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Archive for the ‘BCBSNC Insurance’ Category

North Carolina HMO vs PPO Health Insurance Plans : What’s the Difference?

Monday, April 8th, 2019

When it comes to choosing a Health Insurance Plan, it is great to have options. However, having options in the Health Insurance market can quickly become overwhelming. Two types of health plans that shoppers often find themselves choosing between are HMO and PPO Plans. One of our most commonly asked questions from Health Plan shoppers is: “What is the difference between a HMO vs PPO plan?” There are many terms that are used to describe these types of health plans, and understanding them is key when determining which plan is right for you.

Health Maintenance Organization (HMOs)

The term HMO stands for Health Maintenance Organization. HMOs are regarded as a managed health care system, which provide prepaid medical services with little out of pocket expense. With an HMO plan, the subscriber will be required to see a Primary Care Physician (PCP) that is in network with their HMO plan. These plans have networks of medical providers, and subscribers must seek treatment from these providers. There are no out of network benefits under an HMO plan. Some HMO plans may also require your Primary Care Physician give you a referral in order to see a specialist. Because these types of plans have more restrictive networks, subscribers will generally have lower premiums and low deductibles under these plans.

Preferred Provider Organizations (PPOs)

The term PPO stands for Preferred Provider Organization. These plans are an arrangement under which a group of independent doctors and hospitals become preferred providers in an area. PPO plans offer more flexibility and choices when it comes to choosing your doctor or hospital. Like HMOs, PPOs also have a network of providers. However, there are fewer restrictions on seeing providers who are not in network. Under a PPO plan, you will also usually have the benefit of seeing a specialist without a referral from your Primary Care Physician. Because PPO plans are more flexible, premiums tend to be higher, and it is common to have a deductible.

Point of Service (POSs)

Point of Service Plans (POS) are a hybrid plan that combine features of PPO and HMO plans. These plans are designed so the member can choose (at the point of service) which part of the plan they would like to utilize. If the subscriber stays in network with this plan, they will have HMO benefits. If the member sees an out of network provider, they will be responsible for the out of network rates. Blue Cross Blue Shield of North Carolina offers a variety of Point of Service health plans. CLICK HERE to generate a custom quote and discover your plan options.

What do these plans have in common?

HMO’s, PPO’s and POS plans all have provider networks. A network refers to the list of doctors, hospitals, labs, and other providers that are contracted with the health plan. The difference in these plans network options is the size of the network, and whether or not the plan offers out of network benefits. Each of these types of plans also offer coverage for emergency services both in and out of network.

At NC Health Plans, we understand that making decisions within the Health Insurance market can be confusing. Blue Cross Blue Shield of North Carolina offers a variety of health plans for both under 65 and Medicare shoppers. Give us a call to speak with one of our professional agents and discover what health plan will work best for you or your family.

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.

All You Need to Know About Blue Cross NC Medicare Supplement Plan G

Tuesday, March 19th, 2019

For many years, Medicare Supplement Plan F has been the most popular Medicare Supplement plan. However, many Medicare beneficiaries are now choosing Plan G. Plan G has increasingly become the more popular Supplement plan as Plan F will no longer be offered in 2020 due to the Medicare Access and CHIP Reauthorization Act of 2015.  In many scenarios, Plan G can offer significant yearly savings with very rich benefits.

What is the difference between Plan F and Plan G?

Medicare Supplement Plan G is nearly identical to Plan F except for one difference-the Part B deductible. The Part B deductible in 2019 is $185. The Plan G does not provide coverage for this deductible which means the member would be responsible for paying the Part B deductible ($185 in 2019) out of pocket when incurring Medical expenses for things like doctor’s office visits.  Once the Part B deductible is met, the Plan G pays exactly the same benefits as the Plan F.

Will I save money with Plan G?

Lower premiums are a primary reason why many Medicare beneficiaries are choosing Plan G. In recent years, the monthly premiums for Plan G have been significantly less than Plan F premiums. Plan G has also incurred lower rate increases in recent years.

What does Medicare Plan G pay for?

Medicare supplement Plan G will pay for your hospital deductible as well as other copays and coinsurance under Medicare.

What does Medicare Plan G not pay for?

