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Archive for the ‘Affordable Care Act (ACA)’ Category

The Essentials of Health Care

Friday, October 3rd, 2014

bigstockphoto_trust_4294608Webster’s Dictionary defines the word essential as “extremely important and necessary,” and Blue Cross Blue Shield of North Carolina couldn’t agree more.  Regardless of the coverage you choose, health care reform requires that qualified health plans include 10 essential health benefits that fall into the following categories that will help keep you and your family healthy and secure.

  • Ambulatory Services
  • Emergency Services
  • Hospitilization
  • Maternity and Newborn Care
  • Mental health and substance abuse services (including behavioral health)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive/wellness services and chronic disease management
  • Pediatric services, including dental and vision

BCBSNC understands that your health care matters and that these essential services are extremely important and necessary to your overall wellness and peace of mind.  With a variety of health care policies to meet your essential needs, Blue Cross Blue Shield of North Carolina is committed to offering quality health care that more than covers the basics.  To find a BCBSNC health plan you can trust with your essential care, click here.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.

 

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Go Blue – Avoid Paying Penalties

Monday, September 29th, 2014

GO BLUE – AVOID UPCOMING TAX PENALTIES

In 2014, the Affordable Care Act mandates that all taxpayers purchase health insurance or pay a tax penalty when reconciling taxes.  In addition, the penalty will increase every year until 2016.  Below is a list of the graduating tax penalty as outlined in the Affordable Care Act.

Taxes and BCBSNC

• 2014: a minimum of $95 per year or up to 1% of annual individual income (whichever is greater)

• 2015: a minimum of $325 per year or up to 2% of annual individual income (whichever is greater)

•2016: a minimum of $695 per year or up to 2.5% of annual individual income (whichever is greater)

To avoid having to pay these penalties, get your Blue Cross Blue Shield of North Carolina FREE RATE QUOTE today.  BCBSNC offers a variety of health insurance plans and premiums that will work for both you and your budget.  To find the plan that suits you best, click here.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.

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Who Qualifies for a Government Subsidy?

Monday, September 22nd, 2014

To help make health care more affordable, the federal government offers advance premium tax credits, or subsidies, to low-to middle-income individuals and families. Your subsidy is an advance premium tax credit and is applied directly to your premium. Government subsidies reduce the amount you pay for your insurance plan.

To be eligible for a subsidy, you must meet certain requirements.

  • Be between 100% and 400% of the federal poverty level (FPL).
  • Not eligible for public coverage, such as Medicaid, the Children’s Health Insurance Program,  Medicare or military coverage.
  • Not have access to insurance through an employer. An exception can be made if the employer’s plan doesn’t cover at least an average of 60% of covered benefits or if the employee’s share of the premium is more than 9.5% of his or her income.  Employers can tell you if their plans meet these criteria.

Subsidies can be used on any plan you choose except for grandfathered plans and catastrophic plans for those under 30. How much of a subsidy you qualify for is based on income and household size.

Our free BCBSNC Rate Quote offers a calculator to determine if a subsidy may be available to you.

      2013 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA   
Persons in family/household 100% Poverty guideline 250% Poverty guideline 400% Poverty guideline

1

$11,490 $28,735 $45,960

2

$15,510 $38,775

$62,040

3

$19,530 $48,825

$78,120

4

$23,550

$58,875

$94,200

5

$27,570

$68,925

$110,280

6

$31,590 $78,975

$126,360

7

$35,610 $89,025

$142,440

8

$39,630 $99,075

$158,520

For each additional person, add: $4,020 $10,050

$16,080

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents.Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.

 

 

 

 

 

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What Constitutes a Qualifying Life Event?

Monday, September 15th, 2014

bigstockphoto___155599Negotiating new terminology is one of the toughest parts to understanding all the recent changes in health care policies and procedures.  Terms like “open enrollment,” government subsidies,” and “qualifying life event (QLE)” can be confusing even to the most thorough students of health insurance and the Affordable Care Act.  When applying for health coverage, however, understanding these terms and how they can affect your health care options is an absolute imperative.

Under the Affordable Care Act, there are two different periods in which an individual may apply for health insurance.  The first is referred to as Open Enrollment and during this time any person may apply for health coverage.  During Special Enrollment, however, there are more restrictions and a person is required to have what is referred to as a Qualifying Life Event (QLE) in order to acquire health insurance.  If you do not have one of these Qualifying Life Events, you may not purchase health insurance during Special Enrollment and must wait until the Open Enrollment Period.  This is not a Blue Cross Blue Shield of North Carolina policy, but rather a policy of the federal government under the Affordable Care Act with which BCBSNC must comply.

