Anthem Blue Cross started out as carrier with the largest enrollments in 2014 and 2015. They dropped to 26% market share in 2016. They dropped again 2017 down to 19%. Part of the drop, from my perspective, was related to the cost of the health plan versus their EPO network. People didn’t see the value of the smaller network and no out of network coverage relative to other alternatives. Then in 2018 Blue Cross pulled out of most of California. They offered plans only in region 1 (Northern California), region 7 (Santa Clara County) and region 10 (Central Valley counties). This dropped their market share down to 5%.
There are a variety of reasons why a household member needs to be removed from a family’s Covered California account. In some unfortunate instances a family member has died. Other times a young adult ages-off the plan or a spouse gains other coverage such as Medicare.
New for 2016 is a Blue Shield individual and family health plan that offers $7 primary care office visits. The new Blue Shield of California Silver Seven 3750 PPO also has $7 lab tests as well. The trade-off for the low $7 office visits and other health care services is $3,750 deductible and 30% coinsurance for services subject to the deductible.
Sometimes getting your health insurance company to cover necessary medical expenses is like playing a big game without knowing the rules. The large professional insurance companies know all the rules and the members are just learning how to play the game. But every game has a rule book and for health insurance it can be […]
With the announcement that Blue Shield of California may be dropping Sutter Health physicians and hospitals from their list of network providers in Northern California, Blue Shield members are wondering if their health plans are any good. For all the good of health care reform under the Affordable Care Act consumers are learning that doctors […]
There is little complete data on consumer experience or ratings of health plans offered through Covered California. The Office of Patient Advocate (OPA) released their latest report cards in early October, but even they are devoid of a complete consumer experience with California health plans in 2014. Covered California, who should be in the lead of producing consumer reports, hasn’t […]
Outside of open enrollment there will be few opportunities to switch health plans unless the individual or family has a qualifying event such as moving to a new region. In all cases, if you are making the change through your Covered California account, you’ll need to terminate participation in the current health plan, create a change report and then select a new health plan.
We can be fairly certain that the big push to enroll college students into new ACA health plans will result in a large portion of the students channeled into Medi-Cal plans. It is estimated that are 480,000 young adults age 19-29 that will be eligible for Medi-Cal2. If we assume a full-time student is able to work 20 hours per week, that monthly wage still puts them below the 138% of the federal poverty line ($15,865) and automatic Medi-Cal.