Anthem had their exchange broker roadshow yesterday and announced their brand new plans coming for 2014. The big differences? The drug formularies and doctor networks.
This has been a big concern for health insurance companies in deciding how to take on the increased medical risk and still keep insurance costs down. The best way to do it was to decrease the amount of contracts they issue to doctors and hospitals and change the medications they cover on the plans. They are gearing up to focus more on a patient-centered model where they require more referrals and a concentration of care centered around a general practice doctor.
If you wish to participate on the Nevada Exchange and purchase a plan that includes some advanced premium tax credits, expect to also receive a smaller choice of providers. Be sure to check with the plan's networks and know if that doctor you like will even be participating. Chances are your doctor won't know, so check with the provider directory. Just because they say they accept or are contracted with Anthem, Health Plan of Nevada, etc, doesn't mean they are contracted with your plan. Also, just because your drug was covered with that carrier on another plan, doesn't mean that drug will be covered on your plan either.
This is why it is so important for people to talk with a professional. They can make sure and verify everything and actually guide you according to the plans you actually need.
Thursday, September 26, 2013
Tuesday, September 10, 2013
Why I love Obamacare
These changes are really going to be affecting all of us. As an American citizen, I am a little afraid of what these major changes will do to our budgets and economy, but as a broker, it means great opportunity and will mean a great deal to me. Although I can only imagine that once the system is off the ground, the government will try and push brokers away by cutting payments to us, but I think in the mean time we will all be focusing on new innovative ways to make healthcare more accessible and provide solutions to the problems that arise that will keep us employed.
1. Guaranteed issue for everyone. I have an enormous opportunity as a broker to sign up as many people as I possibly can for health insurance. I no longer have to turn people away and when it comes to finding the right plan, it really comes down to which doctors do you want to see, what medications are you on and what is your budget? I really dislike spending hours with a client only to find out they were declined. I make no money that way, because my compensation is based upon the policies that are in force.
2. More confusion=More need for professionals who know what the heck they're doing. With additional laws and information available it will be very important for people to consult a professional. Those who purchase from a good friend who also delivers pizza on the side will probably find themselves dissatisfied and possibly in a world of hurt come tax season.
3. People actually are thinking about this stuff. For once we actually have demand for our services and products and people have a timeframe to make a decision- or accept a penalty. Insurance is always last on people's list. The whole goal of healthcare reform was to create increased demand in hopes to decrease prices. This might actually come to pass. The problem that we don't know about are the initial wave of super-spenders on the plans making it go the opposite direction.
4. New products. I used to be in the electronics industry and I loved every new year when new stuff came out. It is always exciting to see the new innovations and get up to speed on the new toys. This is like a new year of new toys for a health insurance broker!
1. Guaranteed issue for everyone. I have an enormous opportunity as a broker to sign up as many people as I possibly can for health insurance. I no longer have to turn people away and when it comes to finding the right plan, it really comes down to which doctors do you want to see, what medications are you on and what is your budget? I really dislike spending hours with a client only to find out they were declined. I make no money that way, because my compensation is based upon the policies that are in force.
2. More confusion=More need for professionals who know what the heck they're doing. With additional laws and information available it will be very important for people to consult a professional. Those who purchase from a good friend who also delivers pizza on the side will probably find themselves dissatisfied and possibly in a world of hurt come tax season.
3. People actually are thinking about this stuff. For once we actually have demand for our services and products and people have a timeframe to make a decision- or accept a penalty. Insurance is always last on people's list. The whole goal of healthcare reform was to create increased demand in hopes to decrease prices. This might actually come to pass. The problem that we don't know about are the initial wave of super-spenders on the plans making it go the opposite direction.
4. New products. I used to be in the electronics industry and I loved every new year when new stuff came out. It is always exciting to see the new innovations and get up to speed on the new toys. This is like a new year of new toys for a health insurance broker!
Thursday, September 5, 2013
New nexchange rates released!
The department of insurance released the final rates for the new plans starting January 1st. They have a tool that lets you calculate the cost of your health plan and even lists all of the plan names associated with the price. The only thing we are missing is what the plans actually cover. You can click here to access the tool.
I figured I would check and see how much I would be paying for my insurance and it is quite wonderful (sarcasm). I currently pay just under $400/mo for a family of 4. Calculating the price, I will be looking at about $950/mo next year. Isn't that super exciting?!
If my income is less than $94,000 a year and I am not offered affordable coverage through my employer, I can elect to purchase my health insurance through the Nevada Healthlink from me (the broker). If I do that I will be able to choose from a qualifying HMO plan and have the IRS give me some tax credits to help me afford that $950 premium, so that what I pay for my insurance doesn't exceed 9.5% of my income. For lower wage earners, that percentage is lower as well.
So take the time to look into the pricing and decide if today is the time to get a health plan or to wait until January.
I figured I would check and see how much I would be paying for my insurance and it is quite wonderful (sarcasm). I currently pay just under $400/mo for a family of 4. Calculating the price, I will be looking at about $950/mo next year. Isn't that super exciting?!
If my income is less than $94,000 a year and I am not offered affordable coverage through my employer, I can elect to purchase my health insurance through the Nevada Healthlink from me (the broker). If I do that I will be able to choose from a qualifying HMO plan and have the IRS give me some tax credits to help me afford that $950 premium, so that what I pay for my insurance doesn't exceed 9.5% of my income. For lower wage earners, that percentage is lower as well.
So take the time to look into the pricing and decide if today is the time to get a health plan or to wait until January.
Subscribe to:
Posts (Atom)