Enrollment for federally facilitated Health Insurance Marketplace plans began Nov. 15. Insurers operating in Indiana jumped from four last year to nine this year; the number of plans the combined insurers offer has grown from 278 to 975. However, not every plan will be available in every county.
Heathinsurance.org reported that premiums in our state will rise about 5 percent on average. Last year 132,423 Hoosiers signed up for the qualified health plans; 89 percent of those qualified for financial assistance.
The Indiana Department of Insurance has more than 1,000 certified navigators in all 92 counties to help your patients complete applications for health insurance coverage. To confirm that a navigator is properly trained, you can refer patient inquiries here. Or they can call (317) 232-2414.
Patients re-enrolling from last year will find their online application at HealthCare.gov pre-populated with information, making it easier to complete. Enrollees have already received information about the enrollment process and have until Dec. 15 to update or initiate an application. Those who do not return to update their details will be auto-enrolled in the same plan.
Two key developments
The ISMA is aware of two key developments you should note.
- MDwise - Hoosier Alliance is not participating in the Marketplace with MDwise in 2015 but will continue to participate in Hoosier Healthwise and the Healthy Indiana Plan (HIP). However, Hoosier Alliance has assigned its contracts to MDwise. Also, MDwise will assume all credentialing activities for providers who are transitioning and will work with you to ensure contracting and credentialing information is current. If you are already credentialed to participate in the Marketplace by Hoosier Alliance, that credentialing will continue and your participation will be uninterrupted. If you have questions, call (317) 822-7300 ext. 5800 or email email@example.com.
- Anthem - In the Marketplace plans, Bloomington currently has NO in-network pediatricians and only two in-network ob/gyns. However, those physician practices can provide only prenatal care. IU Health Bloomington and all IU Health facilities and practitioners are out of network. Monroe Hospital is an in-network facility, but does not provide maternity care. According to Anthem, IU Health providers were invited to participate but declined. The insurer also noted that any non-network care due to medical necessity is handled on a case-by-case basis.
For more information about Health Insurance Marketplaces, go here.