The marketplace is open

CHARLESTON, W.Va. — The new health care marketplace is open in West Virginia. Those without health insurance began the process Tuesday of taking advantage of the provision under the federal Affordable Health Care Act.

Highmark Blue Cross Blue Shield is the only provider in the marketplace in the Mountain State and president Fred Early said Tuesday on MetroNews Talkline call volume was up.

“There will probably be some delays here and there,” Early predicted. “We do have some time built into that. It’s Oct. 1 and these policies aren’t going to go into effect until Jan. 1.”

The marketplace is mainly for those who don’t have health insurance. Blue Cross Blue Shield offers four basic plans with about a dozen options for coverage. The plans differ in the cost of monthly premiums and out-of-pocket expenses. Early said  the benefits of each plan are essentially the same.

“The highest rated plan is the Platinum Plan. It would pay 90 percent of the anticipated cost under that entire program and the individual would be left for 10 percent and it goes down 10 percent for each of the other middle levels,” Early said.

West Virginia DHHR Assistant Secretary Jeremiah Samples is the state’s point man on the Affordable Care Act. He said it’s believed as many as 107,000 state residents will receive health insurance through the marketplace by 2016. He said that won’t be everyone who needs it.

“This is not a universal, 100 percent of the uninsured will now be covered, that’s just not going to happen. There’s still going to be a large number of people out there who are uninsured,” he said.

Samples added the federal government hasn’t done an adequate of explaining the new health care options to the general public. He said the DHHR and the state Insurance Commission are working together to make ‘in-person assisters” available in the county DHHR offices to answer questions.

Samples said the marketplace isn’t one-size-fits-all.

“We recommend folks assess what’s available to them in their unique situation and from that make a personal decision on what the course is moving forward,” Samples said.

Early said the process is started by going to  healthcare.gov and from there a person chooses their state and begins reviewing the plans. There’s also information on which doctors will take which plans.

Most other states have more than one provider. Early said his company anticipated as many as six possible providers in West Virginia. He said, despite being the only provider, the company’s prices are competitive.

“When we set those prices we were anticipating that we would have a competitive market,” he said. “We set our prices accordingly.”