Last month, Health Options began filing 2023 individual and small group plan rates. As part of this process, carriers are required to send individual subscribers a letter detailing upcoming rate changes.
Our letter will hit mailboxes this week and based on information from our initial filing, the letter references a rate increase that ranges from 6.4% to 16% depending on the Members’ given plan of coverage. Another round of pricing has been submitted with the goal of reducing the average rate increase. These new plans will be available for purchase beginning November 1, the first day of Open Enrollment. For 2023, nearly all plans include our popular Chronic Illness Support Program (CISP), expanded telehealth services, vision exams for adults and pediatrics, a $5 co-pay on 30-day Tier 1 preferred generic medications on non-HSA plans, and more HMO tiered plans with an expanded tiered network for those looking to save using preferred providers. We are also excited to announce our new Healthy Maine plans that offer a wellness program, unlimited personal health coaching at $0 cost and no deductible, and acupuncture benefits with no deductible. Finally, HSA Plus plans will be available that include an enhanced preventive drug list with no deductible requirement.
The Bureau of Insurance will hold a public forum regarding 2023 individual health plan rates on July 26, 2021, at 10:00 a.m. Read more and register at the State of Maine website. For more information about proposed rates, you may also contact Member Services, Monday through Friday, 8 a.m. to 6 p.m., at (855) 624-6463.
Health insurance metals help people understand the amount of cost-sharing that goes on between the plan holder and the insurance company in any given plan. (Need a refresher on how these costs work? Check out our health insurance lingo blog post here!)
Remember that the exact amount of cost-sharing can vary from plan to plan. And at each metal level, you’ll pay a different percentage of total yearly costs of your care, while your insurance company will pays the rest. Total costs include premiums, deductibles, and out-of-pocket costs like co-payments and co-insurance.
As a rule, the less the insurance company pays in cost-sharing, the lower the cost of the plan. So, Bronze plans typically have the lowest monthly premium costs and highest costs when you need care. Monthly premium costs generally increase according to metal levels. Silver, Gold, and Platinum cost more each month in premium payments but will have lowers costs when you need care. While your monthly premium price is often the top consideration when purchasing health insurance, it’s important to consider the deductible and cost-sharing as well, since these two factors can impact the total amount of out-of-pocket healthcare costs you might incur in a plan year. The total cost of care is what really matters.
When choosing a plan, you’ll want to think about how much you (and your dependents) are likely to use your insurance coverage. Consider things like how often you see a doctor, what medications you take, and whether you foresee scheduling any elective surgery during the year to come. If you think you’ll use your healthcare plan frequently or have prescription medications you take regularly, you might want to consider a higher metal level that offers lower deductibles and makes your costs easier to predict (like a Gold or Platinum plan). If you don’t expect needing many healthcare services, a lower-premium/higher cost-share plan might be a better fit.
One thing that’s important to know is that ALL Health Options’ plans in ALL metal categories offer $0 cost-share preventive care, including yearly wellness checks. Many plans also offer an array of low-to-no-cost benefits that help offset many healthcare expenses (like wellness visits, prescription benefits, and vaccines), even for people with chronic conditions. All non-HSA plans offer Amwell® urgent care telehealth visits with $0 cost-sharing. So, whether you choose Bronze, Silver, Gold or Platinum, you can find a plan that meets your budget and your needs while giving you peace of mind and helping to keep you and your family healthy.