Basically, a Qualifying Life Event is a specific circumstance that has altered your life—and there are strict guidelines to determine exactly what qualifies.  For example, a recent  marriage, divorce or birth of a child are all events that would make you eligible to enroll in health coverage during a Special Enrollment period, so long as you enroll within 60 days of that life altering event.  Losing previously held health insurance involuntarily is another example of a Qualifying Life Event, as is changing your permanent place of residence. If your income increases so that you are no longer eligible for Medicaid, you are also able to enroll in new coverage during a Special Enrollment Period.  Because the list of Qualifying Life Events is so varied, however, it is worth investigating whether you qualify to enroll during a Special Enrollment period.

Although the terminology can be confusing, it is important for you to understand what constitutes a Qualifying Life Event because it can have a huge impact on your ability to purchase health insurance.  In addition, the effective date of your coverage will depend on your QLE and the date of your application.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.

 

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The Cost of Being Uninsured

Tuesday, September 9th, 2014

bigstockphoto_colored_calculator_1756282Everyone knows you have to pay for health insurance, but did you know there is also a cost to being uninsured?  Under the Affordable Care Act there is a price to pay for not carrying health insurance. The penalty incurred for being uninsured is sometimes called the “individual responsibility payment” or the “individual mandate,” and the fine in 2014 is calculated one of two ways.  If you or your dependents do not have health insurance that qualifies as minimum essential coverage you will pay either 1% of your yearly household income or $95 per person, whichever is greater, for the year ($47.50 per child under 18).

Please note, however, that the penalty increases every year.  In 2015 it is 2% of income or $325 per person and in 2016 and later years it is 2.5% of income or $695 per person.  Also, it is important to remember that even if you pay the penalty, you still do not have health coverage and are responsible for 100% of your medical care.

The important thing to understand is that not only is health insurance a prudent decision for your life, it is also a wise choice for your wallet.  Blue Cross Blue Shield of North Carolina (BCBSNC) offers an array of affordable health plans  that not only save you from unwanted out of pocket medical expenses, it can also save you the cost of being uninsured.  For a complete definition of what qualifies as minimum essential coverage and a comprehensive look at how the tax penalty for being uninsured is calculated review the Affordable Care Act guidelines with IRS.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.

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Where Does My Health Insurance Premium Really Go?

Wednesday, April 23rd, 2014

Posted April 14, 2014 – Blue Cross Blue Shield- Health Care Reform Blogbigstockphoto_colored_calculator_1756282

By: James LaCorte

Where does my health insurance premium really go? Health insurance customers often ask a simple question about the premium they pay every month:

Where does my premium dollar go? They’re usually not asking for a quick tutorial on how insurance works: Most people understand that everyone pays into a pool, and only those who need medical care take money out in the form of health care claims. What many of these folks really are asking is how much of that money actually pays for health care and how much goes toward running an insurance company — or toward profits.  Fair question.  Blue Cross and Blue Shield of North Carolina (BCBSNC) paid $5 billion in claims in 2013. Recently we announced that we spent almost 86 cents of every premium dollar paying for our customers’ health care – doctor visits, surgery, tests, medicine, eyeglasses, etc.

Our non-medical spending largely goes toward customer service and technology. We are also a full-taxed company. In 2013, we paid out more than $100 million in local, state and federal taxes.

(more…)

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Do you Qualify for a Special Enrollment Period?

Monday, April 21st, 2014

Open enrollment for health insurance has ended; however you may still Questions and Answers signpostqualify for a special enrollment period due to a qualifying event.  Some examples of these qualifying events include:

  1. Marriage, having a baby, adopting a child or placing a child for adoption or foster care, moving outside your insurer’s coverage area, gaining citizenship, leaving incarceration.
  2. Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.
  3. For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions
  4.  Losing other health coverage—due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances. Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

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Blue Cross Blue Shield of NC FREE RATE QUOTE

Saturday, March 8th, 2014

bigstock--Free-Quote-blue-button-32217869Affordable Care Act Open Enrollment ends March 31. 2014.  You need to purchase your new health insurance policy before the Open Enrollment period ends, if you plan to purchase through the exchange, or face a penalty. GET YOUR FREE RATE QUOTE AND APPLY TODAY for Blue Cross Blue Shield of North Carolina.

You will not have the opportunity to enroll again until  the next Open Enrollment starting November 2014 for coverage that starts January 1st, 2015. That means you cannot wait for a medical need to enroll.

