Under the Affordable Care Act, young adults are now eligible to remain on their parents’ Blue Cross Blue Shield of NC health insurance policies up to age 26, even if they are not full time students. (more…)
“When will my coverage begin?” is one of the questions we are most frequently asked here at Jerry Ballard and Associates. And it’s a good one. In fact, it’s one of the most important questions you can ask regarding your health insurance plan. (more…)
Between web generated quotes, online applications, automatic bill pay and the healthcare Marketplace, you may be wondering why in the world you would even need an insurance agent. When so much can be accomplished right over the phone or online, is there really any benefit to contacting a BCBSNC health insurance agency and what can we possibly do to make purchasing insurance a simpler and more satisfying experience? Although it may seem counter intuitive, the truth is that despite all of the technology and all the companies and agencies involved now in purchasing health insurance, the process is actually more complicated than ever.
The Affordable Care Act alone has added so many pieces to the insurance puzzle that it can leave your head spinning just trying to determine who is eligible to purchase health insurance and when, let alone who qualifies for a federal subsidy and what determines eligibility. Open Enrollment, Special Enrollment, Qualifying Life Events, Premium Tax Credits, Subsidies, Tax Penalties, Cost Share Reduction Benefits and so on are only some of the new terms that now have a profound impact on your health insurance policy and how you go about applying for and purchasing it.
In addition, even though these terms can be researched online and applications completed through various websites and phone lines, the process of purchasing health insurance can be overwhelming even for the most well-versed among us. We all know what a huge difference there is between knowing a fact and understanding how that fact impacts our lives on a personal and financial level. That is the very reason we hire attorneys, accountants, doctors and contractors. We rely on the expertise of those whose job it is to understand their various industry and guide us in making the best decisions based on their professional experience and understanding. Health insurance is no different! In fact, more than ever before it is important, if not imperative, to consult a health insurance professional before purchasing a health plan.
And that’s where Jerry Ballard and Associates can help. The good news is that unlike hiring an attorney, accountant, doctor or contractor there is no fee associated with contacting our office. In fact, having an insurance agent does not impact the cost of your health plan in any way. All it does is allow you the opportunity to have a personal contact person at your disposal to help explain the process, discuss the plans and determine subsidy eligibility and how obtaining a federal tax credit can impact the cost of your health insurance premium.
At Jerry Ballard and Associates, it is our pleasure to provide the professional guidance you need when purchasing health insurance either on or off the federal Marketplace. It is our desire to make the application process as painless as possible and help you determine whether a subsidized or unsubsidized plan is the best choice for you and your family. We will discuss your options in detail, making sure you are 100% comfortable with the BCBSNC health plan you choose prior to enrollment and we will then follow up to make sure your plan is properly processed and that you know how and when to make your payment.
Having an insurance agent is important and Blue Cross Blue Shield of North Carolina understands that personalized service is always in your best interest. In truth, having an agent is one of the great benefits that is available to you when you purchase a BCBSNC health plan. Don’t let health insurance overwhelm you and don’t make important decisions about your health coverage without fully understanding your choices and the implications of your choices. At Jerry Ballard and Associates, we are determined to help you through the process from start to finish!
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, 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.
Getting a Blue Cross Blue Shield of NC health insurance quote has never been easier, or more mobile! In fact, if you have an I-phone, you can get your quote, fill out an application and enroll your BCBSNC health plan in a matter of minutes. At Jerry Ballard and Associates, we understand you are on-the-go and may not have time to sit down at your home computer. You want the ease and convenience of handling personal business from your mobile device. Perhaps you are like many of our clients who travel for much of the work week and who appreciate being able to generate a quote or fill out an application without excess hassle or frustration. Now you can!
To access our Mobile Application, simply Google us at nchealthplans.com. From there, you can generate your health quote, view the Blue Cross Blue Shield of NC plans available to you, estimate your subsidy eligibility, start and complete your application and enroll your new coverage. For short term health insurance, you can view temporary health plans and generate a personalized quote. Or, if you are looking for Dental coverage or a Medicare Supplement, you can get a quote for that as well. In fact, you can complete an application for health or dental insurance in a few short minutes. The bottom line is that getting health insurance has never been simpler.
