Insurance exchanges: What you need to know


Starting Oct. 1, individuals can buy health insurance plans through insurance exchanges operated statewide. The exchanges offer several levels of coverage (Catastrophic, Platinum, Gold, Silver, Bronze) and are designed to make it easy to compare plans offered by different insurers.

Platinum plans, which offer the highest care options, will also be available but prices have yet to be published.

The prices listed in the table at left are unsubsidized. Health insurance costs can be subsidized via tax credits for individuals and families earning between 100 percent and 400 percent of the federal poverty level. Those earning less than 100 percent of the federal poverty level will be eligible for expanded Medicaid coverage in both Washington and Oregon.

The 2013 federal poverty level is $11,490 for a single adult and $23,550 for a family of four, so subsidies would be available for an individual earning less than $45,960 or a family of four earning less than $94,200. The Kaiser Family Foundation has a calculator, embedded below, which can estimate the tax credits you or your family would be eligible for.

Washington’s exchange is called Washington Healthplanfinder, and Oregon’s is called Cover Oregon.

For the purpose of calculating premiums, Washington is divided into five geographic regions. Most of central and southeastern Washington, including Walla Walla, Columbia and Garfield counties, are located in Region 5. In Oregon, Umatilla County is part of the Pendleton/Hermiston region, which includes 14 other Eastern Oregon counties.

The table below specifies which providers cover each county. According to the Washington Insurance Commissioner’s office, premiums vary based on the cost of providing medical care in each region. Monthly prices are for a single, non-smoking person in each of three age categories: 21, 40 and 60. In general, a smoker in Washington can expect to pay premiums 7 to 20 percent higher than those of a non-smoker.

Smoker rates were unavailable for Oregon exchanges, but by law, premiums for smokers may not be more than 50 percent higher than non-smoker premiums.

This article was modified on Sept. 16, 2013, to clarify that listed premium prices are unsubsidized rates, and explain that subsidized coverage is available for some people earning less than 400 percent of the federal poverty level.


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