Medicare Supplement Plan G does not pay for the Part B Deductible.  It also does not include any prescription drug coverage like most other Medicare Supplement plans.  Most Medicare Supplement beneficiaries also enroll in standalone Part D prescription plans for drug coverage.

Is plan G the most popular Medicare supplement?

In recent years, the Blue Cross NC Plan G has become the most popular Medicare Supplement.  Due to Plan F being discontinued for new enrollees in 2020, most insurance companies have strategically made the Plan G a more competitively priced and more attractive plan.

Why should I choose plan G?

Once Plan F is discontinued in 2020, Plan G is going to offer you the greatest benefits under any of the Medicare Supplement plans. Plan G is the most popular Medicare plan because of its wide range of coverage and minimal out of pocket exposure, while offering lower monthly premiums when compared to Plan F.

If you are turning 65 or considering switching your Medicare Supplement plan this year, give us a call and speak with one of our professional Medicare specialists. We are happy to discuss how Medicare Plan G will benefit you, and assist you through the application process. CLICK HERE to request a personal Medicare Supplement quote and discover your Medicare Supplement plan options.

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.

Kennon Wainwright Recognized as Top BCBS Medicare Agent in North Carolina

Wednesday, January 30th, 2019

At NC Health Plans, we strive to assist our customers with their Health Insurance needs throughout every phase of life. One of our top priorities is aiding those in the Medicare, over 65 market and helping this group of North Carolinians understand their options within Medicare. We are very proud to announce that our agency manager, Kennon Wainwright, has now ranked two years straight within the top Blue Cross Blue Shield of North Carolina Medicare Advisors. In 2018, Kennon ranked Number 2 in the state of North Carolina for top performance in assisting Medicare Supplement customers.  He also ranked Number 4 in the state for Medicare Advantage. He is now a member of the Exclusive Century Club, due to his top sales and services to Medicare Beneficiaries. Kennon is honored to serve so many North Carolinians as they make these important Medicare decisions. He quickly recognizes this opportunity would not be possible without the support of the NC Health Plans team and the strength of Blue Cross Blue Shield NC products and brand.

If you have not previously helped a parent or spouse with Medicare, then this topic can often be very foreign. We recognize the importance of understanding your transition into Medicare, and meeting your health care needs. We also understand that with so much information to read online, navigating the Medicare market can be overwhelming. Speaking directly with one of our professionals, like Kennon, can make this confusing topic easier to understand. It is important to learn how each part of Medicare will affect you, and discover which plans will meet your needs as you make this transition.

If you are turning 65 or transitioning to Medicare, we would be happy to help you through this process. Give us a call to discuss your BCBSNC Medicare plan options. To get started on this process, CLICK HERE to generate a custom Blue Cross NC Medicare quote.

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.

NC Health Plans Designated to 2019 Marketplace Elite Plus Circle of Champions

Friday, January 11th, 2019

At NC Health Plans, we want wish you a very Happy New Year. We hope that 2019 brings you health and happiness! As the New Year begins, we would like to proudly announce that we have been designated to the Health Insurance Marketplace Elite Plus Circle of Champions for enrolling 500+ North Carolinians in coverage beginning January 2019. This is the highest achievement attainable for helping customers enroll in affordable health insurance through the Marketplace and we look forward to assisting more North Carolinians as we move into the Special Enrollment Period for 2019.

The health insurance Marketplace, or healthcare.gov is where individuals and families can apply for government subsidies to assist with the cost of health insurance. Subsidies can greatly reduce the cost of health insurance for those who qualify based on their yearly income. Now that we are outside of Open Enrollment for 2019, Special Enrollment Period has begun. You can still apply for Qualified Health Insurance if you have a qualifying life event. The most common Qualifying Life Events include losing coverage, getting married, having a child, or moving. Generate a quote to discover if you may be eligible for a subsidy during Special Enrollment Period.

Navigating the Health Insurance market can be confusing, and we are happy to assist you with every step of the way. We take pride in helping fellow North Carolinians apply for affordable health care through Blue Cross Blue Shield of North Carolina. Thank you for a great year, and we hope to continue serving many of you in 2019.

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.

NC Health Plans Designated to Marketplace Elite Circle of Champions

Monday, October 29th, 2018

NC Health Plans is proud to announce that we have been included in the Health Insurance Marketplace Elite Circle of Champions. This means that we have been designated the top achievement award for helping North Carolina residents enroll in Marketplace coverage through Healthcare.gov. Now that Health Insurance Open Enrollment Period for 2019 has arrived, we are ready to assist more North Carolinians in applying for affordable Qualified Health Care!

