4 Things You Need To Know! New Health Plan Info

It's almost here! The massive health care insurance changes we've discussed for so long are right on the doorstep and will be here before we know it. While some facets of the Patient Protection Act have been implemented, the real deal will come into existence January 1st of 2014, IF federal administrators can pull it off.

#1 - Open Enrollment

While the start date is happening in January, we will need to get to work in October to prepare for OPEN ENROLLMENT on October 1st. During this initial period, US citizens and other eligible participants will begin looking at their health insurance options (on the exchange and off) with plans that are ACA compliant. This first open enrollment period will actually extend through the end February 2014. In subsequent years, Open Enrollment will end in mid December.

During OPEN ENROLLMENT each person or family must obtain coverage if they don't already have it. These individuals and families will go through a process to determine if they are eligible for subsidies through "the exchange" and will examine plan options and costs. Whether on the exchange or not on the exchange, families will identify a plan they like and they will then apply for coverage.

#2 - Online Process

Almost 100% of all applications for coverage will occur through an online application process. You'll be able to apply directly from our website by obtaining a quote directly from our website.

Some people feel more comfortable doing an application on paper, unfortunately, those people will probably have the most trouble as paperwork will get lost, and the process will absolutely take longer. If you are a person that likes paper or face to face meetings, call us and we'll see how we can make this experience an easier one for you.

#3 - What Is The Difference? On Or Off Exchange

If you are not eligible for a subsidy, you can purchase coverage "on the exchange" or off the exchange, you have a choice. Since we don't know the pricing of the "on the exchange" plans, you'll need to wait a week or two until these plans and potential pricing are released.

If you are eligible for a subsidy, you are required to purchase coverage "on the exchange". You will be steered to purchase the "Silver Plan" of coverage in order to receive a subsidy. You will have the option to pay less by choosing the Bronze plan, but you have more out of pocket risk because deductibles are higher in bronze.

While all plans will offer the same health related benefits, the clearest difference you will see in regard to the plan differences will be in the size of the physician networks. Plans that are considered "ON THE EXCHANGE" WILL HAVE SMALLER DOCTOR NETWORKS. In California, Blue Cross Blue Shield's exchange network consists of about 35% of the doctors in their normal network.

#4 - Strategy - Act Now!

As we've mentioned several times, pricing for plans in the new year will be higher unless you are a person that has a pre-existing condition that has caused you to be declined or rated up. If you don't have a pre-existing condition that would cause you to be declined, it may make sense for you to apply for coverage now to attempt to lock in old plan rates before new adjustments become part of the plan pricing. This is one of those times where taking action early will be rewarded.

Get Answers And Take Action!

People are obviously thinking about the new healthcare laws as our web traffic and call volume are increasing daily. I continue to believe that the federal administrators will not be ready for the full individual roll out of this and there will be delays and issues. Even now, brokers and agents have not been allowed to finish the verification and certification process to be able to sell exchange plans! Can you imagine the other issues we are not even aware of? No matter what the issue or delay, Texas Health Design and our team are ready to assist you. If you have questions that need answers, please give us a call, we are happy to help you find answers and we'll even set an appointment to discuss your situation and walk you through the official application process in the coming months. (We already have 30 appointments for conference calls set for November with callers and web visitors that have contacted us over the summer!)

In our next article we'll document the information you need to actually determine eligibility for a subsidy as it can be complicated if your employer OR your spouse's employer offers coverage. We'll detail the items you'll need and get you set to get signed up quickly and without trouble.

Call us for a quote on existing plans today at 713-422-2935 or simply click on our Get A Quote page on www.texashealthdesign.com.

Jason W Bohmann
Texas Health Design