The one aspect of health insurance that the Affordable Care Act did not address is the cost of health care services. Without a governor on the prices that doctors and hospitals can charge, the health insurance companies must constantly increase their rates to cover the cost of health care expenses that seem to rise faster than the national average for inflation. One way to reign in the ever increasing costs of health care is by providing consumer information on the cost of health care services through price transparency. The Health Care Transparency Project has started an online petition to request the Trump administration implement price transparency for consumers.
With the loss of the Anthem Blue Cross PPO plans in most of California and the double-digit rate increases on many plans, consumers are starting to look at the HMO plans available to them. There was a time when HMO plans were always more expensive than PPO plans. In the new health insurance landscape of Obamacare, HMO plans are becoming less expensive. But is a HMO plan right for you and your family?
I would not have believed it had I not witnessed it with my own eyes. When I renewed the Covered California health plan for a client her monthly premium amount she will be responsible for will actually be lower in 2017. Even though the carrier had an overall rate increase and she was another year older, the Advance Premium Tax Credit monthly subsidy calculated by Covered California will be larger in 2017. The net result is she will be paying less than $5 per month for the same Silver health plan in 2017.
Many Californians are facing sticker shock over the new health insurance premiums for their 2017 individual and family plans. Covered California and the insurance companies have pointed the finger at the elimination of the Affordable Care Acts reinsurance provision for the health plans. However, another contributing factor is the lower copayments on specific benefits Covered California has mandated in the new health plans. Consumers will be paying less for some out-of-pocket expenses. As the health plans must make up the difference for consumer’s lower cost-sharing, the rates must inevitably reflect this reality.
A really nice tool for agents and consumers to compare health insurance plan rates is the Shop and Compare Tool. Within this website you can also download a proposal that lists the available health plans by metal tier level for the household information entered. Unfortunately, I recently found that the proposal created may not always match the website results shown.
With the expansion of Medicaid in California a large number individuals and families are now enrolled in a Medi-Cal health plan. The expanded Medi-Cal managed health care plans must cover all the same benefits as private health insurance purchased through Covered California. There is no cost to the consumer in terms of monthly premium, deductible, coinsurance or copayments. However, enrollment in these plans does cost something and I’m often asked how much these plans cost the tax payer.
Whenever a health insurance company or health plan wants to change their health insurance rates in California they must submit a justification for the rate change in the monthly premium amounts to the Department of Managed Health Care or Department of Insurance. Regardless of which agency they must submit their rates to, the agencies just […]
Covered California has released the preliminary health insurance rates for 2016 conveniently avoiding telling some consumers that they will see a 30% to 44% increase in their monthly rates. While Covered California was massaging the statistics to promote a statewide weighted average increase of only 4%, consumers enrolled in some Blue Shield plans in Northern […]
California Department of Insurance Commission Dave Jones excoriated Aetna in a news release on December 18th over Aetna’s planned small group premium increases but he was noticeably silent when Health Net submitted a similar rate increase for individuals and families. The average increase for the 2015 Health Net IFP PPO plans is 10.8% while the Aetna small group […]
The Centers for Medicare and Medicaid released their reimbursements rates for Medicare Advantage plans by each county in the United States. Commonly known as the capitation rate, the table shows what Medicare pays to a private Medicare Advantage plan each month for each beneficiary enrolled in the health plan. The lowest reimbursement is in San […]