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State advises consumers of their rights and options in buying an individual health plan

OLYMPIA — Thousands of consumers who buy their own health insurance will soon receive letters from their insurance company telling them their old health plan is going away and that they will have to pick a new one. Knowing your rights and options will help you get the best plan to meet your needs.

All of the insurance companies selling individual health plans are replacing their current plans with plans that have these new consumer protections. They must give their policyholders a 90-day notice that outlines their options, including:

  • Buying a new plan from a different health insurer either directly or through the WAhealthplanfinder.org
  • Buying a new plan from your current health insurer either directly or through the WAhealthplanfinder.org

If you’ve received a notice from your insurer about picking a new plan and you do not take action, your insurer will automatically move you to the plan that most closely resembles what you currently have. This new plan could cost more, but it’s not your only option.

“Companies are required to give you notice if they’re replacing your plan,” said state Insurance Commissioner Mike Kreidler. “But, unfortunately, they may not include all of your options — including your right to pick a new plan from a different company or buy through the new exchange, WAhealthplanfinder.org.”

Starting Oct. 1, everyone — including people with individual health insurance plans — can shop for a new plan in Washington’s new exchange, WAhealthplanfinder.org.

Under health care reform, all health insurance plans must include new consumer protections including paying for at least 60 percent of medical costs and covering 10 essential health benefits, such as prescription drugs and maternity.

Currently, most plans in today’s individual market — where people go to buy their own health insurance — have very high deductibles and cost-sharing limits of up to $10,000 a year, do not cover many crucial benefits such as prescription drugs, and only pay for 40 percent to 50 percent of medical costs — leaving the rest to the consumer to pick up through high deductibles and large cost-sharing limits.

“For years, people who buy their own health insurance have been paying more and getting less,” Kreidler said. “Starting Oct. 1, they’ll have new and better plans to choose from, with limits on out-of-pocket costs and the possibility of tax credits to help pay their monthly premium.”

Kreidler added that in the past, people who received a rate increase and wanted to shop around were limited if they had a high-deductible plan unless they could pass a health screen again.

“Don’t just take what your insurance company says, make sure you shop around,” he said. “You have the right to buy any plan inside the new exchange or in the outside market.”

Map of plans and their cost by county.

 
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