With Open Enrollment just a few days away, and over 400,000 Texans losing their PPO plans, we’ve got some work to do!
Recently one of my clients who is losing her PPO plan asked me, “Tanya, what can I be doing to help prepare?” Wow! Talk about music to my ears! If only I could’ve hugged her through our virtual connection, I would have! But it made me think, it is without a doubt, homework time.
You see, the Affordable Care Act has changed EVERYTHING! This law dictates what and who insurance companies must cover. And that is just about everything, and everyone. Do this for a couple of years, and you might find yourself in trouble. You, in this case, is the insurance company.
If you missed my story about why one of the largest insurance companies in Texas is cancelling their individual PPO plans, you REALLY should read about it here.
Open Enrollment starts November 1st to shop for plans that begin January 1, 2016.
That’s not a whole lot of time to play the matching game. You know the game, the one where you draw the line from the insurance company to the individual/family? The plan with the right doctor/hospital choices, aka Network. Oh, and don’t forget “affordable”. Prepare to be frustrated, confused, and downright mad. But please remember, do NOT shoot the messenger.
Buyer Beware! This is where you need to pay very close attention. Just because something has a name brand, don’t go skipping up to that checkout line quite so fast. Think about that brand of jeans, made so well they last forever. But then something happens, a law maybe, that dictates how the jeans must be made, and the manufacturer can no longer afford those extra seams. The quality just took a nosedive. This, ladies and gentlemen, is what’s happening to our health insurance companies, networks, and overall choices for our Health Care. Take UnitedHealthcare for example, BlueCross BlueShield, Humana, Cigna, or Aetna, etc. All GREAT insurance companies. Strong name brands everyone knows. But when you dig deep into their networks, you may find only 30% of doctors and hospitals are there. And as hard as you look for YOUR doctor, chances are, you won’t find them. This is when you’ll want to cry.
So as we prepare for what is sure to be a stressful open enrollment season, I present to you, your homework:
- Talk to your doctor! I assure you they know BlueCross BlueShield of Texas is cancelling 400,000 Individual PPO plans. Ask them what they plan to do. Will they hop on the HMO wagon? (I know, you do not like those three letters, believe me.) Get a list of the networks they’ll participate in. Then share it with your broker.
- Make A Deal! Health Insurance is expensive. Many of you won’t be able to afford the plan that your doctor takes. This is where you negotiate. If you LOVE this doctor, pick a plan you can afford, and make a Deal With the Doc. I mean really, how often do you see them anyway? Then tell your broker what they said.
- Prescriptions! Do you REALLY need that brand name drug? Maybe it’s time to try a generic. Insurance companies pay a TON of money in prescription claims. Things are changing. You might need a new drug. (Don’t we all?)
- Work with an Expert! Health Insurance Brokers are professionals! You find one who cares, you’ve hit the jackpot. And don’t kid yourself, you need them more than you ever have before. And guess what? They get paid by the insurance company, so you save NOTHING by going it alone.
Healthcare Reform has brought on higher deductibles, narrowing networks, and limited out-of-network benefits. This is our new reality.
Get a super easy Obamacare, subsidized plan/quote here and avoid that website that is frustrating. Easy Button Right Here —-> https://www.healthsherpa.com/?_agent_id=tanya-boyd
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