Tag Archives: under 65

BCBS PPO ACA

BCBS of TX PPO Members

Urgent ALL BCBS of TX PPO Members must read the following notification just released by BCBS of Texas.  This Notice affects all members who have an ACA (Affordable Care Act) PPO plan with Blue Cross Blue Shield of Texas.

As of December 31, 2015, BCBS of TX will no longer be offering their PPO insurance plans for the individual under 65 block of business going forward.  This means if you currently have one of the new ACA plans purchased after Jan 1, 2014, and it is a PPO, it will no longer be offered for 2016.   This means you must change plans for 2016!

According to BCBSTX, they have filed a new product that should give members a flexible choice.  Bottom line, their PPO network for new ACA plans is going away.  The 2016 plans are currently not available, but as soon as they are released, we will be contacting you.  You can count on us to make sure you see all options available to you, from All Insurers and that we will make this transition as smooth as possible for you.

According to BCBSTX, the reason for this is because for the past 2 years, they have been the only insurer offering individual PPO plans in all TX markets and due to anti-selection, they find the PPO product is unsustainable at an affordable price.  The will continue to offer other plan options in all 254 counties, on and off the Marketplace.

There are about 367,000 members who will have their PPO plan discontinued in 2016.  If this is you, click here.

There are about 148,000 members who are in a Grandfathered PPO plan who WILL NOT have their plan discontinued and will be able to continue to use the Blue Choice PPO network.

This does not affect Employer Group customers or Medicare members.

The Blue Advantage HMO Network will remain and BCBSTX is working to expand the number of providers in that Network.

According to BCBSTX, they paid out $400 million more in claims than it collected in premiums in 2014. Losses that high are unsustainable, and they must adjust offerings, as most of the other insurers have done also, in order to be sustainable in the new market reality.

As a Broker, who represents all the major Health Insurers, we are seeing many changes taking place in this entire market, which can have major effects on many consumers!  According to different Insurance News publications, it appears that Aetna is in the process of acquiring Humana and Anthem in the process of acquiring Cigna.  Acquisitions like this, mean less Insurers in the market, less competition, thereby creating less choices for our customers.  We realize this is not good for anyone, but we will help you find the best products that are available in the market.

Remember…A Broker works for YOU….not the Insurance Company!  It is ultimately our ONLY goal to make sure you have the plan that fits your needs best.  There are more things to take into consideration when choosing a plan, other than just the cost.  Many people found this out this year!

You will never pay more for your premium by working with a Broker, than you do by going direct with the Insurance company or by going direct to the Marketplace.

To shop for 2016 plans now, click here.

 

Medigap Continues to Grow

Recent studies shoe that Medicare Supplement, or Medigap, policies continue to grow in popularity. With over 10.5 million people enrolled in Medigap as of 12-31-2013, that represents a 3.8% growth over the previous year. People are also overwhelmingly satisfied with their Medigap coverage. 94% are satisfied with their coverage, 95% consider it a good value, and more than 9 out of 10 would recommend Medigap to their friends and family. You just don’t see that level of satisfaction with under 65 Health InsurancePlan F continues to be the most popular choice, with 52% of plans purchased. Plan G, our pick for best value, and Plan N are growing in market share. One of the only complaints a person can have with Medigap is the price. While rates do go up, you are always able to change to a new Medigap policy at any time. Medigap policies are not subject to the lock in period that Medicare Advantage has. If you are turning 65, or new to Medicare, give us a call at 877-740-8683, and we will help you find the best rate. If you have a current plan, and would like to make sure you have the lowest price, you can also call, or visit www.emedigap411.com , for a free personalized price comparison.

Medicare Disability-Turning 65

We recently wrote about Medigap Policies for people on Medicare Disability. While some states have under 65 requirements, it is important to remember that each person, regardless of where they live, will have a new Open Enrollment Period the first month that they are both 65 and older, and on Medicare Part B. For people that were unable to get a Medicare Supplement when they were on Medicare Disability, this is a unique opportunity. Perhaps even more important, is the chance for people that had a Medigap Policy under 65 to get a fresh start. When people are fortunate enough to have a Medigap Policy while they are on Disability, the premiums are generally much higher than they would be for someone over age 65, and the plan choices are often limited to Plan A only. While the Plan A can be a good value for many people on Medicare Disability, a Plan F or Plan G provides many more benefits.  We were recently able to help one of our current Plan A customers obtain a Plan G, when they turned 65. While their Plan A policy had gone down in price at their 65th birthday, they were able to get the much better Plan G, for about the same price, without having to answer any Health Questions. If you or someone you know has been on Medicare Disability, please call 877-740-8683, or visit www.freedomfreequote.com , for more information on this important time period.

Medicare Disability Medigap Policy

Many people who are under 65 and on Medicare Disability are unaware that they could be eligible for a Medicare Supplement, or Medigap, policy. That has meant that a lot of people on Medicare Disability have thought their only option was a Medicare Advantage Plan. While not all states have requirements that Insurers offer under 65 Medicare Supplements, if your state has these requirements, it can be a great option. The people we have found that benefit the most from having an under 65 Medigap policy are those that have higher out-patient costs. Even a Plan A Medigap policy(which is often the only choice under 65) will pay the 20% Part B co-insurance. This can be a life saver for people that have high Part B drug costs. It is also important to know that if your state does have under 65 requirements, you have many of the same Medigap protections, such as Open Enrollment within 6 months of Part B effective date, Guaranteed Issue if your plan terminates, etc. To find out if your state has under 65 requirements, and find the best price in your area, call 877-740-8683, or visit www.emedigap411.com