A new insurance company will offer plans for 2024 on the Delaware Health Insurance Marketplace.
Celtic Insurance Co. Ambetter Health of Delaware will join Aetna Health, AmeriHealth Caritas and Highmark Blue Cross Blue Shield of Delaware in offering plans through the Affordable Care Act program once known as Obamacare.
Together, the insurance companies will offer 57 plans.
Most of the carriers raised their rates 2% or 3%, although AmeriHealth Caritas will decrease its plans’ rates an average of 4.52%.
The insurance office celebrated the addition of a new insurer.
In 2022, only one carrier — Highmark — offered plans and there were only 12 to choose from, pointed out Insurance Commissioner Trinidad Navarro in a press release.
“Improving healthcare accessibility and affordability across our state is one of my top priorities, and I’m proud that our work has led both options and enrollments to an all-time high,” said Insurance Commissioner Trinidad Navarro.
Nearly 35,000 residents purchased plans on the Delaware Marketplace during last year’s open enrollment. After Advance Premium Tax Credits, premiums averaged $197 a month. Nearly 6,000 residents were eligible for a premium of $10 a month or less.
Enrollment numbers are expected to rise as state Medicaid rolls are reduced after the end of the COVID-19 Public Health Emergency. A Special Enrollment Period for Marketplace plans is available for persons no longer eligible for Medicaid.
Delaware’s Medicaid expenditures are a little over $1 billion, nearly one-fifth of the state’s budget, up $94.2 this year over last.
About one-third of the state’s population was on Medicaid during the COVID-19 pandemic restrictions. The federal government gave the state money to allow people to come into the program without going through certification.
Now the federal program has ended, and the state is required to confirm people’s eligibility, but the state is only allowed to reduce remove 10% of those it’s removing per month.
That left Delaware on the hook for paying those extra costs, even though federal dollars are not coming in. It also meant that Delaware had to give the program tens of millions last year and this year that had not been budgeted to cover those costs.
Navarro said the state Office of Value-Based Health Care Delivery has made sure the offerings comply with affordability standards and that includes increasing spending on primary care to lower the overall cost of care.
Local navigators are available to assist in choosing the right plan, but Navarro urges residents to shop for the best plan for both their needs and budget.
Open enrollment takes place Nov. 1 through Jan. 15.
Navarro also warned residents to be wary of any health insurance alternative plans marketed as an alternative to traditional insurance, called an insurance alternative or being marketed as short-term limited duration health coverage, or “STLD,” a form of limited benefit nsurance.
These plans do not provide coverage for pre-existing medical conditions, his office said.
Limited benefit plans only cover a set number of doctor visits for a limited dollar amount and may have very high deductibles and copay requirements. They are not major medical, ACA-approved insurance and policies are only effective for three months and are not renewable.
Rates for regulated 2024 health, dental, and small group insurance plans also have been announced.
All ACA-compliant health plans offer essential health benefits, including coverage of pre-existing conditions, prescriptions, emergency services and hospitalization, mental and behavioral health coverage, outpatient care, telehealth, lab services, and more.
Celtic Ins. Co. Ambetter Health of Delaware’s 24 new plans range in base cost, before premium tax credits or other subsidies, from $378 to $532 per month.
Aetna Health (as a Pennsylvania corp.) will increase rates by an average of 2%, with base rate for six plans ranging from $414 to $441.
AmeriHealth Caritas will decrease rates an average of 4.52%. Base rates for their six Marketplace plans will cost $300 to $416.
Highmark requested a rate increase, and an average increase of 3.2% was approved after an initial increase request of 4.9%. Their 18 Marketplace plans have base costs between $274 and $654.
Plans on the marketplace are spread among categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company.
Other ACA rates
Off-market individual offerings include six plans from Aetna Health (as a Pennsylvania corp.), which will increase an average of 2% in cost for the future year.
AmeriHealth Caritas will decrease its plan’s rates an average of 4.52%. Highmark’s two off-market plan costs will increase an average of 3.2% after an initial request of 4.9%.
Delta Dental will increase rates by an average of 4.2% for two offered marketplace plans, and one off-market plan. Dominion Dental will decrease ACA premiums by 0.1% on their 10 plans.
Off-market small group plan options will increase for the coming plan year, with rate finalization occurring in October.
Rate submissions show 62 plan options offered by six carriers: Aetna Health, Aetna Health (as a PA Corp), Aetna Life, Highmark, Optimum Choice, and United Healthcare.
In open enrollment, residents may qualify to enroll or change plans based on special circumstances throughout the year, such as income qualification, loss of health coverage, becoming a parent or other qualifying factors. Check here to see if you qualify for any premium reductions.
Betsy Price is a Wilmington freelance writer who has 40 years of experience, including 15 at The News Journal in Delaware.
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