 138 percent of the federal poverty level. The Alaska federal poverty level is $16,922 for a single person and $34,692 for a family of four in 2022. That makes the qualifications for Medicaid $23,352 for a single person and $47,875 for a four-person family.
Under the American Rescue Plan Act, signed by President Biden in 2021, the federal government increased the premium subsidies as part of the pandemic relief bill. Those are guaranteed through 2025, but Briles said it’s not known what will happen after that.
Her office closes at 5 p.m. today, so after that those needing help with sign-ups before the deadline may call the federal helpline at 800-318-2596. The SEARHC health benefits number is 907-966-8684, and the office is open Monday through Friday.
