Major changes have been implemented to lower health insurance costs for people purchasing their coverage through the Health Insurance Marketplace.  Under the American Rescue Plan of 2021, many Americans will become newly eligible for federal government subsidies applied toward monthly Insurance premiums.  This will trigger plans to be much less expensive for many people that have shopped for health insurance through the Marketplace in years past. 

Who is Eligible?

1. People with Higher Income:

Since the introduction of the ACA, individuals and families making over 400% of the Federal Poverty Level (FPL) did not qualify for a subsidy.  After April 1^st, 2021, many people making a higher income or over 400% of the FPL will be eligible for a subsidy.  This federal subsidy will help reduce the cost of the health insurance.  Many Americans will pay significantly lower monthly premiums for Individual market health plans.

2. People currently eligible for a Subsidy:

Many people who are already eligible and already receiving a subsidy will qualify for more subsidy.  Estimates indicate that most people will see health insurance costs decrease and some will pay as little as $0 per month with the new subsidies applied.  This group should see a significant change in the cost of plans.

When Can I Apply or Change My Plan?

The Federal Government has created a Special Enrollment Period which will allow health insurance shoppers to enroll in a plan now.  This Enrollment Period is currently set to end on Aug 15^th, 2021.  Once you apply, coverage can become effective as early as the 1^st of the month following when you apply.

You can View Plans and Apply Online here for a plan through the Health Insurance Marketplace.

Circumstances with COVID-19 have created unique challenges for managing individuals healthcare and health insurance needs.  Despite these unusual times, many tools have grown in popularity due to the lifestyle changes we are all experiencing.  Here are a few tools that are currently allowing many North Carolinian’s to manage their healthcare and health insurance needs despite these unprecedented times.

1. Virtual Doctors’ Appointments

Blue Cross and Blue Shield of North Carolina has taken steps to increase access the virtual (or telehealth) visits with doctors for current members.  As long as you are seeing an in-network physician, you can rest assured the visit will be covered under a Blue Cross of NC policy.  Learn more about these coverage’s.

Blue Cross NC has decided to waive cost sharing for all telehealth visits conducted through MDLive and/or Teladoc for 90 days, effective March 6, 2020 through June 4, 2020.  Stay tuned for updates as these dates are subject to change. You can also qualify to earn $25 in Blue Rewards just by registering with MDLive.

2. Blue Connect- Online Member Portal

Blue Connect is an online tool for existing Blue Cross NC members.  While the tool has been available for years, the appeal of Blue Connect has never been as obvious as it is today.  Blue Connect allows members to manage insurance policies online or through the Blue Connect app.  From the online portal, members can check the status of a claims, manage billing activity, change an address, search in network providers, and so much more.  The objective is to make managing and accessing your policy easier than ever and under the circumstances, the Blue Connect tool is proving its value.  If you are an existing Blue Cross NC member and have not created a Blue Connect account, now is the time to further explore this tool and it’s capabilities. The Blue Connect system is constantly being updated with enhancements to broaden capabilities and improve the user experience.

3. Online Shopping and Enrollment Tools with phone support

During times of uncertainty, the importance of adequate healthcare coverage continues to be top of mind.  The risk of expensive medical bills associated with a high level of care easily justifies the need for good medical coverage.  However, many North Carolinian’s are faced with loss of employer sponsored group coverage during these unfortunate times.  Our online tools will allow health insurance shoppers to view plans and quickly apply online for coverage under many of these difficult circumstances.  The loss of employer sponsored group coverage is considered a qualifying event and will allow an individual or family to enroll in health insurance coverage, as long as one applies within 60 days of the date of loss of group coverage. We have licensed benefit advisors that will walk you through the entire process when in this situation. Our team is very experienced with such situations and specialize in helping people understand their insurance options. You can reach our staff by calling (888)765-5400 to further discuss coverage needs.

For more information on North Carolina Health Insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

North Carolina’s largest Health Insurer has been working around the clock to provide guidance and information to members related to COVID-19 (Coronavirus) in recent weeks.  This rapidly developing outbreak has led Blue Cross to make frequent updates to this Blue Cross NC webpage.  The latest information from teams following the virus is being posted here throughout the day and updated as more information becomes available.  From the availability of video and phone doctor appointments to regulations and guidance from the CDC, this is a great resource for everything COVID-19. 

Other Helpful Resources

Other very helpful resources for combating the spread and breaking news on this virus is the government website for the Center For Disease Control and Prevention (CDC).  The CDC encourages educating Americans on preventive measure and aspects of the Coronavirus which will help in management of the outbreak.

North Carolina DHHS has also created a webpage that allows you to learn more about when and how to be tested in North Carolina should you feel any common symptoms.

Medicare Population Considerations

One group that may be at higher risk of complications from COVID-19 is the older population and people with underlying medical conditions.  Many within this group are on Medicare Advantage plans.  Under Federal Government regulations, a Medicare Advantage Open Enrollment Period is currently taking place and will end on March 31^st 2020.  This is a good time for existing Medicare Advantage members to give consideration to all Medicare plans as many have an opportunity to make changes to Medicare Advantage plans before the March 31^st deadline.