Accessibility is one of the nicest parts of living in a high-tech world and Jerry Ballard and Associates offers you just that. Despite all of the new information and additional steps the Affordable Care Act may have added to the process of purchasing health insurance, it is our desire to make your experience as easy and satisfying as possible. Customer service is our number one concern and although we may not be able to eliminate all of the red tape, we can offer you access to all the information you will need to make an informed decision right at your fingertips. Check out our Mobile App and see just how easy it can be to enroll your Blue Cross Blue Shield of NC health plan.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, 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.
Are you one of the many Americans who missed Open Enrollment 2015? Despite your best efforts, did February 15th come and go and still you are uninsured? Perhaps you even missed, or did not qualify for, the Special Enrollment period that was in place until April 30th for those individuals who received a tax penalty on their 2014 tax return. If so, you are not wholly out of luck, though there are some things you should keep in mind.
Because we are now in the Special Enrollment Period, the rules regarding Qualifying Life Events are in full force. A Qualifying Life Event (QLE) is some special circumstance in your life that allows you to enroll in health insurance outside of Open Enrollment. As of now, the federal Marketplace has not announced any further exception to the rules of QLE’s, which simply means that you must have one in order to enroll in a health plan. It is a good idea to review the full list of Qualifying Life Events and if you have one, or if you anticipate having one in the near future, then that will serve as your opportunity to get insured. Keep in mind that you must complete an application for health insurance within 60 days of your Qualifying Life Event.
Another thing to note is that if you are uninsured for more than three consecutive months during 2015, you will incur a tax penalty on your next year’s tax return, unless you qualify for an exemption. It is also a good idea to take a look at the list of exemptions and who might qualify.
Finally, keep in mind that being insured is about so much more than incurring a tax penalty. It’s about having the coverage you need in case of a medical emergency and also about maintaining your physical and mental health through preventive care maintenance. Further, having to pay a tax penalty is like throwing your hard earned money out the window because you get nothing in return. On the other hand, although paying a monthly premium for health insurance may seem like a financial frustration, in the end it is money well spent. Your most precious commodity is your health and making an investment toward it is always a smart decision.
If you are still uninsured and do not foresee having a QLE in the next few months, you may still qualify for Short Term Coverage. Although not ideal in most circumstances and though it will not offer you the same level of benefits as an individual health plan, Short Term Coverage can be an effective way to fill in the gap between now and this year’s Open Enrollment which begins in November. Short term coverage has some limitations and will not save you from the tax penalty in that it does not meet the Affordable Care Act’s 10 essential requirements, but it is still better than having no coverage in case of a medical emergency.
The bottom line is you do have options. Although you may not be able to secure your first choice in health plans outside of Open Enrollment, you can be insured in the interim. Also, this is a great time to begin doing research about the Affordable Care Act, what subsidy might be available to you and how that subsidy might affect your federal income tax. Use this time to research the various health plans available to you and also what kind of network works best for you and your family. Open Enrollment begins again in November, which believe it or not, is only 5 months away. Even if you cannot obtain coverage during Special Enrollment, this is a great time to arm yourself with all the information and knowledge you will need to make the very best choice possible come Open Enrollment.
Blue Cross Blue Shield of NC is committed to helping the residents of North Carolina secure and maintain the health coverage you need. For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, 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.
The terms “in -network” and “out-of-network” are terms you may have heard in relation to health insurance, but understanding the implications of these terms is of utmost importance as you select, enroll and manage your Blue Cross Blue Shield of NC health plan. In fact, understanding your network and how it works can have a big impact on the cost of your health care and a little research can save you a lot of money.
