If you did not get health coverage previously under the Affordable Care Act, you can enroll in a plan for next year starting Nov. 15. And if you are already covered, you can change or renew your plan for next year. If you don’t sign up by Feb. 15, 2015, you will be without coverage until January 2016 unless you have a qualifying life event .
There are at least three key components to choosing an ACA plan that is right for you and your family: Benefits, premiums and the network of doctors and hospitals.
All ACA plans are required to cover “essential health benefits” as described in the law. And all individual plans must cover preventive health benefits entirely.
Beyond these requirements, consumers have choices when it comes to how much they pay out-of-pocket for covered services. Plans are broken into four categories — bronze, silver, gold and platinum. As these names suggest, bronze plans have the highest deductibles and co-payments, platinum the lowest.
When shopping for a plan, look for the “Summary of Benefits and Coverage” which describes what the plan covers. Also be sure to review each plan’s prescription drug formulary to see what drugs are covered. Or call the plans you’re considering and ask about any specific services you think you might use in the coming year.
Health plans across the nation have been preparing customers for changes in rates from current plans for the new ACA enrollment period. Generally speaking, the higher your out-of-pocket costs, the lower your premiums are. This tradeoff between rates and out-of-pocket costs is an important element to consider when shopping for coverage, CLICK HERE FOR YOUR NEW 2015 RATE.
Federal subsidies help consumers pay for coverage through the ACA. If your household income is between 100% and 400% of the federal poverty level, you do not have coverage through an employer, and you meet certain other requirements, you will be eligible for a federal subsidy to purchase a plan through the exchange.
Another important consideration for consumers is whether their current physicians and hospitals are in-network. Going outside the plan’s network typically results in higher charges — sometimes significantly higher. And some plans don not cover services provided outside their networks.
If you have had coverage before, or have a current plan, do not automatically assume your doctors will still be in-network for a new or renewed plan. It is best to check each time you go through an open enrollment period. All ACA plans are required to tell consumers which providers are in the plan’s networks. When shopping, look for the link to the provider directory.
For more information on Blue Cross Blue Shield of North Carolina 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 experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.