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.
The limitations to the BlueCard program for 2019 on PPO plans means the out-of-area health care services are no different than Blue Shield’s Trio HMO plan for individuals and families. Unless the health care services are for emergency or urgent care they won’t be covered unless the member has prior authorization from Blue Shield of California.
The big change for the Gold plan was an increase in the MOOP from $6,000 in 2018 to $7,200 in 2018. That is a 16% increase. Before 2018, the Gold plans did not make a lot of financial sense considering they were so much more expensive than Silver plans. In 2018 the Gold plan MOOP was reduced to $6,000 and the Silver plans offered through Covered California were artificially inflated by approximately 10%. This meant for consumers receiving very little monthly tax credit subsidy, they were better off enrolling in a Gold plan because for some carriers the rate was less than the Silver plan.
Short-term, limited-duration insurance, which is not required to comply with federal market requirements governing individual health insurance coverage, can provide coverage for people transitioning between different coverage options, such as an individual who is between jobs, or a student taking time off from school, as well as for middle-class families without access to subsidized ACA plans.
So when an intelligent person calls me and wants my assistance with an insurance transaction that will benefit them greatly at the expense of all my other clients who faithfully make their premium payments every month, with no claims for years, I get an uneasy twinge in my gut. I am not a cheerleader for the health insurance companies. But at the same time I see no reason for me to facilitate an enrollment that will only add additional costs to the system when that client jumps out of the pool.
The big question is how do all these dental tools included in the dental plan help reduce the premiums. The tooth brushes wirelessly connect to a Beam application on the member’s smart phone. Yes, your toothbrush will use Bluetooth technology – isn’t that ironic – to log your household’s brushing frequency. All the frequencies from all the members in the group are then aggregated to provide a score. If the score is high enough, any future rate increase on the renewal date of the dental plan is reduced.
Today, the Centers for Medicare & Medicaid Services (CMS) issued the HHS Notice of Benefit and Payment Parameters for 2019. The final rule will mitigate the harmful impacts of Obamacare and empower states to regulate their insurance market. The rule will do this by advancing the Administration’s goals to increase state flexibility, improve affordability, strengthen program integrity, empower consumers, promote stability, and reduce unnecessary regulatory burdens imposed by the Patient Protection and Affordable Care Act.
So how is getting a quote from me different from other agents? First, I don’t sell my client’s information to anyone. When I give you a quote, no one else will call you, probably not even me. I figure if you have questions, you will contact me when you have a chance. Second, I don’t hound people because that is not the way I want to be treated. Finally, I’m not going to try and up-sell you on more expensive of ancillary products.
The question no one can answer for me is if the expanded Medi-Cal HMO capitation rates have been decreasing because there are more healthy people in the Medi-Cal pool? Or are there other factors that are driving down the rates. There must be good money in Medi-Cal as Aetna, Blue Shield, and United Healthcare have all been approved to offer Medi-Cal HMO plans alongside other private health insurance companies such as Anthem Blue Cross, Health Net, Kaiser, and Molina.
In direct response to President Trump’s October 2017 Executive Order, the Departments of Health and Human Services (HHS), Labor, and the Treasury (the Departments) issued a proposed rule today that is intended to increase competition, choice, and access to lower-cost healthcare options for Americans. The rule proposes to expand the availability of short-term, limited-duration health insurance by allowing consumers to buy plans providing coverage for any period of less than 12 months, rather than the current maximum period of less than three months.