by Andy Marso, KHI News Service
Kansans will get to choose between two insurance companies when open enrollment begins Nov. 1 for 2017 coverage through the Affordable Care Act’s online marketplace.
But for Kansans outside the Kansas City metropolitan area, one company will offer only HMO plans that restrict coverage to in-network providers.
The Kansas Insurance Department published an overview of the marketplace choices this week.
A new insurer, Minnesota-based Medica, has entered the Kansas market and will sell seven traditional health insurance plans — with varying premiums and levels of coverage — in all counties.
Another Minnesota-based company, UnitedHealthcare, pulled out of the market after one year.
Blue Cross and Blue Shield of Kansas City remains in the market and will sell 11 plans in Johnson County and Wyandotte County. It will offer traditional coverage as well as “exclusive provider organization,” or EPO, plans that are like HMO plans in that they can restrict coverage to in-network care and require a “gatekeeper” to approve coverage prior to care.
The Legislature and Gov. Sam Brownback approved the sale of EPO plans this year.
Blue Cross and Blue Shield Kansas Solutions will remain in the ACA marketplace and sell plans in the state’s other 103 counties, but all five of its offerings will be HMO plans.
Kansans who purchase plans through the online ACA marketplace, healthcare.gov, may be eligible for federal subsidies to decrease premiums based on their incomes.
Most Kansans get health insurance through their employer, a family member or government programs like Medicare and Medicaid.
According to the insurance department, only 6 percent of the state’s residents were covered in 2016 by individual health insurance plans like the ones offered on the marketplace.
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