Kansas Health Insurance Exchange: A Comprehensive Resource

The Kansas Health Insurance Exchange is a vital resource for residents seeking affordable health insurance options. The exchange offers a range of plans from different insurance providers.

To be eligible for a plan, you must be a Kansas resident and not have access to affordable health insurance through your employer or another source. You can enroll in a plan during the annual open enrollment period or during a special enrollment period if you experience a qualifying life event.

The exchange offers four levels of plans: Bronze, Silver, Gold, and Platinum. Bronze plans have lower premiums but higher out-of-pocket costs, while Platinum plans have higher premiums but lower out-of-pocket costs.

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The Kansas Health Insurance Exchange is a state-run program that provides health insurance coverage to individuals and small businesses. It was established in 2014 as part of the Affordable Care Act (ACA).

You may be wondering how this exchange works. The key tax credits and tax subsidies are only available for coverage purchased through a public health insurance exchange.

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There are three options for setting up a state health insurance exchange: building a state-based exchange, entering into a state-federal partnership exchange, or defaulting to a federally-facilitated exchange. Kansas defaulted to a federally-facilitated exchange.

Here are the three options for setting up a state health insurance exchange:

The Kansas Health Insurance Exchange opened for enrollment on October 1, 2013.

The Kansas Health Insurance Exchange has a fascinating history. After the Affordable Care Act (ACA) was passed in 2010, Kansas initially considered establishing a state-based health insurance exchange.

In 2012, efforts to establish a state-based exchange slowed down as Kansas waited to see if the ACA would be upheld. Kansas Governor Sam Brownback announced on November 8, 2012, that the state would default to a federally-facilitated exchange.

The Kansas Insurance Department (KID) will still play an active role in the exchange, reviewing and authorizing insurance plans and rates. This role was approved by the Center for Consumer Information and Insurance Oversight (CCIIO) on March 8, 2013.

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Enrollment in Kansas' health insurance exchange is a straightforward process. You can enroll in an ACA-compliant individual or family health insurance plan between November 1 and January 15 during open enrollment.

To get coverage that starts on January 1, you need to enroll by December 15. If you enroll later, your coverage will start on February 1. Outside of open enrollment, you can get coverage through the Marketplace if you have a qualifying life event, such as loss of health coverage or getting married.

There are several ways to enroll in a Marketplace plan, including online through HealthCare.gov, by phone at (800) 318-2596, or with the help of an agent or broker. You can also enroll via an approved enhanced direct enrollment entity.

A significant number of people in Kansas have enrolled in the Marketplace, with a record high of 171,376 people signing up for private plans during the open enrollment period for 2024 coverage. This growth trend is due in part to the American Rescue Plan, which has made ACA's premium subsidies more widely available.

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As of the end of January, 22,388 Kansans had signed up for coverage through the exchange.

This number is a significant improvement from mid-December, when fewer than 2,000 people had enrolled due to issues with the website's rollout.

About 34 percent of those who signed up in Kansas are 34 or younger, which is slightly better than the nationwide average of 32 percent.

This demographic is coveted because they tend not to use many health services and effectively subsidize older people.

Most of the people who have enrolled, around 90 percent, are paying $25 a month or less for their insurance.

This is a win for many low-income individuals and those who were previously in high-risk insurance pools.

The insurance industry sees signs of continued improvement in the exchange, with representatives noting that things started to get better in November and have been steady since.

You can enroll in an ACA-compliant plan in Kansas during open enrollment, which runs from November 1 to January 15.

If you enroll by December 15, your coverage will become effective on January 1. Enroll between December 16 and January 15, and your coverage will start on February 1.

American Indians and Alaska Natives can enroll in an ACA exchange plan year-round.

If you have a qualifying life event, such as loss of health coverage or getting married, you can get coverage through the Marketplace outside of open enrollment.

Subsidy-eligible applicants can enroll in a Marketplace health plan at any time during the year if their household income doesn’t exceed 150% of the federal poverty level.

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If you're looking for in-network providers, Aetna CVS Health is one of the options available.

Aetna CVS Health offers comprehensive coverage for various services. Anthem BCBS also has in-network options, specifically Pathway & Pathway X for services at MO locations only.