Healthcare.gov, also known as the Health Insurance Marketplace, is the avenue that individuals go through to apply for government subsidies to be applied towards their Health Insurance premiums. Subsidies are designed to lower the cost of health insurance for low and middle income individuals or families. These government applications can often be overwhelming and confusing, and we are happy to help you through this process. Our website provides consolidated Health Insurance applications, and we can help you apply for your subsidy right over the phone. CLICK HERE to generate a quote and discover if you are eligible for a subsidy.

We are proud to be recognized as a top leader and guide in helping individuals apply for affordable Health Insurance through Blue Cross Blue Shield of North Carolina and we look forward to helping North Carolinians in the upcoming 2019 Open Enrollment Period, which starts November 1st and ends December 15, 2018.

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.

BCBSNC Mapping Blue Local w/ Duke Customers to New Health Plans in 2019

Tuesday, October 23rd, 2018

As Health Insurance Open Enrollment Period approaches on November 1st, it is important to be aware of any changes to your current plan. Blue Cross Blue Shield of NC has announced that they will no longer be offering the Blue Local with Duke Health and WakeMed plan starting January 1st, 2019. If you are currently enrolled in this plan, you will be mapped to either Blue Value with UNC Health Alliance or Blue Advantage depending on where you live. At NC Health Plans, we understand a change in your plan can be overwhelming and frustrating. However, we are here to help you navigate these changes for the upcoming year. If you are living in the Raleigh/Durham or Henderson regions and are currently on the Blue Local with Duke Health and WakeMed health plan, read below to learn more about your plan changes for 2019.

Raleigh/Durham Region

If you live in the Raleigh and Durham region, your new plan will automatically change to Blue Value with UNC Health Alliance in 2019. The most significant difference between your current plan and 2019 health plans will be the provider network. Duke Health and WakeMed are not in network with Blue Value with UNC Health Alliance. Therefore, if you visit a Duke or WakeMed doctor starting January 1st, you will pay out-of-network rates. However, UNC Health Alliance is partnered with top-rate physicians, practices and hospitals across 700 locations.

Henderson Region

Individuals living in Granville and Vance counties who are currently on Blue Local with Duke Health and WakeMed will be mapped to the Blue Advantage plan for 2019. The BCBSNC Blue Advantage Plan has the widest network of doctors and specialists. This includes Duke Health and WakeMed. With this new plan, you will have more in-network options to choose from.

What’s next?

Open Enrollment for Health Insurance will begin on November 1st and last through December 15, 2018. This is the time of year where you are able to make any changes to your current health insurance plan. If you would like to learn more about your BCBSNC Health Plan options, CLICK HERE to generate your custom health insurance quote. We would be happy to discuss your quote with 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.

2019 Open Enrollment for NC Health Insurance

Thursday, October 4th, 2018

Mark your calendars! The Health Insurance Open Enrollment Period for 2019 is rapidly approaching and at NC Health Plans, we are gearing up to assist individuals and families in applying for Blue Cross Blue Shield of North Carolina Health Coverage for 2019. November 1st to December 15th marks a very important time period for health insurance known as the annual Open Enrollment Period. We know that navigating the insurance market can be overwhelming, and we are here to help! As we approach Open Enrollment, it is important to be aware of important dates and information about your 2019 health coverage. Read below to learn more about Open Enrollment Period for 2019.

When is Open Enrollment for 2019?

The NC Health Insurance annual Open Enrollment Period begins on Thursday, November 1st and lasts through Saturday, December 15th. This time period does not apply to non ACA-compliant plans, or ancillary plans such as dental or vision.

When Will Your Coverage Start?

If you enroll in a BCBSNC Health Insurance plan during Open Enrollment, your coverage start date will be January 1st, 2019. This will also be your initial premium due date.

Applying is Easy!

The annual Open Enrollment Period for Health Insurance is the easiest time of year to enroll in an Affordable Care Act-Compliant plan, also known as “Obamacare”. ACA-compliant plans are required to cover the same set of essential health benefits under the Affordable Care Act laws. Blue Cross Blue Shield of North Carolina offers the broad majority of these plans across the entire state.

