Covered CA Open Enrollment Period starts on November 1. Rumors have been confirmed that not only will premiums increase next year, but there will also be several changes in plans according to recently released information from health insurance companies.
Monthly premiums in California’s health insurance exchange will increase next year by more than 13% on average and 16.4% in San Gabriel Valley. The most preferred insurer Blue Shield will increase their premium by 20%, as mentioned by Covered CA officials.
The annual deductible in each level of plans will increase as well. For example, the deductible in Silver 70 will increase from $2,250 to $2,500; the out-of-pocket maximum will go up from $6,250 to $6,800.
However, there is some good news for people who are panicked for these changes. Some plans will offer much lower co-pays next year, such as Silver 70, who will reduce co-pays from $90 to $35.
In addition, the Federal Poverty Level (FPL) has a slight change as well. Although the minimum household income doesn’t change, the eligibility for Premium Assistance and Cost-Sharing Reduction has extended a little. If you wish to receive the same benefits as last year, you may have to adjust your income.
In 2017, insurers will offer a wider variety of plans. For example, Blue Shield used to only have PPO plans, but will now have HMO plans next year in order to provide a cheaper option.
Meanwhile, Anthem Blue Cross cancelled PPO plans for individual health plans and reactivated EPO plans instead. EPO is a plan in between HMO and PPO, which allows the insured to select any preferred doctors in the network only. There is no coverage for out-of-network providers.
When Anthem Blue Cross cancels their PPO plan, members in PPO plan will automatically be transferred to EPO plan. To prevent it from affecting your plan, you may want to confirm with your insurers to check if your preferred physicians are still in the network.
The biggest change to the PPO plan is that you must select a preferred physician in both PPO and EPO plans. Those insured with a PPO plan still don’t need referrals from their physician to see a specialist.
In regards to the premium increase, KCAL Insurance suggests adjusting your health plan based on your medical history in the previous year. If you rarely visit doctors, you may consider switching to a Bronze plan. By doing so, when accidents occur or any emergencies that require treatment that might result in a huge medical bill, there will be something to back you up.
If you have certain medical needs but wish to spend less, you may consider plans in a smaller network such as HMO. You just have to confirm that your selected physician is in the network.
Before choosing or switching health plans, you should consult with a Covered CA certified agent, just in case you choose a plan that you might regret in the next year, because you won’t be able to make any changes until the next enrollment period.