What To Know About Open Enrollment – 2016

Posted by on Sep 24, 2016 in Important News | 0 comments

Here are the things you need to know this year about Covered California:

  • The open enrollment period for Covered California and all other individual health plans in California starts on November 1st and ends January 31st It is important to know that if you sign up after December 15th your plan will not start until February 1st and if you sign up after January 15th your plan will not start until March 1st.
  • Update your Consent for Verification. Part of an application for Covered California requires you to give consent for electronic verification for some of your personal information such as income, immigration status, and incarceration status. You can choose to give consent for 1-5 years. Depending on how many years you chose when you enrolled you may have to recertify by December 15th or YOU WILL LOSE YOUR TAX CREDITS. This is easily done through your Covered California account online (CoveredCA.com) or by calling the member services line at (800) 300-1506. The best option is to call your agent as they can recertify for you.
  • Throughout California the average premium increase in 2017 will be 13.2%. In Butte County Anthem Blue Cross will increase on average 10.5% and Blue Shield will increase on average 22.3%. Most people will not actually notice the premium increase because their tax credits will increase as well.
  • Anthem Blue Cross has decided to eliminate their PPO (Preferred Provider Organization) plans and replace them with EPO (Exclusive Provider Organization) plans. THIS IS A HUGE CHANGE. This means Blue Cross members that are on EPO plans will no longer be able to get coverage outside of the Blue Cross network. They must see Anthem providers or they will pay full price.
  • Blue Shield of California will be the only insurance company offering PPO plans in Butte County for 2017. Blue Shield is also the only insurance company being offered in Butte County via the SHOP (Small Group Exchange). This is good news for many small businesses as it may allow them to offer Blue Shield PPO plans and qualify for a business tax credit.
  • Starting in 2017 most Covered California members will be assigned to a Primary Care Physician. If your plan is a PPO or EPO the assignment of a Primary Care Physician does not affect your ability to see the provider that you want. According to Covered California this is designed to match people with physicians that are currently accepting new member’s but has no bearing on the physicians they can actually use. So if you have received a notice from Covered California letting you know that you have been assigned to a new physician please be aware that it means absolutely nothing!
  • In 2016 dental & vision coverage were added as an option to Covered California. The dental options are not very robust and can be expensive for what you get in return for services. The vision plans through VSP are reasonably priced and offer a very good benefit. I would encourage you to ask an agent about both.

Here are the things you need to know this year about Medicare:

  • Open enrollment for Medicare starts October 15th and ends December 7th. There is little change to the types of plans being offered in Butte County but as always there is great change in the companies offering plans and the premiums. Each year as you get older your premiums will increase. In addition to this annual increase many companies such as Blue Shield, AARP and Blue Cross all raised rates across all plans during 2016. This is your opportunity to shop for better plans and lower premiums.
  • An important aspect of Medicare open enrollment is to re-evaluate your Part D prescription drug coverage. This is especially true if you have added, dropped or changed medications during 2016. There are a huge number of Part D plans available and the best plan for you depends primarily on what medications you are taking. In my opinion the only way to effectively compare Part D plans is to utilize the Medicare Plan Finder tool at Medicare.gov, click on the green “Find Health and Drug Plans” button and follow the instructions. This tool will calculate the least expensive plan for you based on the medications and the pharmacy you use. You can even apply directly from their website.

Good luck during this open enrollment. As always local agents are here to help you. It is important to remember that you do not pay anymore by using an agent and it can be very helpful to have a knowledgeable professional working for you.

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