During this time period, anyone shopping for individual or family Health Insurance plans can enroll in ACA-Compliant Health Insurance without having a Qualifying Life Event. In other words, individuals do not need a special reason to apply for health coverage during Open Enrollment. To get started on your application, generate a BCBSNC Health Insurance quote!

Is it Affordable?
One of the amenities of the Affordable Care Act is federal tax credits, also known as subsidies. Subsidies are designed to lower the cost of health insurance for low and middle income individuals or families. Subsidies are primarily based on your household income per the number of people on your tax return. To determine if you are eligible for subsidy to help reduce your premium, you can generate a quote and estimate your subsidy.

For those who are not subsidy eligible, Short Term health insurance could potentially be a more affordable option. While these plans are not ACA-compliant, Short Term plans are now offered for up to 360 days of coverage while also offering an additional rider, Health Protector Guard, that will also enhance your benefits. For more information about these plans, generate your Short Term Insurance Quote.

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.

Happy Labor Day from NC Healthplans

Saturday, September 1st, 2018

NC Health Plans would like to wish you a happy, safe and enjoyable holiday weekend.  Labor Day, the first Monday in September, is a creation of the labor movement and is dedicated to the social and economic achievements of American workers. It constitutes a yearly national tribute to the contributions workers have made to the strength, prosperity, and well-being of our country.

Since Americans have many definitions of work based on many different experiences, a day set aside to honor their work reflects those differences. Marching in a parade, going swimming, visiting friends, having a cookout, Americans honor the essence of Labor Day simply, by taking the day off.

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.

Five Reasons to Talk with an NC Health Insurance Agent

Friday, August 24th, 2018

Navigating the insurance market as a first-time buyer can be overwhelming. Customers often call us lost and confused after they have attempted to understand the process of applying for health insurance, especially if it is their first attempt doing so. At NC Health Plans/Jerry Ballard & Associates Inc., we know that this process can seem daunting and stressful, but we are here to help! Our professional agents are not only helpful guides to choosing your best plan, but are also here to assist you with the entire application process. Lastly, they can provide you with important information regarding the details of your coverage. Here are five reasons why you should talk with an agent when applying for NC health insurance:

Find Out When You Can Apply:  An agent will be able to determine the time frame in which you are able to apply for insurance. These times frames include Open Enrollment Period and Special Enrollment Period. During the Special Enrollment Period, you must have had a Qualifying Life Event occur within the last 60 days to enroll in an ACA-compliant plan. Talking with our agents can verify that you meet the requirements to enroll during special enrollment.

Determine Your Eligibility for Savings: Federal tax credits, also known as subsidies, are an amenity of the Affordable Care Act that are designed to lower the cost of health coverage. Talking with an agent can help determine if you are subsidy-eligible and meet the requirements set by the federal government. GENERATE YOUR QUOTE to determine if you are eligible for a subsidy, that could significantly reduce your monthly premium!

Get Help when Applying Online: Applying for coverage through the Health Insurance Marketplace can be tricky. Having an agent help you submit your application can avoid confusion during this process and ensure that your application is complete and submitted correctly. Our agents can help you submit your application right over the phone, it could take as little as 15-20 minutes!

Gain Knowledge About Your Coverage: Not only can agents provide insight about your plan’s benefits, they can also help you understand the details of your coverage. With so many options, such as Gold, Silver, and Bronze plans it can be confusing to determine which BCBSNC plan is best for you. It is also very important to know if your healthcare provider is “in-network.” Since it can be more costly to seek “out-of-network” coverage, knowing which doctors and hospitals accept your plan is one of the best ways you can manage your healthcare costs.

Ensure You Get Coverage When Needed: While applying for health insurance, customers may find that they have a lapse in coverage before they are able to enroll in a Blue Cross Blue Shield of North Carolina plan. It is important to avoid any gaps when you may go without coverage! Speaking with an agent can ensure that you are enrolled in the correct effective date so you won’t go without the protection and quality coverage that you need to maintain your health. We can’t wait to hear from 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.

Learning about North Carolina Health Insurance

Thursday, August 16th, 2018

North Carolinians already know that we live in a wonderful and special place. It is not often that you can make a trip from the most beautiful mountain tops to the crystal clear waters of our coast in just a day. With North Carolina having so much to offer, it is not surprising that our population is growing, and more and more people are choosing North Carolina to call home.

