What You Need to Know about 2025 Individual Health Insurance Plans Available in Alaska.

Moda Health Plan and Premera Blue Cross Blue Shield of Alaska are the Affordable Care Act (ACA)-compliant individual health insurers in Alaska for 2025. Premera offers coverage statewide. Moda Health Plan offers coverage to residents of Municipality of Anchorage, Matanuska-Susitna Borough, Kenai Peninsula Borough, Fairbanks Northstar Borough and Southeast Alaska. Be sure to review your plan to identify the areas where network coverage is available.

Open enrollment for the individual health market runs from November 1, 2024, to January 15, 2025. The open enrollment period goes until January 15, 2025; however, if you don’t enroll by December 15, 2024, you will not have coverage for January 2025. You must enroll by December 15, 2024, for January 2025 coverage.

Those looking for individual health insurance outside the open enrollment period can seek a special enrollment period (SEP) if you have experienced a qualifying event (e.g., loss of a job, marriage, or the birth of a child). You can apply for the SEP through the Marketplace.

For more information you can contact the Federally Facilitated Marketplace online at Healthcare.gov or by calling 1-800-318-2596. Insurance plans can be obtained directly from the insurance companies or through an agent, broker, navigator, who can be identified online at Localhelp.Healthcare.gov. United Way of Anchorage serves as Alaska’s health insurance navigator for helping Alaskans understand their health insurance options. They can be contacted by phone at 2-1-1 or 1-800-478-2221 or online at: Healthcare Navigators

Enhanced Premium tax credits and increased income limits have been renewed through 2025 under the federal Inflation Reduction Act.

The federal government has fixed the family glitch. The previous rule allowed people to qualify for Marketplace tax credits if their employer-based coverage exceeded 9.6% of the household income for self-only coverage. For plan year 2025, the new rule allows families to access subsidies if the cost of employer-based family coverage exceeds 9.02% of their household income.

If you previously did not qualify for premium tax credits, you may now qualify for them. All Alaskans are encouraged to shop this year to consider their best options for coverage.

Due to the seasonality of work in Alaska, consumers with advance premium tax credits should carefully consider and disclose what they expect their annual income to be, not just their current monthly income. In addition, income sources such as unemployment compensation, the sale of a business or other investments, may impact your income. If consumers have a change in income during the year, they should update their account at Healthcare.gov to ensure that their premium tax credit is correctly applied to their insurance. Consumers who underestimate their income may have significant tax consequences and be required to repay some or all of their advanced premium tax credit.

Frequently Asked Questions

1. Who is ModaHealth Plan? Are they the same as Moda Assurance?
   Moda Health Plan is an insurance company offering individual market health plans in Alaska in 2025. No, Moda Health Plan is not the same as Moda Assurance, but they are part of the Moda family of companies.
2. Why is Moda not offering coverage on a statewide basis?
   Moda has made a business decision to provide coverage in these areas only. Offering coverage to the Municipality of Anchorage, Matanuska-Susitna Borough, Kenai Peninsula Borough, Fairbanks Northstar Borough, and Southeast Alaska will provide a majority of the Alaska individual insurance market with two insurance options.
3. Where can I learn more about special enrollment periods (SEP)?
   You can call 1-800-318-2596 or visit Healthcare.gov, the following link provides information specific to SEP: healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period
4. When does open enrollment begin for 2025?
   November 1, 2024. If you have any questions or require additional resources, please call Consumer Services at the Division of Insurance at 907-269-7900.
5. Why are some plans only available on the Marketplace?
   Insurers can make a business to decision to offer plans on and/or off the Marketplace. Any plan that is available on the Marketplace may also be purchased directly from the insurer when a consumer requests it. Please contact your preferred insurer if you would like to purchase a plan off-exchange that you have viewed on-exchange.
   
   Learn more about fake and inadequate products being marketed that may not meet your needs:
   Beware of Fake Health Insurance Plans
   
   More Information on Open Enrollment from the NAIC
   How Do I Enroll in a Health Insurance Marketplace Plan for 2025?

