CHICAGO (AP) — Many Illinois consumers will pay higher prices for health insurance entering the third year of President Barack Obama's health care law, industry experts said after the government published the 2016 prices Monday.
The federal government said the cost of a benchmark plan in Illinois on HealthCare.gov will increase 6.1 percent for 2016 coverage, but most people will be able to buy a plan for less than $100 a month after tax credits.
Many health plans are changing: The state's dominant insurer, Blue Cross Blue Shield of Illinois, killed off a popular plan offered last year that covered every hospital in the state. Offering fewer hospital choices is one way insurers can keep their costs down.
"No one should assume their doctor is covered by a particular health plan," said Shelley Schiff, an insurance broker in Northbrook, who is getting calls from concerned clients. "I'm advising them not to rush."
About 297,000 Illinois residents now get coverage through HealthCare.gov. Consumers can start choosing plans on Sunday through the online marketplace. They have until Dec. 15 to buy coverage if they want it to start Jan. 1.
Choice in plans varies by region in Illinois. Residents of all counties have at least 37 plans to choose from.
The Illinois Department of Insurance said Monday the statewide average rate increase for the lowest cost silver plan is 5.3 percent and for the lowest cost bronze plan is 11.3 percent.
Plans get a metal rating based on what they cover: Bronze plans cover about 60 percent of health care costs; silver plans cover about 70 percent.
Tax credits lower the monthly cost for many consumers. Consumers who choose the benchmark plan — the second lowest silver plan offered in their area — will see an increase in their tax credits that roughly matches their premium increases.
A quick look at the prices before tax credits shows:
—The price of a benchmark silver plan for a family — two 40-year-old parents and two children — is $591 per month in Cook County, $886 per month in Sangamon County and $824 per month in St. Clair County.
—For a 30-year-old nonsmoker, a benchmark silver plan is priced at $175 per month in Cook County, $263 per month in Sangamon County and $244 per month in St. Clair County.
—For a couple aged 55, a benchmark silver plan is $689 per month in Cook County, $1,033 per month in Sangamon County and $960 per month in St. Clair County.
Dave Axene of the Society of Actuaries said some insurers underpriced their plans the last two years and now are raising prices.
"How the public responds to this is really important," Axene said. "If there is any significant shifting around of healthy vs. sick people, that's going to mean more turmoil next year" in prices.
Look beyond premium prices to the expected out-of-pocket costs, Axene advised. In general, the lower the monthly payment, the more consumers will pay each time they get care. Consumers should make sure their favorite doctors and needed medications are covered by their health plans, Axene said.
For many, the financial help they receive from the government will also increase, said Marc Pierce of Stonegate Advisors, a Chicago-based health care consulting company. However, wealthier consumers without employer-based coverage won't get that break.
"Understand what your subsidy is and your buying power and look for the best plan for you," Pierce said.
AP Medical Writer Carla K. Johnson can be reached at https://twitter.com/CarlaKJohnson