Will Your Doctor be on your new Covered California Plan?

Question: Will doctors and hospitals who accept health insurance from companies like Blue Shield accept insurance sold by the health insurance exchange? I’ve heard that Cedars-Sinai, for example, will not accept coverage from Covered California.

Answer: You heard right, Lily.

Let’s say you currently buy health insurance on the open market. But you discover that you can get tax credits from the state’s new health insurance exchange, called Covered California. (For people whose incomes qualify, tax credits will lower the cost of premiums. To find out if that includes you, use Covered California’s rate calculator.)

And wouldn’t you know it, the same insurance company that covers you now also offers a plan on the exchange.

That means you’ll get to keep your doctor if you buy that Covered California plan. Right? RIGHT???

Not necessarily.

Many insurers are limiting the networks of doctors and hospitals that participate in their Covered California plans, meaning your doctor may not be included.

“You need to do your homework because the same doctor may or may not be there,” says Nicole Kasabian Evans of the California Association of Health Plans. “It depends by plan.”

Read more here: http://www.fresnobee.com/2013/10/03/3534005/not-all-doctors-and-hospitals.html#storylink=cpy

What’s New in Small Business Health Options Program (SHOP)?

Covered California has released the list of Health Insurance Companies that will participate in (SHOP).  Six players will provide HMO and PPO plans.  Premiums appears to be close to the 2013 rates.  If your company qualifies for discounts those will only be available by participation in (SHOP)

For more information please see http://www.californiahealthline.org/articles/2013/8/2/covered-california-posts-details-premium-rates-for-shop-plans.

Understanding the Affordable Care Act (ACA)

The way Americans receive health care will be changing starting in 2014.  With individual “Open Enrollment” just around the corner (October 1st  - December 15th) much confusion still exists.  The Kaiser Family Foundation released a new animated video to help people understand the health care system changes on the horizon.  “The You Toons Get Ready for Obamacare” explains the basic changes in the way American will get health coverage.  For help in navigating the new system and for questions regarding help with federal tax credits, contact your health professional

http://www.youtube.com/watch?v=JZkk6ueZt-U

New Health Exchanges May Mean Fewer Choices

Nearly half of all proposed health insurance exchange plans examined in a McKinsey & Co. analysis were health-maintenance organization (HMOs) or similar plans, and many others have networks that limit the choices of doctors and hospitals.  That could force some people to choose between switching doctors or paying out of pocket.

The Wall Street Journal (tiered subscription model) (8/14)