It’s coming. You’ve heard about it; you’ve either worried about it, celebrated it, or a little of each… I am talking about the changes in health care (ObamaCare, as it’s been dubbed), health care open enrollment starts in just a week or so.
Anthem Blue Cross and Blue Shield and its Sister Plans make up one of the largest health benefits companies in the nation, and last week we had an online meeting with them about the upcoming changes to health care. I was so nervous about all of the changes before our chat, and honestly? I still am. I don’t think I will feel better about it until I see it in action and see that myself and my family are going to be ok and be paying the same amount as we are now (or less). The things that they told us in the seminar did make me feel a tiny bit more relaxed though.
Open Enrollment starts October 1st 2013 and it marks the start of health care reform, which passed in Washington a couple of years ago. This will be the start of a complete change in the way that we purchase health care coverage and access care.
Understanding the changes in health care
A good way to understand what is to come is to look at the intentions behind health care reform, which was to make sure that everyone has access to good health care at a reasonable cost. This is how they (the government) decided to tackle that issue.
- They tried to create a system where everyone can buy health insurance, regardless of whether they have a pre-existing condition, and women are charged no more than men.
- If you do not get insurance through your employer, you can get insurance through an online marketplace, or exchange.
- If you need and qualify for help paying for your coverage on the exchange, you can get help from the government through subsidies.
- If the government subsidies don’t give you the help that you need, you can get coverage through Medicaid.
Secondly, there will be certain benefits that will be included in your coverage no matter what. Things like emergency services, maternity and newborn care, pediatric services, mental health and substance use disorder services, along with preventative care and chronic disease management. Third, there is to be an incentive for people to buy health insurance with a tax penalty to people who choose not to buy the insurance coverage (who are not eligible for government coverage). The penalty tax will be 1% of your annual income, or $95 per person, $285 per family, whichever amount is greater. If you are currently insured through an employer, the vast majority of your plans shouldn’t really see any changes.
- What is the health insurance exchange?
A health insurance “exchange” is another word for “marketplace.” The health insurance exchange will be similar to Amazon, Expedia or Travelocity, but it is solely for health insurance options. Plans are going to be available to purchase on October 1st, 2013, with coverage beginning on January 1st, 2014. Each state will have its own exchange serving people who buy health insurance for just themselves and their families. Anthem Blue Cross Blue Shield really seems to want to help in this confusing time. They want you to know that:
Health insurance isn’t simple, but choosing the right plan should be.
Later this fall, Anthem Blue Cross Blue Shield will have online tools available to help individuals choose the right health plan:
Family Checklist- We are providing customers simple steps to help them select the right health plan.
Subsidy Estimator: We are working with members and consumers to help them navigate through their options, including subsidies for qualified individuals and tax credits for small employers.
Health Care Tiers
At Anthem Blue Cross Blue Shield, they are refining their networks, and negotiating the best rates that they can get for covered products and services and making more tools available to help members get better health management and out-of-pocket costs. Basically, there will be different tiers of coverage that you can choose from:
- Levels are based on the percentage the plan pays of the average overall cost of health benefits
- Each level may have a few plans to choose from.
- Bronze plans have the lowest monthly premium, but will cover 60% of expected costs (the purchaser will pay the remaining 40%)
- Platinum plans have the highest monthly premium, but will cover 90% of expected costs (leaving just 10% to the purchaser)
- The good news about ObamaCare
- The plan is to put the ‘primary’ back in primary care
- Your doctor will spend more time with you
- Doctors will coordinate all aspects of your medical care
- A strong foundation in primary care lies at the heart of our networks and products. Through patient-centered primary care initiatives, primary care physicians are offered incentives to spend more time with their patients, including focusing on preventive services.
- Primary care physicians will actively coordinate specialty referrals and total care for their patient populations.
More information about Health Care Reform
There is a new website (http://HealthCareReformForYou.com) that has information from Blue Cross Blue Shield for potential new members to educate you on reform laws, what the laws mean to you and the timelines for enrollments, etc.
You can also visit HealthCare.gov and Anthem.com for more information.
I was part of this campaign offered through The Motherhood. I received promotional items to thank me for sharing with my readers my honest opinions.