As information continues to develop, you can rest assured that we will make you aware of the information that will help protect the health and well-being of all North Carolinians.

For more information on North Carolina Health Insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

With the 2020 presidential election approaching, healthcare and health insurance are yet again popular topics of conversation.  The different opinions and visions of the health insurance landscape is often very distant from the realities we experience everyday in North Carolina.  The media attention that surrounds this dialog makes it more difficult to follow current changes to health insurance in North Carolina.  A couple recent changes have impacted the options for many North Carolinians.  Here, we will outline two recent changes and the details consumers should keep in mind now and moving forward.

3 Year Term- Short Term Plans

One such change is the implementation of 3 year policy periods on “Short Term Health Insurance Plans.”  An executive order was signed in 2018 making 3 year policy period Short Term Medical plans available, but the plans were not offered to North Carolina health insurance shoppers until recently.  The North Carolina Department of Insurance approved the these plans in the Spring of 2019.  The availability of Tri-Term Medical plans is significant in that longer policy period plans allow members to avoid the application process every 90 days.  The plans allow you to apply once for a coverage term of 3 years.  Prior to this option, enrolled members were forced to re-qualify by answering health underwriting questions each time the policy expired.  This meant the applicant would risk being denied the ability to re-enroll if unable to pass medical underwriting based on changes in medical conditions.  A 3 year policy period plan will minimize this risk since the applicant is not required to answer health eligibility questions as frequently.

The Short Term Health Insurance market has grown in North Carolina, particularly for consumers that do not qualify for a government subsidy.  The plans often provide non-subsidy shoppers a less expensive alternative to the ACA compliant plans.  The 3 year term plans will continue to strengthen the alternative options for this group of health insurance consumers.

Qualifying Life Event Tweaks

Ever since the introduction of the Affordable Care Act in 2014, consumers have needed a Qualifying Life Event to make changes to plans or apply for new plans when outside the Open Enrollment Period.  The specifics of these Qualifying Events have seemed to continuously change each year.  This year, most Qualifying Life Events now require the consumer to have also carried prior creditable coverage.  For example, a change in permanent residence address and a marriage are two qualifying events that now require the applicant to have carried prior coverage for at least one of the prior sixty days.

Additionally, existing members that are trying to make plan changes based on Qualifying Events must meet additional requirements in order to make changes to an existing plan.  These changes often come as a surprise to consumers that have experienced similar changes in the past and expected similar options to be available.

The healthcare discussion will only continue in the months ahead, but it’s important we don’t lose focus of the changes that are being implemented.  As insurance advisors, our commitment is to educating consumers and allowing them to make the best decisions within this ever changing market.  One way to do this is by understanding whether any of these market changes would affect you.

For more information on North Carolina Health Insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

Blue Cross Blue Shield of North Carolina announced on July 31^st the company has filed for an average rate decrease of 4.1% on Affordable Care Act individual health plans for 2019.  This will mark the first year North Carolina’s largest health insurance company has filed for a rate decrease on individual plans after several years of double digit increases since the implementation of the Affordable Care Act in 2014.

“We’re moving in the right direction, but even with a lower rate, premiums are still too high — particularly for those who don’t get a subsidy,” said Dr. Patrick Conway, Blue Cross Blue Shield of NC’s President and CEO.  “With more certainty from Washington, rates would be 15 percent or more lower. We must address both market instability and the rising price of health care.”

A number of factors contributed to this rate filing.  Brian Tajlili is BCBSNC’s Director of Actuarial and Pricing Services.  He references: the cost of providing medical services and prescription drugs for members, new provider arrangements that will reduce costs, the suspension of the federal Health Insurer Tax, and the elimination of the individual mandate penalty; as a few of these contributing factors.

Although the overall average rate will decrease on plans across the state of North Carolina, some counties will still see rate increases.  The counties that do see a rate increase will not incur increases over 10%.  Blue Cross will not release the exact rates for plans until closer to the start of Open Enrollment on November 1^st.

Other Changes to Blue Plans

Another of the most significant Blue Cross NC plans will take place in the Triangle and surrounding regions.  The Blue Local with Duke Health and Wake Med will be discontinued in 2019.  This plan currently covers approximately 50,000 members in 12 counties.  These members will be receiving notices in the coming months to help prepare for the transition to new plans.  Alternatives to the Blue Local with Duke and Wake Med will depend on which county the member resides in.

Transitional Plans will continue to be offered in 2019.  Transitional plans are plans purchased between March 2010 and October 2013.  These plans do not meet the ACA requirements and are only offered to existing customers.

More details on these changes and others will likely continue in the months ahead.  Blue Cross Blue Shield NC has filed for plans in all 100 counties of North Carolina for 2019 and continues to be the only insurer in North Carolina that offers Individual ACA health plans in all counties.

For more information on North Carolina insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.