Insurer’s demise forces Ohioans to find new coverage

Published 12:00 am Sunday, July 31, 2016

COLUMBUS (AP) — Thousands of Ohioans have been pushed to find new health insurance this summer as their financially troubled carrier winds down operations, an inconvenience that could come with a higher price tag.

Becky Mohler said she went to get a prescription filled only to be told by the pharmacist that her insurer was being liquidated, and she would have to pay the full cost of her medicine. She later got a letter from the suburban Columbus-based Coordinated Health Mutual Inc. about its financial troubles.

“I had no idea that something like this could happen,” said Mohler, 60, of Logan.

Email newsletter signup

Ohio regulators took over the company in late May after a judge granted the state’s request to do so. A financial review showed the company’s losses would prevent it from paying future claims. The insurance co-op sold policies under its InHealth Mutual brand.

Such insurance co-ops were created under President Barack Obama’s health care law to provide a nonprofit alternative to commercial insurers. But they struggled to build their businesses and more than a dozen have collapsed.

InHealth Mutual provided health insurance to nearly 22,000 Ohioans, who may now end up paying more for their coverage.

Most InHealth customers have switched insurers, according to state and federal regulators. But with their new plans, they likely will have to satisfy new deductibles and out-of-pocket maximums — even if they met their previous ones.

That’s what Mohler discovered when she changed her coverage in June.

She had heart bypass surgery earlier this year and had already met InHealth’s individual deductible of roughly $6,250 and her out-of-pocket maximum. Now she has to meet a new $6,500 deductible and pay a premium that’s roughly $40 more per month.

“It doesn’t seem fair in the middle of the year that I have to do that,” she said in a recent interview.

The move to a new plan also meant she had to forgo the remainder of her cardiac rehab sessions, which were fully paid by InHealth but too steep to afford with her new coverage.

“That was kind of crappy,” Mohler said. “It would have been probably over $1,000 to finish their program out of my pocket.”

Health care advocates, industry groups and the state’s insurance department have urged insurers who pick up InHealth members to apply any medical expenses already incurred toward their new deductibles and out-of-pocket costs. But it’s unclear if any have or will.

“It just isn’t workable for many people,” said Kathleen Gmeiner, of the Universal Health Care Action Network of Ohio, one of the groups calling for relief.

About 7,800 customers are expected to remain on InHealth plans come August, according to the state’s insurance department. Those people are no longer eligible for the government subsidies that help lower their monthly premiums.

Customers still covered by InHealth may be eligible to switch insurers through the federal marketplace. They face an Aug. 29 deadline to make the change.