Because the health Insurance industry is regulated partially at the state level, living in North Carolina can directly affect the health insurance that is available to you, and how and when you can apply. Whether you have deep roots or have just become a resident of “The Old North State”, these are some things that all North Carolinians should know about North Carolina Health Insurance:

What Types of Coverage are available to me in NC?
Residents of North Carolina have two major types of individual/family insurance available to them, Affordable Care Act (ACA) compliant, also referred to as “Obamacare”, and other alternatives like Short Term coverage. ACA-compliant plans are required to cover the same set of essential health benefits under the Affordable Care Act laws. Blue Cross Blue Shield of North Carolina offers the broad majority of these plans across the entire state. Short Term plans are not ACA compliant, but allow individuals and families to enroll outside of Open Enrollment Periods without a Qualifying Event. These plans do not cover pre-existing conditions, but are often more affordable than ACA compliant plans.

When Can I Apply?
The Open Enrollment Period is a yearly period when individuals and families can enroll in health insurance. Open enrollment for 2018 will begin on November 1st and last until December 15th. Open Enrollment is a very important time period because all individuals are eligible to enroll. If you miss Open Enrollment, you must qualify for a Special Enrollment Period. To qualify for Special Enrollment, you have to experience a Qualifying Life Event. Qualifiers such as getting married, having a baby or losing coverage provided by an employer could make you eligible to enroll during Special Enrollment, as long as you enroll within 60 days of the life altering event.

Is it Affordable?
One of the amenities of the Affordable Care Act is federal tax credits, also known as subsidies. Subsidies are designed to lower the cost of health insurance for low and middle income individuals or families. If you are eligible for a subsidy, it could greatly reduce the cost of your monthly premium. Generate a Blue Cross Blue Shield of NC health insurance quote to find out more about whether you are eligible for a subsidy.

At NC Health Plans/Jerry Ballard & Associates Inc., we love living in North Carolina and take pride in serving North Carolinians statewide. Our website allows you to generate quotes, shop for plans, and apply online at your convenience. If we can assist you in selecting a health insurance plan, please call us at 888-765-5400. We are North Carolinians serving North Carolinians!

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.

2019 Blue Cross Blue Shield of NC Rates and Changes

Friday, August 3rd, 2018

Blue Cross Blue Shield of North Carolina announced on July 31st 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 1st.

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.

North Carolina Health Insurance when Turning 26

Wednesday, August 1st, 2018

If you were born in ‘92, we want to wish you a happy 26th birthday! Another trip around the sun is always something to celebrate and be thankful for, and we hope that this upcoming year is your best one yet! Adults in their mid-twenties find themselves in many different walks of life. Whether you have gotten married, had children, graduated, or simply having fun, there is something all 26 year-olds have in common. That is, that you’re aging out of your parents’ insurance plan!

Health Insurance shoppers at this age often call us with concern, saying, “I have never shopped for insurance before and don’t know what to do or where to start!” We realize that navigating this transition and the insurance market can be stressful and overwhelming.  However, it is not something to put on the back burner or avoid! Here are some helpful things you should know about applying for insurance:

  • You have 60 days!

Turning 26 and aging out of your parent’s health insurance plan is considered a Qualifying Life Event.  This qualifying event will provide you a 60 day window outside the Open Enrollment Period to enroll in a new plan.  Make sure you know when this starts and stops in order to avoid any lapse in coverage.

  • You can save money!

Based on your household income, you may be eligible for a federal subsidy which can greatly reduce the cost of your monthly premiums. Generate a Blue Cross Blue Shield of NC health insurance quote to find out more about whether you are eligible for a subsidy.

  • Don’t go uninsured!

Did you know that under the health care law, you must have qualifying health coverage? Without it, you may face a penalty on your next tax return. In addition, it is important to have protection and quality coverage to maintain your health, or in case of sickness or an accident!

  • Don’t stress! It’s easier than you think!

This process can seem overwhelming. However, it is easier than you think. We are here to help you through the entire application process right over the phone, and it only takes about 25 minutes to apply for health insurance!

As you are thinking about your 26th birthday celebration, remember your health insurance – and don’t let those 60 days slip away! Here’s to many more years of health and happiness!

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.