BCBS of Kansas offers two in-network plans: BlueCare and Blue Choice. BlueKC is also an in-network option, with plans including BlueSelect Plus and Preferred Care Blue.

On a similar theme: What Does Aetna Health Insurance Cover

Medica is another in-network provider, offering Medica with MU HealthCare and Select by Medica.

For those with Oklahoma Medicaid, SoonerSelect Dental Plans are an in-network option. United Concordia Dental is also an in-network provider for those with Oklahoma Medicaid.

Here's a list of some of the in-network providers mentioned:

If your child needs medical care, it's essential to understand their insurance coverage. Ambetter from HomeState Health Plan (Missouri) and Ambetter from Sunflower Health Plan (Kansas) are two plans that offer coverage for medical services.

You can also consider Anthem Pathway/Pathway X, which is available in some Kansas locations. Arkansas Medicaid Provider-Led Arkansas Shared Savings Entity (PASSE) is another option for families in need of medical care.

Ascension Personalized Care EPO and Aspen STM (All Hospital/Facility Services) are two plans that provide comprehensive medical coverage. Balance by Medica and BlueKC Blue Access are also available for families seeking medical care.

If you're looking for a specific type of medical coverage, Cox Health EPO and Custom Network Plans (Administered by United Healthcare) may be good options. HealthChoice of Oklahoma and Kaiser Permanente offer medical coverage for families in Oklahoma.

Additional reading: Oklahoma Health Insurance Exchange

For families in Arkansas, LifeShield STM (All Hospital/Facility Services) and Walmart / Mercy: Arkansas Local Plan & Southwest Missouri Local Plan are available. MedBen and Mercy Anthem Alliance EPO (Anthem BCBS) offer medical coverage for families in Missouri.

Oklahoma Medicaid SoonerSelect (Managed Medicaid plans Only) and Oscar Health are also available for families in need of medical care. PHCS Practitioners Only (All Hospital/Facility Services) and Preferred CommunityChoice offer comprehensive medical coverage.

Prime Health Services (PHS) and United Healthcare ACA Exchange [Gold, Silver, Bronze] are two plans that provide medical coverage for families. US Health and Life Vālenz Health - Ascension Personalized Care (offered in Wichita market) and Well First by Medica (offered in St. Louis) are also available for families in need of medical care.

Here is a list of medical plans available in the region:

The Kansas Health Insurance Exchange offers a range of plans to choose from. All plans meet the ACA definition of a qualified health plan (QHP).

You can compare plans on an "apples to apples" basis by looking at their level of coverage for essential health benefits (EHB). The four metal levels are Bronze, Silver, Gold, and Platinum, which correspond to the plan paying 60%, 70%, 80%, and 90% of the costs, respectively.

Here's a breakdown of the metal levels:

BlueCare plans are also available in Kansas, but they're not offered in Johnson and Wyandotte counties.

In Kansas, you can choose from a variety of Marketplace plans to suit your needs and budget. The plans are categorized into four metal levels: Bronze, Silver, Gold, and Platinum.

The Bronze level has lower monthly premiums, but higher out-of-pocket costs when you receive medical care. It's a good option if you're a young adult with few health services needed during the plan year.

The Silver level has moderate out-of-pocket costs and is a good balance between monthly premium and out-of-pocket expenses. Silver plans are also eligible for cost-sharing reductions, which can help reduce deductibles and out-of-pocket expenses.

For another approach, see: Monthly Premium for Health Insurance

The Gold level has lower out-of-pocket costs and is a good option if you expect to have many health services during the plan year. However, it comes with a higher monthly premium.

The Platinum level has the lowest out-of-pocket costs, but also the highest monthly premium. It's a good option if you want the most comprehensive coverage.

Here's a summary of the metal levels:

Keep in mind that these plans are offered by various insurance companies, including Aetna, Cigna, and United Healthcare, among others. You can explore these options and choose the one that best fits your needs and budget.

Medicare is a vital part of healthcare for many Americans, including those in Kansas. Medicare in Kansas has its own set of rules and regulations, including specific Medigap coverage.

Medicare Advantage plans are available in Kansas, offering an alternative to Original Medicare. These plans often include additional benefits like dental and vision coverage.

