For the second time since the launch of Obamacare and Covered California, Anthem Blue Cross has cut the commissions they will pay agents for assisting consumers with enrollment into individual and family plans. Anthem Blue Cross now has one of the lowest commission structures for agents helping individuals and families apply for health insurance in California. This commission cut, coupled with rules limiting Covered California delegated agents from receiving commissions, has resulted in agents thinking twice before assisting consumers with Anthem Blue Cross health plans.
Anthem Blue Cross
Posts related to health insurance plans offered by Anthem Blue Cross in California for individuals, families, small groups, Medicare, Medi-Cal.
Comparing California Health Insurance Companies
The Department of Managed Health Care (DMHC), who regulates most of the individual and family plans offered through Covered California, has developed a website to allow consumers to compare health insurance companies. The Health Plan Dashboard website does not assign any performance review ratings. But it does give consumers a high level view of some of the data collect on the health plans such as enrollment, complaints, and enforcement actions for medical, dental, and vision plans.
Finding out if your hospital is in-network with your new health plan
The California individual and family plan market place will be changing quite a bit in 2017. Next to confirming if your favorite doctors are covered by the new health plans, many consumers want to make sure their chosen hospital is in-network as well. From information provided by Covered California and the health plans, I have put together a table of California hospitals by region and the health plans they accept.
Bay Area vacuum of health care providers
It is a reasonable expectation to assume that when a family enrolls in a health plan through Covered California that there will be local doctors to address their health care challenges. Unfortunately, some health plans have a virtual vacuum of providers in fairly large communities. This is the case for members of Anthem Blue Cross PPO individual and family plans in Livermore, California. For one family, the nearest in-network pediatrician is over 15 miles away from their Livermore home.
Aetna chooses welfare over work
The big headline in August was that Aetna would not be expanding their Obamacare individual and family plans in 2017. The smaller headline from a week earlier was that Aetna was seeking approval to become a Medi-Cal manage care health insurance provider in California. Just like other health insurance companies have found, welfare pays better than work when it comes to health insurance.
Comparing the cost of Short Term Medical plans
Short term medical plans are a less than perfect bridge for individuals and families in between credible minimal essential health insurance coverage. Even though short term medical plans can deny applicants for pre-existing conditions, charge more for being a female, and have caps on how much the plan will pay, they can be a solid backstop to ridiculous emergency room bills. The rates for short term medical plans will usually be in the neighborhood of a California Bronze individual and family PPO health plan.
Calculating the value of the maximum out of pocket amount for health insurance
All individual and family health insurance plans include a maximum out-of-pocket amount that is the most an individual will pay on in-network health care services for a calendar year. This is particularly important for sole proprietors and self-employed people as one emergency room visit can easily top $20,000, and without health insurance, can imperil the person’s business. The value of the maximum out-of-pocket benefit can be measured and compared between different metal level health plan tiers and carriers as one guide in selecting a health plan.
Native American health plans misrepresented on Covered California
American Indians and Native Alaskans have access to special $0 cost share health plans that are available through Covered California. A recent enrollment by a member of a federally recognized Indian tribe was offered four different Anthem Blue Cross PPO $0 cost share plan where each one had a different premium rate. This is odd since regardless of the metal tier level of the $0 cost share American Indian-Native Alaskan (AI-NA) health plan, they all have the same exact benefits: zero dollar cost share for all services.
Health Insurance companies tackle fraud and abuse with new verifications
Health insurance companies are deploying a variety of measures to reduce fraud and abuse such as only accepting paper applications or requiring proof of residency and identity.
Anthem Blue Cross Tiered PPO Hospital Coinsurance
In 2016 Anthem Blue Cross introduced their new Tiered PPO Network health plans in four counties of California. The Tiered PPO marketing literature noted the member’s cost share would be less if he or she used a Tier 1 hospital, but it didn’t indicate how much less expensive it would be.