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Known Changes to NC Health Insurance in 2018

Wednesday, May 24th, 2017

Between media outlets and elected officials in Washington, there is no shortage of discussion and published content about the future of health insurance in North Carolina and across the country.  However, we still have very little concrete direction about what consumers, insurance companies and the healthcare industry can expect moving forward.  In the beginning of 2017, we provided our thoughts on the health insurance market in North Carolina moving forward.  Now, in May, we have some information about known changes, but uncertainty still exists.

The most recent and significant changes will impact all health insurance shoppers during the coming years Open Enrollment Period.  On April 13th, the Center of Medicare and Medicaid Services introduced final “Market Stabilization” rules for the Individual health insurance market.  From these changes, the Open Enrollment Period is now set to begin on November 1st and end of December 15th for an effective date of January 1st.  This will be the shortest Open Enrollment Period thus far and is the first time only one effective date option is available.  The previous Open Enrollment lasted until January 31st and offered effective dates of both February 1st and March 1st.  This means shoppers will need to make sure they have completed the enrollment process during these new Open Enrollment dates, otherwise, Special Enrollment Period requirements will apply.

Other notable changes impact Special Enrollment Periods and the requirement for documentation to prove Qualifying Life Events in order to enroll in health insurance plans outside the Open Enrollment Period.  This has been a request of insurance companies for several years now and simply requires customers to verify with supporting documentation that a Qualifying Life Event has occurred.

Other major changes are expected, but timelines and impacts of possible changes are very difficult to calculate now.  As we receive further guidance, we will continue to update the consumer community and empower you with the knowledge needed to navigate this constantly changing health insurance market.

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.

Affordable Health Insurance in NC- What We Can All Do

Friday, March 17th, 2017

The cost of health insurance and healthcare is growing and has been for a long time; but what can be done?  First, let’s understand that the health insurance industry is very complicated and unlikely to be accurately summarized in a short article.  The topic can be broken down into so many segments, each of which deserves its own time and attention.  Few segments are as important as the concept of affordability.  Without affordability, health insurance begins to lose its value and is capable of serving less people.

The concept of affordability is no simple matter.  Analyzing Medical Loss Ratios and actuarial values is a task performed by some of the best and brightest the insurance companies have to offer.  There’s no question these professionals have earned a seat at the table when discussing the cost of health insurance.

When looking beyond the highly publicized drivers of health insurance costs, there are a few much more simple concepts that can have significant impact on the affordability of health insurance in North Carolina and the entire country.  These are ways consumers can help in the fight to lower healthcare spending and health insurance premiums.

  1. Eat Healthy and Exercise Regularly: There is no shortage of available information about healthy diets and exercise. Positive Health Wellness is a great resource for ideas that can help us live healthier lifestyles and feel better as a result.  Large insurance companies like Blue Cross Blue Shield of North Carolina have been open about concerns regarding the health status of so many insured members.  This has initiated the insurance company to become more active in paving the way for their member to live healthier lifestyles.
  2. Take advantage of preventive care doctor visits: Most health insurance plans have coverage for services like routine physicals and screenings.  Typically, these visits are covered at 100%.  Utilizing these covered services may help identify potential illnesses before they become more severe.
  3. Use the Emergency Room for Emergencies: BCBSNC has found that a very large percentage of emergency room visits are for non-emergency situation that could have been handled in a Primary Care Doctors Office or an Urgent Care facility.  Emergency Rooms are often one of the most expensive places to seek care.  Emergency Rooms serve an important purpose and are recommended for certain situations.  However, it’s important to make sure this is the best place to be seen based on the circumstances.

Understanding that we all have some control of the cost of health insurance can change the conversation.  The recommendations listed don’t provide an immediate fix to the on-going problems but they can certainly contribute to a solution.