The first thing to understand is that Blue Cross Blue Shield of North Carolina is not an HMO, meaning you are not required to stay within your network in order to have coverage. This is good news in that it allows you more freedom and flexibility, as well as covering you in case you have an out-of-network provider you either prefer to use or must use for your medical needs. The benefit of both in-network and out-of-network coverage is not something every health insurance company offers, which is one of the reasons BCBSNC is a recognized leader among health insurance providers and the only company with a presence in all 100 counties within the state of North Carolina.
That being said, it is still in your best financial interest to stay in-network. In fact, the difference between “in-network” coverage and “out-of-network” coverage can sometimes be the difference between a small co-payment and having an office visit that is subject to your medical deductible. That is why understanding your network is so important.
Basically, BCBSNC has four different networks available: Blue Advantage, Blue Select, Blue Value and Blue Local. The broadest of these networks is the Blue Advantage and over 95% of doctors and hospitals in the state are a part of the Advantage network. If you can afford it, this is always the network we would recommend as it offers you the most amount of choices when it comes to in-network providers. Blue Select is a tiered network and though also a broad network, it will require a little more management in that some of the providers are Tier 1 providers and some are Tier 2 providers and there is a difference in the cost of these two tiers. If you choose to go with a Blue Select plan, just keep in mind that you will need to research the tiers and providers therein prior to selecting a doctor or hospital.
Blue Value is a more limited network than either Blue Advantage or Blue Select. In fact, the Blue Value network is not even offered in some areas simply because there are not enough participating providers to warrant that option. However, in some instances and if your doctors and hospitals are a part of this network, choosing a Blue Value plan can be a smart way to save money as the monthly premiums are lower. Keep in mind, however, that this is where doing your research becomes necessary. If you have a particular doctor or specialist you must see, you may want to call his or her office and verify that they are a part of the Blue Value network and accept that plan. Less expensive can be good, but only if you are satisfied with your choice of providers and have ample doctors and hospitals to choose from in your area. You can always use the BCBSNC Find a Doctor tool to research providers.
Finally, Blue Local is the most limited of the four BCBSNC networks. This is a new network with Carolinas HealthCare System and is only available in nine counties in North Carolina. Again, this network will be less expensive, but also more exclusive. If you do not intend to stay within the Carolinas HealthCare System, this is not the network for you as you will wind up paying out-of-network prices.
The main thing to remember is that a small amount of research can save you big bucks in the long run. Taking a few minutes to call your doctors to determine which plans they accept and which networks they are a part of can make a drastic difference in your overall out of pocket healthcare expenses. Blue Cross Blue Shield of NC is committed to providing a broad range of coverage at a variety of price points, allowing you to determine which networks and which plans work best for both your family and your finances.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, 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.
Managing your health can be tricky, but there are some things you can do to make a big difference in the cost of your overall health care. Although this list is not exhaustive, Blue Cross Blue Shield of North Carolina offers some great tips on how you can help keep the cost of health care to a minimum. Whether you are enrolled in one of many popular plans, including Blue Advantage, Blue Value or Blue Select, the following management tips can help you maximize your plan’s coverage and minimize your plan’s cost.
1. See your primary care physician first: Typically, primary care doctors offer a variety of important services and usually cost less than more expensive specialists. Your primary care physician is also more acquainted with your health history and is better equipped to help guide you should you be in need of more specialized care.
2. Stay in network: Choosing an in-network provider is of utmost importance as it will help reduce your out-of-pocket expense. Blue Cross Blue Shield of NC offers a convenient Find a Doctor tool that will allow you to research whether your particular doctor is a part of the BCBSNC network.
3. Determine if you have an emergency: For situations that are non-life-threatening, urgent care facilities will often save you both time and money. If you do have an emergency, you should always call 911 or visit the closest emergency room, but for less serious illnesses and injuries an urgent care doctor may be your best choice.
4. Read your benefit book: Although not the most exciting book you may read this year, it could be among the most important. Understanding how your plan’s benefits work will help you avoid unexpected costs and reading your booklet or contacting a benefit specialist can save you big bucks.
