Kevin Knauss: Health, History, Travel, Insurance
By banning all short term medical plans, California is punishing people who are not out to manipulate the system for their own benefit. All they wanted was a little assurance that if something really nasty happened, they wouldn’t have to declare bankruptcy. Now these families, who just forgot about the enrollment deadlines, will be subject to the wolves of the health care field.
Blue Shield individual and family plans also come with Teladoc for phone call consultations, NursesHelp 24/7 online chat, and the BlueCard program that allows member’s access to providers when they are travelling out-of-network. The plans also include a physician home visit. The home visit, Heal on-demand house calls, is subject to the member’s location. There is also Telebehavioral health benefit that helps members with mental or substance abuse challenges access therapy online with mental health professionals.
Proposed Covered California Fiscal Year 2018 - 2019 Budget.
But once you cross the border, some plans can be a little coy in whether they will cover any health care services. For both travel in the United States and abroad, you really need to study the health plan’s member agreement also referred to the Evidence of Coverage (EOC). The EOCs are those big documents that tell you have the plan works, what’s included, and what’s excluded. Some EOCs are specific about foreign travel coverage while others that I have studied make no mention of coverage outside the U.S.
The health plans don’t recognize the invoiced amount of the health care services from out-of-network providers as either accruing toward the deductible or for their cost-sharing of 50% before the maximum out-of-pocket amount is met. The health plans apply a Usual and Customary Rate (UCR) or the Allowable Amount. This limits their responsibility for payment and increases the health plan members costs.
Covered California plans from Anthem Blue Cross for 2018
Marketing Matter: Lessons from California to promote stability and lower costs in National and state individual insurance markets.
Covered California rate book for plans offered in the 19 different regions of the state by age for 2018
Map of Covered California health plans by region for 2018.
Covered California letter to HHS Secretary Tom Price informing him of the California increased Silver plan rates to cover any potential reduction in CSR payments from the federal government.
