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Details Fuzzy as ACA Signup Approaches

Open enrollment for the Affordable Care Act begins Nov. 1. (Jerry Oster)
Open enrollment for the Affordable Care Act begins Nov. 1. (Jerry Oster)
October 24, 2016

LAKE ANDES, S.D. — The signup for insurance coverage under the Affordable Care Act opening on November 1st, but there are still a lot of unknowns.

Alexa Raymond is a navigator with the Rural Office of Community Services in Lake Andes.

"At this point we do not have a provider list available to us to let us know which providers are going to be in which network,” Raymond said. "So it's really kind of up in the air. We're hoping to get it out soon, so we have that information for Nov. 1."

The two major health insurance providers in the state, Sanford Health and Avera Health, have decided not to allow the use of their network by those holding outside coverage. That puts geographic limitations on the coverage available.

Raymond said those who use the individual insurance market will have many of the same coverage choices, but will have to check details closely.

"People are going to have an average of about 18 plans to choose from, but this year they are going to be really careful,” she said. "If they are going to choose an Avera plan they need to know they can have Avera providers, and the same way if they choose a Sanford plan, they have to stick with Sanford providers."

Raymond said the insurance choices will be driven more by location this year.

"It's going to be difficult for people that maybe have used both of the providers for different areas of their health needs,” she said. "It's going to require more travel time, it's going to require more forethought into where you can go to get that help, get that service provided. Both Avera and Sanford have a rate increase of 36 to 39 percent."

The enrollment period will run from November 1 through December 15.

Jerry Oster, Public News Service - SD