State officials set to roll out health plans | NevadaAppeal.com

State officials set to roll out health plans

State officials building the program designed to provide health benefits to all Nevadans say four major providers have submitted plans to the Silver State Health Exchange providing full coverage across Nevada.

Health Exchange Director Jon Hager and Insurance Commissioner Scott Kipper said they are confident the exchange will work but that they can’t yet say whether costs will be higher or lower than in plans currently offered.

“There will be health insurance offered in every corner of Nevada,” Hager said.

“They are going to be significantly different than the products available now,” Kipper said.

Under so-called Obamacare, everyone must buy health insurance by Jan. 1, 2014.

The biggest reason costs can’t be compared, they said, is that the Affordable Health Care Act mandates a list of 10 specific services that each plan must provide — several of which are not currently required by health insurance companies. In addition, Hager said, the new law doesn’t allow insurers to deny coverage or boost charges for those with pre-existing conditions.

“The entire market is changing,” he said.

Some states have indicated they see insurance costs going down. Both Hager and Kipper said that in some of those cases, the premium goes down but the co-pays and deductibles go sky-high — in some cases so high the patient wouldn’t be able to use his or her plan’s benefits.

Beginning in January, every plan will have to provide at least 10 benefits: ambulatory patient care, emergency room, hospitalization, maternity and newborn care, drug, mental health and behavioral disorder coverage, prescription drugs, rehabilitation, lab services, preventative care chronic disease management and pediatric care.

Advocates said the good news is that the rates those four providers are proposing for those inside the exchange are about the same as they will charge for clients outside the exchange.

The bad news for anyone not living in Clark County is that the plans are significantly more expensive in the north and rural areas — almost universally more than $100 a month more.

A review of proposed rates by those four insurers shows costs ranging from $120 a month for some one 20 or younger in Southern Nevada to $975 a month for a rural resident 60 or older. That is for the baseline “silver” plan.

But people making less than $45,960 a year, they pointed out, will be eligible for a subsidy that, especially for young and healthy clients, will cover the majority of that cost.

Hager said, for example, a 20-something making $15,000 a year would have all but $44 a month covered by the subsidy.

Hager said that when enrollment opens Oct. 1, the exchange’s staff will provide everyone with help navigating the system, choosing and plan that meets their needs and calculating its cost.

“We think with the assistance of the tax credit, insurance should be available to everybody,” he said.