It's open enrollment season once again on Delaware's federal health care marketplace. Most premiums are increasing this year -- but officials have been encouraging residents to shop around for different plans, even if they're already enrolled.
They say Delawareans could see big savings by switching to a different plan that offers the same coverage. Delaware Public Media's Annie Ropeik found out if that's true.
The short answer is yes. Some people will save money by switching health plans. But for many others, it's not that cut and dry. In Delaware, rates are going up this year -- meaning finding discounts might require a little math.
"So we really want our consumers to make the informed choices," says state health and social services secretary Rita Landgraf. "I think in order to do that, you really do want to spend some time going through the variety of plans, as well as any differences that have occurred in your family or your income, and really do that level of analysis."
Going into this winter's open enrollment, she says people need to account for whether they've had a baby or become a senior citizen, and for any big changes in their health.
"So it's impossible for me to actually give you hard numbers about any potential savings without, indeed, knowing that individual's situation or what subsidies they might qualify for," Landgraf says.
Eight in 10 Delawareans got a tax credit off their rate this year, versus seven in 10 nationally. The average credit was $260 a month.
But Landgraf says people who want lower co-pays should focus on the silver plans. That's the middle tier, and the only one designed to reduce out-of-pocket costs.
A November report from the Kaiser Family Foundation says the lowest-cost silver plan is changing in almost three-quarters of counties across the nation next year. That means if you enrolled in the cheapest silver plan, you'd need to switch to keep saving money.
The average savings for those who do so is more than $300 nationwide -- but you won't see those savings in Delaware.
Kaiser's associate director for the study of health reform and private insurance is Cynthia Cox. She says data for Kent, Sussex and New Castle Counties shows premiums are going up by about by $50 a month for the two lowest-cost silver plans. And the cheapest plan this year will still hold that title next year -- meaning First State residents can't save money by switching silvers.
But Rita Landgraf says it's important to look beyond just premiums. You might pay more up front for a silver plan next year -- but cheaper co-pays could help make up the difference in your wallet.
"The silver plan would be attractive in that if you're using your insurance to access health services, you're gonna literally have a limited to no co-pay in that level of access," Landgraf says.
About 14,300 Delawareans had silver plans as of June. That translates to 62 percent of enrollees, slightly fewer than the national average.
Then again, Landgraf says people who are just getting check-ups should opt for even cheaper bronze plans. Those are especially good for some younger buyers, who the state is pushing hard again to enroll this year. Landgraf says more of them are coming to the marketplace as their income pushes them out of expanded Medicaid.
Jonathan Gold is the press secretary for the federal department of health and human services. He says their data shows 83 percent of Delawareans can save about $300 a month by switching within their metal level -- like silver or bronze.
No matter what, he says people should shop around during every open enrollment.
"That's what the marketplace is for, so you can really explore your options, and in a transparent way, too," says Gold.
And don't forget one last cost -- that of being uninsured. The tax penalty for not enrolling is going up next year, too: from $325 per adult or 2 percent of household income, to $695 or 2.5 percent, whichever is greater.
Open enrollment runs through January at health care dot gov -- where you'll also find an out-of-pocket cost estimator. Current enrollees who want to make a switch need to do so by mid-December to get their new plan at the start of the new year.