Consumer Resources

• www.cms.gov/nosurprises/consumers
• What you should know about surprise billing

Provider Resources

• Understanding the Requirements for Health Care Providers and Facilities under the No Surprises Act
• Provider Complaints
• CMS Federal IDR Process
• Certified IDR Entities List

Additional Resources:

• www.cms.gov/nosurprises

Things that you should know if you are on Medicaid:

Medicaid Annual Renewals Will Restart April 1, 2023

Alaska will return to the regular pre-pandemic process of Medicaid annual renewals beginning April 1, 2023. When it is your turn for renewal, Alaska Medicaid will recheck your eligibility to make sure you still qualify for Medicaid coverage. There are two steps you need to take to make sure you complete your renewal on time and stay covered:

1. Make sure that your contact information is up to date with the Division of Public Assistance so that important information about your coverage gets to you. This is especially important if you have moved in the past three years, or your phone number has changed. You can update your contact information by calling the Virtual Contact Center (VCC) 800-478-7778.
2. Check your mail for important information about your coverage. You will receive a letter in the mail from the Division of Public Assistance sometime in the next 12 months. This letter will tell you if your coverage has been renewed, or if a response is needed. If you receive a renewal form in the mail, fill it out and return it as soon as possible.

If you are notified that your Medicaid coverage is ending you should note the following:

What to do if your Medicaid Coverage is Ending:

• Don’t miss your Special Enrollment Period. Because of your disenrollment from Medicaid you are eligible for a special enrollment period.
• Be sure to consider your options from Healthcare.gov, directly from an insurance company, or through an employer health plan.
• This special enrollment period is for a limited time. It is typically open for 30 days for employer-based coverage. For Marketplace plans through healthcare.gov, you will have 60 days from when you start a marketplace application.
• Tax Credits Available. Most consumers are eligible for a tax credit that will reduce the monthly premium cost of a new health plan. You must enroll at Healthcare.gov to get this tax credit.
• Cost Sharing. Health insurance plans in Alaska have deductibles and cost-shares that you will be responsible for paying when you get health care services, supplies, or fill a prescription.
• If your income is lower than 250% of the Federal Poverty Level, you will qualify for lower out of pocket costs, when you select a silver plan. You must enroll at healthcare.gov to receive this option.
• Carefully estimate your 2023 income when applying. Please note that Alaskans received a larger than typical PFD payment in October 2022. You may not wish to consider the 2022 PFD in your 2023 income estimate.
• Alaska currently has two health insurance companies on the Marketplace. Moda Assurance and Premera Blue Cross Blue Shield are the two companies offering comprehensive health insurance on healthcare.gov. You will only be able to receive tax credits with these companies. All plans offered on healthcare.gov are comprehensive. They cover prescriptions, doctor visits, urgent care, hospital stays, and more.
• Beware of Marketing. Medicaid renewals are happening across the United States and some companies may market limited benefit plans also known as “skinny plans” that do not cover comprehensive benefits. Additional information about alternative coverage types can be found under information sheets for Short Term Limited Duration Insurance or Health Care Sharing Ministries. Things to watch out for:
  • Low monthly cost relative to a Premera or Moda plan.
  • Requirement to join an Association
  • Pre-existing Condition limits
  • Health Discount plans or other arrangements that are not considered insurance and do not have insurance related consumer protections under Alaska Insurance law.
• Medicare Supplement Guaranteed Open Enrollment Period. If you became Medicare eligible (e.g., age 65) while on Medicaid, insurers are required to offer you an open enrollment period for Medicare Supplement insurance plans. For Medicare questions contact the Alaska Medicare Information office at 1-800-478-6065 (TTY: 800-770-8973). Additional information can be found in the Division of Insurance Medigap guide.

Need help?

Private Insurance


Visit healthcare.gov or call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to get details about Marketplace coverage.
You can find assistance through a navigator or insurance agent by choosing “find local help on the website” or by dialing 2-1-1.

For those over age 65 or disabled
Alaska Medicare Information Office
Website: health.alaska.gov/dsds/Pages/medicare/default.aspx
Phone: 1-800-478-6065

Medicare.gov website for shopping for Medigap plans in Alaska.

For additional questions about Medicaid see:
health.alaska.gov/dpa/Pages/medicaid/Medicaid-Renewals.aspx

• Alaska Medicare Information Office
• Medicare Supplement Insurance (Medigap) Guide
• Choosing a Medigap Policy
• Find a Medigap policy that works for you using the search tool on the Medicare website
• Research additional topics and questions by contacting the Alaska Medicare Information Office at 907-269-3680
• Medicare & You 2023

Links to the Federal Medicare webpages:

• What is Medicare Supplement Insurance
• Guaranteed Issue Rights (also called Medigap Protections”)
• Switching Medigap policies

Additional information can be found reviewing the general website at: www.medicare.gov