March 28, 2024

Wellmark, Aetna Health Insurance announcements cause concern for Newton Residents

Recently, both Wellmark and Aetna announced they will leave the Affordable Care Act under-65 individual market in Iowa in 2018. The change impacts over 50,000 Iowans and was implemented due to heavy financial losses in the turbulent ACA market — more than $90 million by Wellmark alone over the last three years.

Those with ACA individual under-65 policies in Iowa will receive termination notices in the coming months and will retain their current coverage until the end of the year. During the next Open Enrollment Period (OEP) in the fall, they can change their plan to another health insurance carrier.

“When news of Wellmark’s announcement broke, and then Aetna’s three days later, my first concern was for my clients,” said Jeff Maki of Clemon Maki Insurance in Newton. “I knew a lot of them would be worried that these changes applied to them. The main message is that it does not impact anyone with group coverage, a Medicare Supplement policy, or anyone who purchased their individual under-65 plans prior to Jan. 1, 2014.”

As of now, in 2018, there will only be two health insurance carriers in the ACA individual under-65 market in Iowa: Medica, which covers all 99 counties, and Gunderson, which offers coverage to individuals living in Allamakee, Clayton, Fayette, Howard and Winneshiek counties.

“If you are impacted by this change, it’s important to know that you have time,” said Maki. “You can keep your current coverage until the end of the year. During the OEP in the fall, you should meet with your local insurance agent to find out what plan makes the most sense for you.”

Wellmark and Aetna are the latest in a number of health insurance carriers that have either pulled out of select counties or completely left the state due to significant financial losses in the ACA market.