Wil Petty Staff Writer email@example.com
December 12, 2013
Ashe County, under the Affordable Care Act, is part of a four-county region that has the highest healthcare marketplace rates in the state.
“The impact of the ACA looks different for everybody,” said Ryan Vulcan, communications specialist for Blue Cross Blue Shield of North Carolina. “Some people will pay more for coverage, some will pay less.”
Ashe is in a four-county district with Alleghany, Watauga and Wilkes counties. There are 16 health districts across the state.
For a 45-year-old person from Ashe County applying for healthcare, the cheapest option in the marketplace is the Blue Advantage Bronze 5500 plan, which has an estimated monthly premium of $310 for one enrollee. The plan includes a $5,500 per year deductible while paying a max of $5,500 out-of-pocket.
The copayments for primary and specialist doctors, generic prescriptions and emergency room visits have no charge after the deductible.
For a 27-year-old person from Ashe County applying for healthcare, the cheapest option in the marketplace is the Blue Advantage Catastrophic Plan, which has an estimated monthly premium of $177. The plan includes a $6,350 annual deductable with a max $6,350 annual out-of-pocket cost.
The estimates do not take into account if a person uses tobacco products or if the applicant qualifies for lower costs.
Prices will be lower for those with smaller incomes. For instance, a four-person family can receive lower premiums if their salary is between $23,550 and $94,200, according to Healthcare.gov.
For people in states that expanded Medicaid, there will be coverage to those who fall below a salary gap. For states that are not, such as North Carolina, if an income is below a certain level, people will not be able to apply for Medicaid.
For example, a family of four with a salary below $23,550 will be unable to qualify for additional savings programs in the marketplace, according to Healthcare.gov.
Vulcan said there are several factors that go into determining premium costs. Those include age, tobacco use and geographic location. Under the new laws, premium ratings based on gender and health status are no longer allowed.
“It is difficult to take a snapshot and point to which plans are the most expensive and the cheapest,” Vulcan said. “When you’re looking at the rating area that includes Ashe County that probably has fewer providers and less competition, different kinds of plans are available.”
Blue Cross and Blue Shield of North Carolina will file rates with the N.C. Department of Insurance annually, meaning the costs will not stay the same.
Vulcan said BCBSNC offered enough options (13 in the marketplace) to consumers given the parameters of actuarial value and the Affordable Care Act.
“We aimed to have a balanced product portfolio across the metallic spectrum, giving customers options both in terms of price point and benefits,” she said.
Bronze rates and plans for 45 year olds in N.C. health districts
Jefferson (3) : $309.91
New Bern (3) : $295.28
Fayetteville (5) : $289.22
Wilson (3) : $283.60
Wilmington (6) : $277.75
Troy (3): $274.82
Hickory (5): $272.58
Elizabeth City (3) : $271.91
Asheville (5) : $271.91
Charlotte (8) : $252.71
Winston-Salem (8) : $248.56
Oxford (5) : $237.08
Gastonia (7) : $236.15
Greensboro (5) : $230.53
Raleigh (8) : $222.13
Durham (8) : $221.63
*Source: Centers for Medicare and Medicaid Services