Blue Advantage plans are available in all metallic levels: bronze, silver, gold and platinum. The levels differ by how much of your medical costs a plan will pay on average. They are based on approximate values for standard medical expenses.  If you qualify for a subsidy through the Marketplace, it could significantly decrease the amount of your monthly premium for your Blue Cross coverage.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

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Preventive Care Outline

Sunday, February 23rd, 2014

bigstock-The-word-Health-surrounded-by--43388209The Affordable Care Act does a lot to boost access to preventive services and encourage consumers to use them. Health care reform also requires that many preventive services be provided at no cost to the consumer, such as colonoscopies and contraceptive and many more services.  Click on the link to view all services that is outlined by BCBSNC.

Regular preventive care can help you stay in better overall health.  Make sure you understand how your preventive care benefits work, and be sure to take advantage of them.

Preventive care services are generally covered at 100 percent of the allowed amount when they meet the following conditions:  The service is delivered by an in-network provider;  The service is performed in an in-network, office-based setting or   stand-alone clinic and filed as an office visit;  The service is received only once per benefit period, and the service does not include any additional procedures.  Get your Free Rate Quote today.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

Free Rate Quote and Apply Online

Tax Credits – Lower your Insurance Premium

Tuesday, February 18th, 2014

bigstock-Health-Coverage-Tax-Credit-30011972To help make health care more affordable, the federal government offers advance premium tax credits, or subsidies, to low-to middle-income individuals and families. Your subsidy is an advance premium tax credit and is applied directly to your premium. Subsidies reduce the monthly cost of an insurance plan. You do not have to pay the cost upfront and receive your tax credit later.

To be eligible for a subsidy, you must meet certain requirements.  Be between 100% and 400% of the federal poverty level (FPL). Not eligible for public coverage, such as Medicaid, the Children’s Health Insurance Program, Medicare or military coverage.  Not have access to insurance through an employer. An exception can be made if the employer’s plan doesn’t cover at least an average of 60% of covered benefits or if the employee’s share of the premium is more than 9.5% of his or her income. Employers can tell you if their plans meet these criteria.  Subsidies can be used on any plan you choose except for grandfathered plans and catastrophic plans for those under 30. How much of a subsidy you qualify for is based on income and household size.

Our FREE RATE QUOTE through Blue Cross Blue Shield of North Carolina offers a calculator to estimate your subsidy.  Just click on the blue calculator at the top of your rate quote and enter the income information.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

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Tax Credits and Cost-Sharing Reductions

Friday, February 14th, 2014

bigstockphoto_man_and_girl_writing_discount__5849701Getting your subsidy starts with a free rate quote.  When you generate your rate quote, you can estimate your subsidy and how it affects your premium.  To apply you simply press Get Started, in your quote, to begin your application.  Once you register, there will be a link you click on that will take you to the Marketplace to complete your subsidy and get the actual amount you qualify for.  You can enroll in your plan through the Marketplace and Blue Cross Blue Shield of North Carolina will send you a bill once healthcare.gov uploads your file to BCBSNC.

In addition to advance premium tax credits, the government also provides cost-sharing reductions (CSR) for those who qualify. Cost Sharing Reductions allows you to pay for a standard silver plan, but get richer benefits.  To be eligible for Cost Sharing Reductions your income must be between 100% and 250% of the federal poverty level (FPL).  CSR is only available on silver plans. These special CSR plans provide enhanced benefits that can mean your “silver” plan has the benefits of a plan with a higher metallic value.

Once at the Marketplace, you will need your Social Security number, employer and income information to register and complete your subsidy application.  You can apply online or you can call and complete your application by phone.   Then you will be automatically transferred back to BCBSNC to see your final subsidy and premium. Choose and buy your plan.  You can call our office 888-765-5400 to go over the plans, process and confirm deadline dates to enroll.

 

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

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BCBSNC to Offer Family Coverage for Same-Sex Couples and All Domestic Partners in ACA plans

Wednesday, February 12th, 2014
bigstockphoto_hand_shake_147012CHAPEL HILL, N.C. Brad Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina (BCBSNC), has issued the following statement about family coverage for married same-sex couples and domestic partners. “In order to ensure that our technology was ready for the Affordable Care Act, our company chose to postpone a number of product updates until 2015. One of these was to begin making family coverage available to same-sex married couples and domestic partners (same-sex or opposite-sex) in our ACA-approved plans.We should have more thoughtfully considered this decision, with full appreciation of the impact it would have on same-sex married couples and domestic partners. We’re sorry we failed to do so. Our employees have worked with the Centers for Medicare and Medicaid Services and the Department of Insurance over the past week to update our plans in order to make family coverage available sooner. Starting Monday, same-sex married couples and anyone in a domestic partnership may purchase new family coverage on or off the Exchange for an effective date of March 1.  Domestic partners and same-sex married couples who enrolled separately on ACA plans can convert them into family plans retroactive to their original effective date.
This information was Posted By: MEDIA STATEMENT
BCBSNC Online Newsroom: Jan. 29, 2014

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

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