General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsAbout those letters from Blue Cross Blue Shield:
Last edited Mon Oct 21, 2013, 11:50 AM - Edit history (1)
(Don't let Blue Cross hoodwink you!)
-hoping it's ok to post the whole article,
Adam Linker is a policy analyst at the N.C. Justice Centers Health Access Coalition
http://www.newsobserver.com/2013/10/11/3273010/nc-needs-to-dig-deeper-into-those.html
Recently, many people across the state received a note from Blue Cross and Blue Shield of North Carolina notifying customers that the company is discontinuing the members insurance policy. The correspondence has frightened some families because BCBSNC matches these letter recipients with a plan that has similar benefits to the policy that will end. Oftentimes the new policy also comes with a heftier premium.
You do not have to buy the policy to which you are matched. The new plans listed in the letters represent only a suggestion from BCBSNC. Instead, everyone should shop around for the best-fitting plan. All of the new policies sold to consumers will be comprehensive, and the insurance companies are not allowed to deny coverage or charge more based on a persons medical history.
Many people who received letters will qualify for help purchasing insurance coverage as part of the Affordable Care Act. For example, a family of three with one child and two parents over 40 years old earning $45,000 annually can expect to pay about $276 per month for coverage. If the family chooses a lower-cost plan, they could pay about $160 per month. Assistance from health reform will pay the rest of the premium.
This premium help is available to many people earning less than $46,000 per year for an individual or $94,200 per year for a family of four. When the federal healthcare.gov website, which has been overwhelmed in recent days, is running efficiently, folks can check there to see what kind of premium discount to expect. In the meantime, there is a calculator online at the Kaiser Family Foundation site that can estimate potential savings.
Those who receive the BCBSNC letter and earn too much to qualify for assistance should shop inside and outside of the new online marketplace for the best deal available. Those who do not qualify for subsidies then have a broader range of insurance companies from which to choose. You can find out from the N.C. Department of Insurance which companies offer individual and family plans in the state or an agent or broker can help you shop for new options.
Premiums are also steeper in North Carolina because Gov. Pat McCrory and the legislature fought reform at every turn. According to Insurance Commissioner Wayne Goodwin, defaulting to the federal government to run a portion of our insurance marketplace has resulted in less competition and less competitive pricing.
And, as a brief by the American Academy of Actuaries showed, by refusing to expand Medicaid, more costs are shifted to people who purchase private insurance.
Some people are pointing to the letters from BCBSNC as evidence that people cannot keep their plans if they like them. That is not the case here. After health reform passed, BCBSNC offered its customers the option to grandfather or keep their plans. If members chose to alter plan benefits then BCBSNC warned that the policy would lose its grandfathered status. Its true that most people dont read everything sent to them from an insurance company, and often what they do read is not clear, but there was an option for BCBSNC customers to retain their plans.
Anyone who receives a letter from BCBSNC, or any insurance company, should not stop reading at the new premium prices. Look through the entire document. Shop around for new options. Check out the websites of different insurers, keep checking healthcare.gov and call (800) 318-2596 for assistance.
Insurance is confusing, especially when it is mixed with national policy changes, partisan rhetoric and misinformation. No one should make a decision too quickly based on a single letter. Open enrollment runs until March 31. And consumers have until Dec. 15 to buy a plan that begins coverage Jan. 1.
Adam Linker is a policy analyst at the N.C. Justice Centers Health Access Coalition.
DURHAM D
(32,611 posts)I don't understand the way BCBS is using the term "grandfathered". Seems like a scare tactic.
Last week I was trying to help a friend (she currently has BCBS's cheapest coverage and got the grandfather letter) and only BCBS and Coventry are listed as providers in NC. She has decided to wait a bit while things settle down before she makes a decision.
Thanks
sorry I neglected to include it..corrected
DURHAM D
(32,611 posts)BCBS has had a booth in the mall with 3 agents working at all times.
My friend stopped to talk with them and I listened as the conversation got more and more confusing and the blame for higher premiums got put on the ACA. I explained to her about NC opting out of the federal dollars so she should blame the NC legislature but it doesn't really matter to her as her premium (so far) has appeared to skyrocket. She makes less than $20K a year and I hope she stops using BCBS as her go to for information.
G_j
(40,370 posts)really there to help the individual find the best options for themselves.
