Deal lets CareSource ACA plans be used at Kettering Health

CareSource, pictured at its Dayton headquarters, has a contract deal with Kettering Health Network. FILE
CareSource, pictured at its Dayton headquarters, has a contract deal with Kettering Health Network. FILE

CareSource insurance plans sold on the Affordable Care Act marketplace can continue to be used at Kettering Health Network next year after contract deal was struck Wednesday.

CareSource, a Dayton-based insurer, sells individual plans on the ACA marketplace in 60 Ohio counties and the contract means Kettering Health's hospitals, emergency departments and doctors offices will remain in-network through 2018 for patients with those policies.

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“We were negotiating with CareSource, and we’re happy to say those negotiations have come to a fruitful resolution, and we want to assure people who have CareSource marketplace that there will be no interruption of service,” said Elizabeth Long, spokeswoman for Kettering Health Network.

Open enrollment for buying insurance on the Affordable Care Act marketplace ends Dec. 15.

During last year’s open enrollment, about 10,500 people in Montgomery County bought Affordable Care Act plans.

County enrollment 
Number of ACA enrollees by county during last year's open enrollment. 
CountyTotal enrollees
Butler County7,806
Champaign County587
Clark County2,074
Darke County1,005
Greene County3,015
Montgomery County10,486
Miami County2,162
Preble County764
Warren County5,359
Source: Centers for Medicare and Medicaid Services

People in Montgomery County can buy ACA plans for next year through CareSource, Buckeye or Molina.

Premier Health, the other large network of doctors and hospitals in the Dayton region, stated that does not accept the individual CareSource plans that are sold on the Affordable Care Act marketplace.

A spokesman said the health network is not in negotiations with CareSource for its marketplace insurance plans, though it does have a contract for Medicaid plans through CareSource.

CareSource is the only Affordable Care Act insurance available in Miami County where the only hospital is Upper Valley Medical Center, which is Premier Health affiliated and out of network with CareSource’s marketplace insurance.

Local resident Kathy Dye said when she was signing up for CareSource’s marketplace insurance, it was stressful trying to find a doctor before the contract was finalized when she didn’t know if both Miami Valley Hospital and Kettering Medical Center would end up being both out of network.

“I think the next step is probably I’ll stick with CareSource. I still haven’t totally decided on that, but at this point I think that’s the way I’m going to go,” she said, adding that she plans to look for a doctor at Kettering Health.

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CareSource said in a statement that its important to shop around for the right plan, even if you already bought a plan last year, because the providers that insurance plans cover may have changed from year to year. CareSource said it has added new provider groups since last year.

It’s been a chaotic year for the ACA marketplaces, facing repeal and replacement efforts and with consumers looking at sharp increases in the sticker prices of plans sold in Ohio.

Affordable Care Act individual insurance plans premiums are 34 percent more on average in Ohio next year. That means in 2018 the average individual premium price will be up to $5,798.

However, while sticker prices are up, the actual cost of premiums might be down for some plans because tax credits can make the final price of health insurance cheaper than the listed price.

CareSource said many consumers will qualify for tax credits that subsidize the cost of premiums and can reduce the rates.

READ MORE: What you need to know about Obamacare open enrollment