The Enid News and Eagle, Enid, OK

Local news

October 19, 2013

Health care coverage estimates available

ENID, Okla. — Although the insurance exchange marketplace for Oklahoma has been overwhelmed since it went online Oct. 1, it’s possible to get an estimate of what health insurance is likely to cost if bought there.

To do so, go to healthcare.gov and click on the “Want to learn more first?” option. For specific information that applies to you, it will be necessary to answer questions about whether you will be shopping for an individual or family policy, medical or dental insurance, and your location.

In Garfield County, for example, Blue Cross Blue Shield of Oklahoma, Coventry Health and Life and GlobalHealth policies are available for purchase through the marketplace.

The window for open enrollment is through March 31, and coverage effective on Jan. 1 can be purchased as late as Dec. 15.

Things to have handy when you log on to actually buy insurance will include names, date of birth, and Social Security numbers for everyone to be on the policy; projected household income for 2014; employer names and addresses; and details of current health insurance coverage.

For getting an estimate only, though, it is only necessary to know the type of coverage desired, ages of those to be covered and where they live, and household income.

Available plans are called “bronze,” “silver,” “gold” and “platinum.” The difference among them is how much the plan pays on covered services. A less-costly plan will pay less on services, but a more expensive plan can save money over a year for those whose medical expenses are high.

The Henry Kaiser Family Foundation website, kff.org, has a premium subsidy calculator available to estimate the tax subsidy, if any, available to help defray the premium of a plan purchased through the marketplace. The marketplace website for Oklahoma has a link to the subsidy calculator.

For example, monthly premiums for a 51-year-old Garfield County resident through the marketplace would range from $201 for a Blue Cross Blue Shield bronze preferred provider policy to $520 for a Coventry Health and Life gold $5 copay plan.

If the same 51-year-old Garfield County resident’s household income is $20,000 per year, he would pay $1,157 per year out of pocket for a $4,419 silver plan. The tax subsidy, which can be paid directly to the health insurer, would amount to $3,262, or 74 percent of the cost.

Things to know before deciding which policy to purchase through the marketplace include medications taken by family members; names of the family’s physicians; and the plan’s copays, deductibles and coinsurance rates, so that you can understand what your actual costs will be.

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