Daemonaquila
(1,712 posts)Read the article and take it to heart. This is BCBS all around the country, not just NC. I have BCBS of MN, a "good" state for getting coverage. They sent a letter that told my husband and me that our premiums were going up over 1/3, to a ruinous price, and not offering any alternatives. 2 weeks later, we found better coverage for only 1/3 of the price we had been paying for years. The moral of the story is that (a) they are thieves who are trying to take in big profits in the initial chaos, and (b) ACA benefits the INFORMED SHOPPER who does actual research. Go check out options - there are good deals to be had.
trumad
(41,692 posts)You hit the nail nail squarely on the head.
dicksmc3
(262 posts)My wife recently received a letter form her provider, Blue Cross/Blue Shield of Illinois stating the exact same notice of discontinuance of her policy. Then they had the nerve to suggest shopping around for a better policy. The letter also stated that she would receive info on new policies offered by the company that "BASICALLY" match her existing policy!! BULL!! The policies offered on their websites were in some cases, twice as much as her existing policy with less in benefits. It's all a scam by the insurance bigots to keep their pockets lined with millions in salaries and millions more in stock!!! I truly hope OBAMACARE takes off and is an added benefit to our existing social safety net. God knows with Republicans trying to cut everything to the "BONE" we need all the help we can get!!
sabbat hunter
(6,835 posts)that these companies actually act as if they are independent of each other ie that BCBS of NY isn't owned by the same parent company of BCBS of Michigan or NC, etc by calling them 'licensees'
IT is why the plan that some GOPers put forward to allow people to 'shop across state lines" was such a joke. They would just set u p shop in states with very low regulation, rules and close the rest down forcing people to pay far more. The same way that credit card companies are basically set up in only two states, delaware and ND.
JP morgan Chase is HQ in NYC, but their CC arm is in Delaware. That way they get around NYS usury laws.
Fla Dem
(23,741 posts)http://kff.org/interactive/subsidy-calculator/
(Thanks to DUer randr)
http://www.valuepenguin.com/ppaca/exchanges
(Thanks to DUer steve2470)
JustAnotherGen
(31,879 posts)I ran the following information for my zip code in nj:
This applies to my husband and me:
2 Adults
Non Smokers
44 and 40
No children.
This doesn't apply: Employer coverage is not available. Then I ran two lower incomes.
40K a year.
Plan Total: $7977 per year.
Possible Tax Credit (Subsidy): $4665
Annual Cost after credit: $4665
Monthly: $276 or 8.28% of household income.
Our cell phone plan wit my mom's iPhone (family share everything) would be $270 per month if I did not get my employee discount.
Then I ran $158K per year -
Plan Total: $6782 per year.
No tax credit - but 1.65 percent of TOTAL Income.
Then I ran our income - 1.65% of our total income - the same amount as $158K per year for cost $6782.
Even high cost of living NJ - after our taxes, NJ property taxes, NJ income taxes, hard to find a small home or condo for less than $275K in our legislative district - that couple making $158K per year in their 40's CAN afford it.
We need to increase the income levels for subsidies and expand the amount of subsidy and tax credit for the 40k couple - but this is one hell of a good start for people whose rates of breast cancer, prostate cancer and general aging has increased (couple in their 40's). One hell of a good start!
pangaia
(24,324 posts)Although I have Medicare.
One issue is the site does not say what is covered, or what may be covered, under the catch all phrases of bronze, silver gold and drum roll PLATINUM> :>
Klukie
(2,237 posts)What "grandfathered" means and how it impacts customers and members
June 15, 2010
The Patient Protection and Affordable Care Act (PPACA) distinguishes between health plans that existed prior to the March 23, 2010 enactment date and those that come into existence afterward. Individual and group health plans already in existence prior to enactment are referred to as "grandfathered" plans, and new health plans (or plans which have been materially modified after March 23, 2010) are referred to as "non-grandfathered" plans. This distinction is important because grandfathered health plans are, in some cases, exempt from certain reform requirements.
The Department of Health and Human Services (HHS) recently released regulations that further define "grandfathered" and in what cases health plans can lose grandfathered status.
Please review the questions and answers below for an overview of the grandfathering regulation. More details, including specific examples, are available in a HealthReform.gov Fact Sheet.
http://www.bcbsm.com/content/microsites/health-care-reform/en/reform-alerts/what-grandfathered-means-and-how-it-impacts-customers.html
JustAnotherGen
(31,879 posts)Sharing on Twitter and Facebook. This article MUST go viral and the next step is to punish Isurance companies that are DELIBERATELY misleading customers. This is deliberate and a way for them to price gouge.
G_j
(40,370 posts)it's not just in NC.
sulphurdunn
(6,891 posts)is a byzantine labyrinth of confusion and wasteful costs. Single payer would be s-o-o-o much better for the people and the economy.
PasadenaTrudy
(3,998 posts)saying my PPO would no longer exist at end of yr. They offered a plan that looks identical to their Platinum plan for a dollar less a month than if I bought it on the exchange. So, what should I do? Both of these plans are nine dollars cheaper than my current plan, and no deductibles. Current plan has a $1000 deductible...oh, also I'm turning 50 in Jan, single, make $45K a year. I'm not in great health, so I do want the Platinum level.
Lex
(34,108 posts)Intentionally muddying the water to make it MORE confusing for folks to figure out what to do.
G_j
(40,370 posts)to say the least.
ScreamingMeemie
(68,918 posts)Out of all the companies on the marketplace, BC/BS Texas has no doctors withing 90 miles of my suburban Houston home. Interesting.