Tennesseans have more health insurance marketplace options, but will consumers sign up?

Posted by Alex Tolbert on Wed, Aug 01, 2018 @ 09:08

Insurers re-entering Tennessee market

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Next year, Tennessee consumers will have more options for coverage through the Affordable Care Act (ACA) marketplaces, as carriers reverse the trend of previous years and re-enter or expand in the state’s individual market.

Right now, five different insurance carriers have filed with the state to sell individual health plans in 2019. This is the most carriers selling in Tennessee’s individual market since 2016.

However, it is possible that fewer Tennesseans will enroll in this kind of coverage. Below, we’ll look at new options for Tennesseans and some factors to consider about marketplace plans versus other options.

Which carriers are selling in Tennessee?

The five carriers planning to sell individual plans in Tennessee are BlueCross BlueShield of Tennessee, Cigna, Oscar Health, Bright Health and Celtic Insurance Company.

Oscar Health, which sold plans in Nashville in 2018, plans to expand into Memphis. Cigna, which previously offered coverage in Memphis, Nashville and the Tri-Cities area, plans to expand to Knoxville.

Celtic Insurance Company, owned by St. Louis-based Centene Corporation, hasn’t sold plans in Tennessee since 2016, but has filed to re-enter the market and offer coverage in Memphis and Chattanooga.


Last, Minnesota-based insurance company Bright Health is planning to sell in Nashville, Knoxville and Memphis. Bright Health has previously never sold individual plans in Tennessee.

Do I need a marketplace plan in 2019?

Some Tennesseans might be wondering if they even need a marketplace plan in 2019. President Trump and his administration have changed some rules that make it possible that fewer consumers will choose this type of coverage.

One major change is that beginning in 2019, there will be no tax penalty for not carrying comprehensive health coverage. The ACA required most consumers to have qualified health insurance or pay a tax, but this tax is set to be $0 next year. So, if you do not get a marketplace plan in 2019, you won’t have to pay a penalty when filing your taxes in 2020.

However, there are other reasons to sign up for marketplace coverage besides the tax penalty.

Whether you elect a marketplace plan will depend on your personal situation, especially your health status and income. Let’s look at each.

Health status

The more health care you expect to need and use, the more likely it is that you will want to sign up for an ACA plan. ACA plans are required to cover 10 essential health benefits, including preventive care, prescriptions, hospitalizations and more.

There are other coverage types available, including short-term plans and underwritten coverage, but they may not provide enough value for people who expect to need a lot of health care services throughout the year.

Short-term plans typically only cover you in the event of an emergency and don’t cover prescriptions or preventive care, which means they aren’t a good fit for people who need to regularly see a doctor or take medications.

Underwritten plans, like plans offered through Farm Bureau, cover more than short-term plans, but the carrier can deny coverage to consumers with pre-existing conditions. 
These kinds of plans can be a good option for consumers who are pretty healthy. They are also typically cheaper than ACA plans, which brings us to the next factor to consider when selecting health coverage — income.

Income

Tennesseans who make less than 400 percent of the federal poverty level are eligible for premium subsidies for marketplace plans. While marketplace plans are typically more expensive than short-term plans or underwritten options, consumers eligible for subsidies may be able to offset these costs.

On the other hand, if you are not eligible for marketplace subsidies, the full price of these plans may be prohibitively expensive. Consumers who can’t, or choose not to, pay hundreds of dollars in premiums per month may benefit from one of the cheaper, less comprehensive coverage options.

The consumers who will face the highest insurance costs are sicker, older consumers who need robust coverage but don’t qualify for marketplace subsidies.

Which carrier should I choose?

Plan information from each carrier is not yet available, but keep an eye out for another column comparing these options. For now, consumers might want to think ahead about what type of coverage might provide the most value for their particular circumstance.

This column was originally published in The Tennessean

Topics: healthcare, The Tennessean, healthcare costs, surprise medical bills

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