Medigap coverage, also known as Medicare supplement insurance, can help fill gaps in Original Medicare coverage. In Kansas, Medigap plans are regulated by the state to ensure they meet minimum standards.

Medigap plans can be purchased by Kansas residents who are already enrolled in Medicare, and can help cover costs like copays and deductibles.

Here's an interesting read: What Are Qualifying Reasons for a Medigap Guaranteed Issue Right

Seven insurers are offering plans through the Kansas health insurance Marketplace for 2025. This is a decrease from the eight insurers that were offering plans in 2024.

Ascension Personalized Care (US Health & Life) is exiting the market at the end of 2024, which led to the decrease in insurers.

In 2024, Aetna joined the Marketplace in Kansas, but Cigna stopped offering coverage in the Kansas Marketplace at the end of 2023, resulting in the same number of insurers as in 2023.

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Marketplace health insurance premiums are increasing in Kansas, with some issuers seeing significant hikes.

Ambetter from Sunflower Health Plan/Celtic has the lowest increase at 2.07%, while Blue Cross and Blue Shield of Kansas City is seeing a 24.4% jump.

The overall average premium increase in Kansas has been steadily rising over the years, with 2016 seeing the largest increase at 23%.

Here's a breakdown of the average premium increases in Kansas from 2015 to 2024:

If you're looking for more affordable options, you can explore other plans in the exchange that may offer comparable benefits.

If you're considering a Marketplace Plan, it's essential to understand the out-of-network options available to you.

Ambetter from Home State Health (Missouri) and Ambetter from Sunflower Health Plan (Kansas) are two plans that offer out-of-network coverage.

Balance by Medica, offered in parts of southwest Missouri, is another option to consider.

Blue KC BlueSelect is a plan that also provides out-of-network coverage.

Cox Health EPO and Oscar Health are two more plans that offer out-of-network benefits.

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United Healthcare ACA Exchange plans, including Gold, Silver, and Bronze options, also provide out-of-network coverage.

Well First by Medica, offered in St. Louis, is another plan that offers out-of-network benefits.

Here are some of the out-of-network plans available in the Marketplace:

To enroll in a Kansas health insurance exchange, you'll need to follow these four steps:

Sign up between November 1 and January 15 during open enrollment to buy an ACA-compliant individual or family health insurance in Kansas.

To get started, you can enroll online through HealthCare.gov, by phone at (800) 318-2596, or with the help of an agent/broker, navigator, or certified application counselor.

If you're eligible for an ACA Marketplace plan, you can also enroll through an approved enhanced direct enrollment entity.

Here are the key enrollment periods to keep in mind:

The Kansas Health Insurance Exchange will be following federal guidelines for insurance professionals selling policies through the Exchange and for navigators assisting consumers and small businesses. This means you'll have access to a network of professionals who can help guide you through the process.

Insurance professionals can register with the Exchange and receive commissions directly from carriers, using their Exchange ID number and NPN. This can be a convenient option for those who want to sell policies through the Exchange.

Navigators, on the other hand, will assist consumers in making choices about their health care options and accessing their new health care coverage. They can also help with accessing premium tax credits for eligible consumers.

You can enroll in a Marketplace plan in Kansas through various channels. Online enrollment is available through HealthCare.gov.

To get started, you can visit HealthCare.gov and follow the prompts to enroll in a plan. If you prefer to speak with someone, you can call (800) 318-2596 for assistance.

You also have the option to work with an agent/broker, navigator, or certified application counselor for help. These professionals can provide guidance and support throughout the enrollment process.

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If you're looking for in-person assistance, you can find an approved enhanced direct enrollment entity in your area.

Here are the ways to enroll in a Marketplace plan in Kansas:

If you're a Kansas resident looking for health insurance resources, there are several options available.

You can enroll in a health insurance plan online through Healthcare.gov, the ACA Marketplace, by visiting their website or calling (800) 318-2596 for assistance.

SHICK, or Senior Health Insurance Counseling for Kansas, offers help with questions about Medicare.

Medicaid, also known as KanCare, may be an option for certain people who meet the income limits, even though Kansas hasn't expanded Medicaid.

Check this out: Medicaid Managed Care Organization