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What to expect if you’re shopping for health insurance–on and off–the marketplace

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MANCHESTER TWP., Pa. - Much has been made about the open enrollment period for health insurance on the online marketplace, including the increase in premiums, the potential for reduced benefits, and the fewer options available on the insurance exchange.

For most shoppers in York County, that last part, the fewer options, might be the issue that isn't getting enough attention for Tiffany Blackstone, a mother of two who is currently shopping for insurance.

"Right now, we have four options, and you can go to McDonald's and order off the dollar menu and have more options there," she said.

Aetna stopped offering plans on the marketplace statewide. Highmark also stopped offering plans on the marketplace in York and Adams counties, citing rising costs. UnitedHealthcare stopped selling individual health insurance plans to Pennsylvania consumers. What's left are four total plans available on the marketplace for most York County shoppers from Capital Blue Cross and Geisinger.

In York County, the only way to find a bronze level plan is off the exchange. Only gold and silver plans are on the exchange. Platinum level plans are not offered in York County.

Blackstone says she has purchased individual insurance annually after the passage of the Affordable Care Act, but not necessarily through the online marketplace.

"Every year that the Affordable Care Act has been in play, my insurance plan has been canceled," she said. "There are even years that I have appreciated my plan, but despite my best efforts, I can't keep it for the next year."

According to the Pennsylvania Insurance Department, the average premium has gone up 33 percent.

Blackstone's shopping around this year revealed that she is facing a $700 a month increase for a similar plan that she had this year for her family.

"It's hard to choose one that's actually working out for my budget based on the cost that's there," she said.

The premium increases have prompted state insurance officials to do something unprecedented: encourage shoppers to search for plans directly from insurance providers in addition to the online marketplace. Although those off-exchange plans do not qualify for tax subsidies, they can be more affordable for those who make more money than the threshold to qualify for a subsidy.

However, some say the amount in tax credits has also gone up, and "80 percent of consumers who shop on the marketplace are eligible for premium tax credits, so it's important that consumers go out, log in, choose plans and do some shopping and comparing," Tia Whitaker, the statewide director of outreach and enrollment for the Pennsylvania Association of Community Health Centers, said. "That's the most important part."

For those who need help trying to find the best coverage for them, there are navigators statewide who can help consumers free of charge. More information on those can be found here.

The government has made strides to improve the online marketplace in recent years, Whitaker said.

"It is very simple," she said. "To get on the marketplace, create an account, go through your initial information, choose a plan and pay your first premium can be done in about 20 minutes."

Click here and scroll to the bottom of the page for a list of insurance plans available in Pennsylvania by county.

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