Top Nine Questions Around Open Enrollment

Top Nine Questions Around Open Enrollment

For many Americans, the ins-and-outs of finding individual health care coverage is complex and

difficult to understand.

Paired with the extensive amount of health care-related terminology, many health plan options, tax

penalties and sign-up procedures, signing up for health insurance is

no walk in the park.

Blue Cross Blue Shield of Michigan looks to ease the process, by

providing our members with as much information and assistance

as possible.

Here’s a list of the most frequently asked questions with the answers

you need.

1.I want to keep my

current plan, what do I need to do?

1.I want to keep my

current plan, what do I need to do?

If you want to keep your current plan with Blue Cross, you do not need to take additional action.

You will be automatically renewed with your current plan if you take no action. If you’d like to make changes to your current plan, our health plan advisors can help you learn more about other health plans that fit your needs and your budget.

2.I missed the deadline,

can I still enroll?

2.I missed the deadline,

can I still enroll?

If you missed the deadline for January 1 coverage, you have until January 31, 2016 to enroll in a health plan for coverage that begins in March 2016.

3.How do I know which plan is right for me?

3.How do I know which plan is right for me?

To determine what plan is right for you, think about how you’ve utilized health care in the past. Make a list of health care services you used in the last year, including any prescriptions you need filled on a regular basis.

3.How do I know which plan is right for me?

Do you or anyone in your family have a chronic condition or anticipate surgery in the coming year? Do you have a preferred doctor or hospital? How often do you see the doctor? Answering these types of questions will help you select the best plan for you.

4. I enrolled last year, why is my plan unavailable?

4.I enrolled last year, why is my plan unavailable?

Under the Affordable Care Act plans are measured by the government on coverage relative to the cost of the plan. This information is used to put plans into four categories – Bronze, Silver, Gold or Platinum. If a plan is determined too generous for its category then it is required to be adjusted or in some cases replaced.

5.If I change plans, can I

keep my current doctor?

5.If I change plans, can I

keep my current doctor?

Before changing networks, check with your preferred doctors to see if they accept the new plan you’re interested in.

Blue Cross’ “Find a Doctor” tool can help you determine if your new plan will allow you to continue to see your current doctors.

6.My plan has gotten more expensive. Why did the

prices go up?

6. My plan has gotten more expensive. Why did the

prices go up?

Under the Affordable Care Act, health insurance has become a consumer product available to purchase by individuals – like anything you buy at retail. Just as underlying costs, like raw materials and labor costs, add up to a vehicle’s sticker price, there are a variety of unseen costs driving the up the price people pay for health insurance. Things like the type of care you routinely receive, expensive specialty drugs, and visits to specialists are examples that contribute to increases in monthly premiums.

6. My plan has gotten more expensive. Why did the

prices go up?

If your health care premium increased, you have options. Explore other plans or contact your health plan directly to find one that better meets your financial and health needs. Remember financial help is available. Nearly 80% of Marketplace enrollees received financial assistance last year.

6. My plan has gotten more expensive. Why did the

prices go up?

If you don’t have coverage in 2016, you’ll pay a penalty of 2.5% of your yearly household income (HHI) or $695, whichever is higher. This is up from $325/2% of HHI for not having coverage in 2015.

7.How can I lower my health care costs?

7.How can I lower my health care costs?

A subsidy is a form of financial assistance that helps you pay for your individual health care plan. Think of it as a discount, not a loan. Last year, around 80 percent of individuals who enrolled in a Blue Cross plan received some form of a subsidy through the federal government.

7.How can I lower my health care costs?

There are two types of subsidies you may qualify for:

• The Advanced Premium Tax Credit (affects your premium) lowers your monthly health insurance payment

• The Cost Sharing Reduction (affects your copay) reduces the amount you pay out-of-pocket for services

7.How can I lower my health care costs?

Subsidies are based on income levels, and Blue Cross makes it easy for everyone to know if they qualify. Our subsidy estimator tool makes it simple to check your eligibility for 2016.

7.How can I lower my health care costs?

It’s important to note that if you qualify for Medicaid or Medicare, or if an employer offers coverage that meets the minimum essential coverage and affordability standards, you likely will not qualify for a subsidy.

7.How can I lower my health care costs?

Members can also lower their costs by choosing a higher deductible plan.

8.I received a tax credit

last year, do I need to do anything this year?

8.I received a tax credit

last year, do I need to do anything this year?

If you receive a subsidy, it’s important to re-determine your tax credit every year. Changes in marital status, income, having a child and where you live could increase, lower or eliminate the amount of subsides you qualify for, as well as which plans are available to you.

8.I received a tax credit

last year, do I need to do anything this year?

Even if your income stayed the same, the amount of financial assistance you’re eligible for may still increase or decrease based on the cost of plans offered in your area. If you don’t re-determine your subsidy, you may end up owing money at tax time.

9.Why didn’t I get a

subsidy this year when I’ve gotten one for the

past two years?

9.Why didn’t I get a

subsidy this year when I’ve gotten one for the

past two years?

There are a variety of factors – like household income and the cost of health plans in your region – that affect whether or not you qualify for a subsidy. If a person received a subsidy in 2014 but has not yet filed their federal income taxes for that year, they would stop receiving their subsidy until those taxes are filed.

If you still have questions regarding your plan, our health plan advisors are eager to help. Contact them at

888-899-4931, or go to bcbsm.com/myblue to learn more about plan

options.

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