Last chance to double-check your 2015 health insurance plan before Feb. 15

Published 12:04 pm Monday, February 2, 2015

By Bill Hinkle
Washington Health Exchange board member

So, you signed up for a new health plan on the Washington Health Plan Finder. It has the right price and the co-pay and deductible were reasonable.

But when your coverage began in January, you found that some of your prescriptions weren’t covered. Or they want you to switch to another version of your medicine. Or your doctor isn’t covered.

In its second year, our state’s healthcare exchange is working better, but some people are still having a tough time receiving the coverage and benefits they want. It can be very difficult to determine what is actually covered by the plan you choose. Sometimes the plan with the least expensive premium isn’t always the cheapest plan for you.

If this is your situation, there is still time to find a plan that is best for you with just a few simple steps.

First, it might be that you don’t find out about the limits of your coverage until later in the year. People don’t always visit the doctor in January, and many people have 90 days worth of their medicines on hand. It may appear that your plan works today. That may not be the case in April.

Fortunately, there is a great tool that can give you some general guidance on what type of health coverage is best for you. The National Health Council has examined the plans in Washington state and offers a free, online tool that can provide guidance geared toward your health needs.

Visit puttingpatientsfirst.net and enter some simple information, including your age, prescription medicines and how often you visit the doctor. It will tell you what type of plan – silver, gold, platinum – works best for the healthcare expenditures you expect. It won’t tell you the particular plan to choose, but it can help narrow down your choices to help avoid surprises later in the year.

So, what happens if you find the plan you chose for 2015 isn’t best for you? There is good news: open enrollment continues through late Sunday, Feb. 15. You can switch plans until then.

Visit the health plan finder at wahealthplanfinder.org and choose a plan that is more consistent with your healthcare needs. You may need to call the health insurance company to double-check your medicines are covered or doctor is on their plan. But, as we say in healthcare, an ounce of prevention is worth a pound of cure. Checking your plan today can help you avoid problems later in the year when switching is not an option.

Even with these options, there are still challenges for Washington’s health exchange. We need to make the system more transparent, giving patients better information about the plans they are choosing and the options. Insurance Commissioner Mike Kreidler says he is making improved transparency a priority.

As a board member of the exchange, I can tell you that I share Commissioner Kreidler’s concerns about transparency. First and foremost, however, we must bolster accountability and get our core mission right. Making sure that people looking for healthcare coverage find the Washington Healthplanfinder a resource is critical. We must ensure when customers pay their premiums, they receive healthcare services that are effective for them. We’re committed to getting this right!

With 10 different companies providing 90 different plans in Washington state, patients have more choices than ever before for coverage. Finding the right coverage, however, can still be difficult.

Through Sunday, Feb. 15, you still have the chance to make sure you have the plan that’s best for you, for your wallet and for your health.

Bill Hinkle, a resident of Cle Elum, serves as a board member for the State of Washington’s health insurance exchange.