888-765-5400BCBSNC – OPEN ENROLLMENT BEGINS NOVEMBER 1st
If you did not get health coverage previously under the Affordable Care Act, you can enroll in a Blue Cross Blue Shield of NC health plan for next year starting November 1st. In addition, if you are already enrolled, you can make a change to your existing coverage or renew your plan for 2016. Open Enrollment will end January 31st, 2016 and if you do not enroll in a plan during this time, you will not be able to obtain health coverage until 2017 unless you have a Qualifying Life Event.
There are at least three key components to choosing an ACA plan that is right for you and your family: Benefits, premiums and the network of doctors and hospitals.
Benefits:
All ACA plans are required to cover “10 essential health benefits” as defined under the law. In addition, all individual plans must cover preventive health benefits entirely.
Beyond these requirements, consumers have choices when it comes to how much they pay out-of-pocket for covered services. Plans are divided into four metallic levels — bronze, silver, gold and platinum. As these names suggest, bronze plans have the highest deductibles and co-payments, while platinum plans have the lowest. Inversely, bronze plans are typically cheaper on a monthly basis, while platinum level plans have the highest monthly premiums.
When shopping for a plan, review the “Summary of Benefits and Coverage,” which describes what the plan covers. Also be sure to review each plan’s prescription drug formulary to see what drugs are covered and how much you will be paying out of pocket. Getting an idea of what plans interest you most prior to November 1st will help you be prepared for the enrollment process.
Premiums:
Health plans across the nation have been preparing customers for changes in rates from current plans for the new ACA enrollment period. Generally speaking, the higher your out-of-pocket costs, the lower your premiums are. This tradeoff between rates and out-of-pocket costs is an important element to consider when shopping for coverage.
Federal subsidies help consumers pay for coverage through the ACA. If your household income is between 100% and 400% of the federal poverty level, you do not have access to coverage through an employer, and you meet certain other requirements, you will be eligible for a federal subsidy to purchase a plan through the federal exchange.
Networks:
Another important consideration for consumers is whether their current physicians and hospitals are in-network. Going outside the plan’s network typically results in higher charges — sometimes significantly higher. Some plans, especially HMO type plans, do not cover services provided outside their networks.
If you have had coverage before, or have a current plan, do not automatically assume your doctors will still be in-network for a new or renewed plan. It is best to check each time you go through an Open Enrollment period. All ACA plans are required to tell consumers which providers are in the plan’s networks and it is important for you to do your research.
For more information on Blue Cross Blue Shield of North Carolina insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888*765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.