Kevin Knauss: Health, History, Travel, Insurance
Posts related to Blue Shield of California for individuals, families, small groups, Medicare, Medi-Cal, Covered California.
Six months into the new ACA health plan year and Blue Shield of California still has a broken billing system. Individuals and families who bought their 2014 health plans directly from Blue Shield and then had a change in the household members being covered are encountering issues with their invoices. Blue Shield has been unable […]
Thanks to the Affordable Care Act all individual and family plans now include coverage for maternity care. These new health services, many of which are provided at no cost to the patient, also extend to the new born. Prominent in many private health plans is coverage for routine infant circumcision.
To be honest, I was fully prepared to be dragged kicking and screaming out of the Blue Shield of California corporate offices in El Dorado Hills. Numerous phone calls and emails on behalf of a client who had made his monthly premiums like clockwork, only to have his health insurance cancel, resulted in hollow promises and no action by Blue Shield to resolve the billing and cancellation nightmare. My last hope to help restore the health insurance for my long distance truck driving client was to rattle the corporate cage of the carrier.
Solid information is hard to come by when it relates to what health insurance plans will cover for gender reassignment surgery in California. In response to the Insurance Gender Non-Discrimination Act passed by California in 2013, some health plans have created detailed medical policies for transgender health benefits. For a variety of reasons the health insurance companies don’t make their policies readily available to the general public. I was able to locate two detailed outlines issued by Blue Shield of California relating to gender reassignment surgery.
Blue Shield of California sent notices to their appointed insurance agents that the agent’s Social Security number had been displayed during the course of member’s online payment. The letter from Blue Shield, dated February 18, notifying agents of the breach to their private personal information does not mention how many agents had their Social Security number’s compromised. While I was not shocked to receive the letter informing me that my personal information was displayed, I was angry that Blue Shield let this happen.
Blue Shield has introduced a very competitive Medicare Advantage plan in ten select counties through out California. With the acquisition of GEMCare, Blue Shield will be able to more easily offer a version of their Blue Shield 65 Plus HMO plan in the GEMCare service area. While some Medicare Advantage plans seem to be reducing plan benefits and dropping counties, Blue Shield has been selectively increasing their MA-PD footprint in California.
One of the biggest questions I get is, “When will Covered California send me a bill for the health insurance?” Unfortunately, Covered California doesn’t invoice for the health insurance, that is left up to the insurance companies. If your application has been successfully transmitted to the insurance company you can make your first premium payment over the phone. Some applications have not, and may never, actually make it to your selected insurance company.
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
Blue Shield of California has agreed to allow upwards of 115,000 individual and family plan members to keep their existing policies through March 31, 2014. The press release from the office of Insurance Commissioner Jones indicated the agreement to allow the policy holders to keep their plans past the original December 31, 2013 cancellation date was the result of a late filing or notification requirement for plan closures on the part of Blue Shield.
Covered California released their small business health option plans (SHOP) for small employers and they might prove competitive for some companies with less than 50 employees. There will absolutely be small businesses that will not participate because they don’t want to support any government bureaucracy, even if it is to their benefit.