5. Talk to a nurse first: As a BCBSNC member, you can call Health Line Blue 24 hours a day, 7 days a week to speak with a specially trained nurse and ask questions before you visit your health care provider. Discussing your symptoms with a nurse or even your own physician first can help you determine if an appointment to your doctor’s office is necessary or not.
6. Ask questions: Very often, the billing department at your provider’s office can tell you the exact cost of a procedure or service before you have it. This can help you avoid unexpected fees.
7. Practice preventive care: With every Blue Cross Blue Shield of North Carolina health plan, preventive care maintenance is covered at 100% so take advantage of those benefits. Regular check-ups and immunizations go a long way in helping you to stay healthy.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, 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.
For individuals and families who did not have health coverage in 2014 and are subject to the tax penalty when they file 2014 taxes, a special enrollment period (SEP) has been announced. This SEP has been created for those individuals who were unaware of the tax penalty or failed to fully understand the implications of the penalty for not enrolling in coverage during 2014. From March 15th to April 30th, CMS is providing consumers with another opportunity to purchase health insurance; however, if consumers do not purchase during this enrollment period, they may have to pay the penalty when they file their 2015 income taxes.
The special enrollment period will begin on March 15, 2015 and will end at midnight Eastern Standard Time on April 30, 2015. If a consumer enrolls in coverage before the 15th of April, coverage will begin on May 1st and if a consumer enrolls between April 16th and April 30th, coverage will begin on June 1st.
Because this year’s tax season is the first time individuals and families are required to provide information about their health coverage on their tax returns, CMS recognizes that there may be an adjustment period. Administrator Marilyn Tavenner stated regarding this special enrollment period, “Our priority is to… provide those who were not aware or did not understand the requirement with an opportunity to enroll in affordable health coverage this year.” Further, those who could not afford coverage or met other certain conditions may be eligible to receive an exemption from the tax penalty.
The majority of taxpayers will only be required to indicate on their tax return that they had health coverage in 2014, either through an employer, Medicare, Medicaid, or other health coverage that meets the requirements of minimal essential coverage. Other taxpayers will be granted an exemption from the tax penalty and still other taxpayers will pay a penalty for choosing to remain uninsured. Americans who do not qualify for an exemption and who are required to pay the penalty will be paying a fine of $95 per adult or 1% of their income, whichever is greater. This special enrollment period is designed to allow such individuals one final opportunity to get coverage and avoid having to pay other penalties in 2015.
Those eligible for this special enrollment period must meet ALL of the following requirements:
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, 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.
All information contained herein is subject to change, from time to time, if the Federal Government or Blue Cross Blue Shield of North Carolina implement any new updates and/or changes that can impact information provided in this blog.
The Open Enrollment period for 2015 and your once-a-year opportunity to enroll a new Blue Cross Blue Shield of North Carolina health plan or make changes to your current plan is coming to a close February 15th. Open Enrollment began November 15th, but if you are one of the many Americans still trying to obtain health insurance for 2015 or if you still need to make changes to your health insurance policy, there is still time.
Here are four different scenarios that may apply to you:
Members with Grandfathered Plans:
A Grandfathered Plan is a health plan that was in place on March 23, 2010 and has had no changes made to it. These plans are exempt from many of the Affordable Care Act requirements; however, you do have the option to change to an ACA plan. Keep in mind, though, that once you give up your Grandfathered plan you will not be able to get it back. Carefully consider the costs and benefits of your current plan and compare it against the available ACA plans before making a decision to change.
Members with Transitional Plans:
A transitional plan is a health plan that was purchased between March 24, 2010 and October 1, 2013. These plans were originally supposed to be canceled on January 1, 2014 because of the new ACA requirements, but the administration decided at the last minute that members could keep these plans for two additional years. Like with Grandfathered Plans, you may decide to switch to an ACA plan but remember, a new plan may cost more than your current plan, even with a subsidy applied. Be sure to weigh your options carefully.
