WASHINGTON STATE

Washington State House Democrats

HOUSE DEMOCRATS

Answers to your health care questions

October 1st marked the beginning of open enrollment and the launch of Washington Healthplanfinder – our state’s online health insurance marketplace. The overwhelming number of visitors temporarily disabled the website, but the kinks are being worked out and folks are now able to sign-up for health care from the convenience of their own computer.

Before you sit down to shop for insurance, make sure you have the correct website: www.wahealthplanfinder.org. Unfortunately, a number of copy-cat websites are cropping up.

It’d be easy to accidentally confuse the real website (above) with www.washingtonhealthplanfinder.com or www.washingtonhealthplanfinder.org. In fact, the lookalike website even reads “Welcome to the Plan Finders” and offers a subsidy calculator. Don’t be fooled though, the website isn’t run by the state and doesn’t offer the same privacy protections.

Here are this week’s frequently asked questions:

1. Will the cost of my insurance go up?

  • Like any other year, some people can expect their premiums to rise. This has been an ongoing trend for the past few years, and the Affordable Care Act is not to blame.
  • The Affordable Care Act requires all insurance to cover a minimum set of benefits, including things like mental health and preventative care.
  • It’s one thing to have health coverage. It’s another for that coverage to be meaningful.
  • Obamacare also stops insurance companies from raising premiums or denying coverage based on health status.
  • Insurance companies must cover everyone and can’t charge a sick person more than a healthy person.
  • Women can no longer be charged a higher rate than men, and older people can only be charged a fixed amount more than young people.
  • The average cost of health insurance is going down, while the rate at which costs are rising are being curbed by the law.
  • It’s also important to note that prior to Obamacare, those of us with health insurance pay about $1 billion/year in the form of higher premiums to cover the costs of the uninsured.
  • We can only expect this number to drop as more people have health insurance coverage.

2. I’ve got VA medical benefits. Does anything change under the Affordable Care Act? Is there a form to fill-out or a program to sign up for?

The short answer: No and no.

According to the U.S. Department of Veterans Affairs:

If you are enrolled in any of VA’s programs below, you have coverage under the standards of the health care law:

  • Veteran’s health care program
  • Civilian Health and Medical program (CHAMPVA)
  • Spina bifida health care program

You don’t need to do anything more. The health care law does not change your VA benefits or out-of-pocket costs. You can continue to enjoy VA health care, which means you have:

  • Medical care rated among the best in the U.S.
  • Immediate benefits of health care coverage.
  • No enrollment fee, monthly premiums, or deductibles.
  • More than 1,700 places available to get your care.
  • Met the new requirement to have health care coverage that meets the minimum standard.

3. With all the changes coming, will coverage for chiropractic care be affected?

No. However, on October 1st Regence made a few changes to how they reimburse for chiropractic care.

Regence will require providers of physical medicine services (which includes some forms of chiropractic care as well as physical therapy, massage, etc.) to obtain prior authorization. Once authorized, Regence must reimburse the provider for the service. Patients seeking chiropractic services can continue to self-refer to any chiropractor they like in the Regence provider network.

The Office of the Insurance Commissioner has weighed in on this change, concluding that Regence hasn’t violated state law:

  • Health care coverage contracts must offer coverage for chiropractic care on the same basis as any other care.
  • Health insurance carriers cannot require enrollees (persons covered by the carrier’s health plan) to obtain a prior referral before seeing a chiropractor.
  • Health insurance carriers may require prior authorization for certain procedures so long as the requirement does not result in excluding entire categories of providers unreasonably.

4. I’m over 65 and on Medicare. Am I going to lose my Medicare coverage due to the ACA/Obamacare?

No. Health reform and the Exchange do not affect your Medicare coverage. You’ll still have the same benefits and security you have now with Medicare.

  • You do not need to replace your Medicare card, either, but some people may try to convince you otherwise. Don’t listen to them. Protect your Medicare card just like you would a credit card or your Social Security card.
  • Medicare is not part of the new Exchange, so you don’t need to do anything.
  • In fact, it’s against the law for someone who knows you have Medicare to sell you an Exchange plan.
  • BUT, open enrollment in Medicare begins Oct.15 and you may have received a notice that your current Medicare Advantage (supplemental coverage) is changing. This is not related to the Exchange or ACA. Here’s more information.

Still have questions about the Affordable Care Act? The Washington Post has a very handy, readable guide.

https://www.washingtonpost.com/blogs/wonkblog/wp/2013/09/30/%3Fp%3D63297/