Health Insurance Marketplace in Alaska
Choosing the Right Health Insurance Plan
There are 5 categories of Marketplace insurance plans: Bronze, Silver, Gold, Platinum, and Catastrophic.
Plans range from bare bones “bronze” plans which cover 60% of pocket medical costs to “platinum” plans which have greater coverage but come with higher premiums. In general higher premiums mean lower out-of-pocket costs and a wider insurer network of doctors and hospitals.The plans are as listed below:
NOTE: All cost sharing is of out of pocket costs. Please see ObamaCare health benefits for services that are covered at no out of pocket charge on all plans. The maximum out-of-pocket costs for any Marketplace plan for 2014 are $6,350 for an individual plan and $12,700 for a family plan.
Bronze Plan: The bronze plan is the lowest cost plan available. It has the lowest premiums and in exchange has the lowest actuarial value. The actuarial value of a bronze plan is 60%. This means that 60% of medical costs are paid for by the insurance company, leaving the other 40% to be paid by you.
Silver Plan: The Silver plan is the second lowest cost plan, it has an actuarial value of 70%. This means that 70% of medical costs are paid for by the insurance company, leaving the other 30% to be paid by you. The Silver plan is the standard choice for most reasonably healthy families who historically use medical services.
Gold Plan: The Gold plan is the second most expensive plan, it has an actuarial value of 80%. This means that 80% of medical costs are paid for by the insurance company, leaving the other 20% to be paid by you.
Platinum Plan: The Platinum plan is the plan with the highest premiums offered on the insurance exchange. The Platinum plan as an actuarial value of 90%. This means that 90% of medical costs are paid for by the insurance company, leaving the other 10% to be paid by you. This plan is suggested to those with high incomes and those in poor health. Although coverage is more expensive up front the 90% coverage of costs will help those who use medical services frequently.
Catastrophic plans – which have very high deductibles and essentially provide protection from worst-case scenarios, like a serious accident or extended illness — are available to people under 30 years old and to people who have hardship exemptions from the fee that most people without health coverage must pay.
Alaska has not chosen to expand its Medicaid program at this time. Read “What if my state isn’t expanding Medicaid?” to learn more. You can find out whether you qualify for Medicaid under Alaska’s current rules 2 ways: Contact your state Medicaid agency right now or fill out an application for coverage in the Health Insurance Marketplace.
Who can help you (the Navigators)
Get local help Alaska Native Tribal Health Consortium The Alaska Native Tribal Health Consortium is a non-profit tribal health organization that will partner with each regional health corporation in Alaska that wishes to participate in outreach activities to raise public awareness of how the new insurance Marketplace impacts them and the healthcare system. United Way of Anchorage The Alaska Navigators Coalition is a group of non-profits, led by the United Way of Anchorage. They plan to do outreach to uninsured populations throughout Alaska to promote awareness of new health care options and facilitate the enrollment of individuals.
Who you can contact for more help
If you need more detailed analysis, identification of issues, solutions, and implementation of your health insurance plan please let us know with the form below and we’ll get right back to you. [contact-form-7 id=”73″ title=”Contact form 1″]
Accountable Care Organizations in Alaska
ACOs are profit-driven health innovators primarily serving Medicare patients who are financially rewarded by the government and private insurance companies for delivering medical services that lead to better health outcomes for less money.
- Peacehealth Ketchikan Medical Center AK – Health Care Innovation Award
- Anchorage Neighborhood Health Center, Inc. Anchorage, AK- Federally Qualified Health Center Advanced Primary Care Practice Demonstration
- Mat-Su Birth Center Wasilla, AK – Strong Start for Mothers and Newborns Initiative
- Geneva Woods Birth Center Anchorage, AK- Strong Start for Mothers and Newborns Initiative
- Juneau Family Health and Birth Center Juneau, AK – Strong Start for Mothers and Newborns Initiative
- Windsong Midwifery/The Birth Place LLC Wasilla, AK – – Strong Start for Mothers and Newborns Initiative
Establishing the Exchange in Alaska
On July 17, 2012, Governor Sean Parnell (R) announced that Alaska will not create a state-run health insurance exchange, and instead will allow the federal government to operate an exchange in the state.1 While a bill establishing an exchange was introduced in the 2011 legislative session and reconsidered in 2012, it failed to pass. Prior to the announcement that the state would not operate its own exchange, Governor Parnell openly opposed exchange legislation and affirmed that if Alaska proceeded with developing a state-based exchange, it would use its own money.2,3 As such, the Alaska Health and Social Services Department hired a subcontractor to conduct background research, complete an overview of state options, and conduct a financial analysis of the costs of an exchange. The final report released in June 2012 was cited by the Governor in his decision not to proceed with a state-exchange. Essential Health Benefits (EHB): The ACA requires that all non-grandfathered individual and small-group plans sold in a state, including those offered through the Exchange, cover certain defined health benefits. Since Alaska has not put forward a recommendation, the state’s benchmark EHB plan will default to the largest small-group plan in the state, Blue Cross Blue Shield of Alaska- Alaska Heritage Select Envoy PPO.
Alaska is the only state that chose not to apply for the $1 million federal Exchange Planning grant. Instead, the state allocated $200,000 of its own funds for background research and analysis.5
Expansion of Medicaid
From 2014 to 2017, the federal government will pay for 100% of the difference between a state’s current Medicaid eligibility level and the ACA minimum. Federal contributions to the expansion will drop to 95% in 2017 and remain at 90% after 2020, according to the ACA. As the ACA was originally written, states would lose all Medicaid funding if they refused to expand their program to the ACA minimum. However, the Supreme Court in June 2012 ruled that the federal government could not withhold Medicaid funding for states that chose not to expand their programs. The decision effectively allowed state officials to opt out of the expansion, and some have said they will do just that. Alaska is not participating in Medicaid expansion.
The federal government will assume full responsibility for running a health insurance exchange in Alaska beginning in 2014.
1. Press Release. Office of Governor Sean Parnell. July 17, 2012. http://www.gov.state.ak.us/parnell/press-room/full-press-release.html?pr=6195 2. Bohrer, B. “State moving ahead with health exchange plan” Associated Press. September 1, 2011.http://ap.peninsulaclarion.com/pstories/state/ak/20110901/879792853.shtml 3. Letter from Governor Parnell to Senator French. March 11, 2011:http://aksenate.org/27thpress/031411_Parnell_Letter_Exchanges.pdf 4. State of Alaska Department of Health and Social services Health Insurance Exchange Planning. Final Report. June 21, 2012. http://hss.state.ak.us/pdf/AKHealthExchangeReport2012.pdf 5. Feidt, Annie. ‘Alaska Takes Biggest Step Yet Toward Exchange.’ Kaiser Health News. February 14, 2012.http://www.kaiserhealthnews.org/Stories/2012/February/14/alaska-exchange.aspx
Also of interest
Provided by the Henry J. Kaiser Family Foundation