Members with ACA or Subsidized Plans:
ACA plans include many of those purchased on the Health Insurance Marketplace for 2014. If you have one of these plans, there are some important questions you need to ask. You want to consider how much you want to pay out of pocket for premiums and deductibles and also you need to consider the size of your network. If you received a subsidy in 2014, you need to visit the Marketplace and update your subsidy qualifications. If you don’t, you might not receive as much subsidy as you deserve and could wind up paying more than necessary for your health plan.
Members with ACA or Non-Subsidized Plans:
If you did not receive a subsidy in 2014 and you would like to make changes to your plan, you can still see if you qualify for a subsidy. Again, consider the plans carefully, including the size of your network, out of pocket costs and monthly premiums.
FEBRUARY 15, 2015 is the last day you can apply for a 2015 plan or make changes to your current plan before the end of the Annual Enrollment Period. After February 15, you will be subject to the rules of Special Enrollment involving Qualifying Life Events.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, 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.
Blue Cross Blue Shield of North Carolina announced that it will begin providing many of its ACA (Affordable Care Act) members the opportunity to receive an in-home visit offering a comprehensive medical exam. During this at-home visit, members can review medications and discuss health care conditions and concerns with a licensed medical professional. BCBSNC is offering this program in an effort to better assess the health conditions of its members and to help encourage members to practice preventive health care maintenance.
Because Blue Cross Blue Shield NC recognizes that many of its members are new to the health care system, they are making strides to try and engage new ACA enrollees in a health maintenance program. These visits not only offer members a chance to discuss their health history with a professional from the comfort of their own home, the home assessment also helps identify any urgent health care problems. During the visit, members can ask questions and get advice on issues they may need to discuss further with their primary care doctor. Once the at-home visit has taken place, the health professional will share the results from the assessment with the member’s primary care doctor to ensure that the PCP has knowledge of the member’s overall health status and to help manage any health concerns.
BCBSNC sent letters to many ACA members and has also made phone calls offering these in-home health assessments. Members may have been contacted for various reasons, including being high-risk, having no prior history with a Primary Care Physician or having a medical condition that would benefit from such an assessment. These home assessments come at no charge to members and are performed by certified registered nurse practitioners, physicians and physician’s assistants. Although not required, Blue Cross Blue Shield NC encourages its members to take advantage of the at-home assessment.
Typically, the at-home visit take about an hour and there is no lab work or blood work done during the assessment. At the conclusion of the visit, the health provider will provide the member with information based on the outcome of the assessment and will discuss the importance of maintaining a relationship with a health care professional. Members are being encouraged to follow-up with their PCP to discuss the outcomes of the assessment.
BCBSNC is committed to the health and well-being of its members. Offering in-home health assessments is just one more way Blue Cross Blue Shield of North Carolina is striving to insure the health of North Carolina residents. For more information on Blue Cross Blue Shield of 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.
Blue Cross Blue Shield of NC offers catastrophic plans to eligible customers as a lower cost, minimum coverage option. Qualified customers can save as much as 22% by selecting a catastrophic plan over BCBSNC’s least expensive bronze plan.
To be eligible for a catastrophic plan, you must meet one of the following criteria:
•Be under 30 years of age when the plan year begins
•Qualify for a hardship exemption through the federal government
BCBSNC Catastrophic plans cover preventive care at 100% and include $35 copayments for your first 3 visits to an in-network primary care provider. These plans have high deductibles that you must meet before BCBSNC pays for Essential Health Benefits. A catastrophic plan may be a good option if you don’t expect to have many medical expenses.
Catastrophic plans cover the Essential Health Benefits as well. These essential health benefits include:
Keep in mind, if you choose a catastrophic plan, you cannot use an advance premium tax credit (federal subsidy). If you don’t qualify for or decide to forego a subsidy, you may save money with these plans.
Generate a quote today to learn more about catastrophic plans and other health insurance plans offered by Blue Cross Blue Shield of North Carolina.
For more information on Blue Cross Blue Shield of 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. 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.
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.
Benefits:
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.
Premiums
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.
Networks
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.
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