It’s all over the news this week. Millions of individual health insurance policies are being canceled.
Here at Virginia Medical Plans, we have known this was coming for months. In fact, back in June we wrote about it right here. Since then, we have assisted literally hundreds of clients with their decision about coverage in 2014.
Here are some of the questions we are hearing, along with the answers:
Why is my policy being canceled?
Policies are being canceled because, unless they are grandfathered — meaning they were purchased before the Affordable Care Act (ACA — or “Obamacare”) was signed into law on March 23, 2010 — they must comply with all of the requirements of the new law.
Some examples of why an existing policy may not comply with the law are:
- Deductibles and co-pays in your plan exceed the law’s out-of-pocket maximum of $6,350 for individuals and $12,700 for families
- There is a dollar cap on preventive doctor visits
- Emergency room visits, maternity care, mental health care, etc. are not covered (Click here for a list of the Ten Essential Benefits required on all 2014 plans)
What does early renewal mean?
Early renewal is a way to allow you to stay with your current plan as far into 2014 as possible. You can renew your current plan — at TODAY’s prices — for another year. Your premiums may rise some, but this is due to regular price increases, rather than any new provisions or pricing structure required by the new law (see below).
Click here to learn what early renewal can do for you.
If you think early renewal may be the best option for you, please keep in mind your carrier’s deadline for informing the company of that decision.
- Anthem – *December 16, 2013 (extended twice – once from Nov 15 to Nov 30, again from Nov 30 to Dec 16,2013)
- CareFirst – November 22, 2013 (extended from Oct 31)
- Aetna – November 25, 2013
*Updated 11/27/13.
Why are premiums changing for 2014 plans?
If you have shopped for 2014 plans, you may have noticed that your premiums will change — in some cases pretty dramatically in either direction.
The reason behind the change is a shift in the way policies are priced. It used to be you had to complete a detailed medical history before being accepted for coverage. That is no longer the case. Under the new law, insurers cannot charge more for people who are sick. Furthermore, women can not be charged more, no one can be rejected, and older people can be charged only three times more than younger ones.
This means that older consumers or those with health problems may actually see a drop in premiums. On the flip side, however, younger, healthier people are likely to see their rates rise.
It gets even a bit more complicated, however, because pricing can also vary by region.
Some people may be eligible for a subsidy, making coverage more affordable. Click here to see if you qualify.
I don’t need all of the coverage mandated by ACA.
If you are a single male, you don’t need maternity coverage. By the same token, a single female does not need coverage for prostate cancer screening. Younger, healthier people are less likely to use coverage for arthritis, heart disease, and a whole host of other ailments typically afflicting older people.
The concept behind the pricing is this: just like you can’t choose what disease or condition you may get, or whether you are ever injured in an accident, you can’t choose the benefits in your insurance coverage.
The risk is spread across all Americans.
I got a cancellation notice. What now?
The right decision for you will be based on many factors — your age, your health status, your eligibility for a subsidy, the date of your existing policy’s next renewal, where you stand with your current policy’s deductibles, etc.
Remember, whatever your situation, you cannot be denied coverage.
But you do need to fully understand your options — all of them.
- Should you renew early?
- Should you do nothing for now, and wait for your next renewal date before making a change?
- Should you allow your carrier to “transition” you to a plan it says is similar to your current plan?
- Should you shop for a whole new plan?
- Should you go through the federal exchange for a subsidy?
These are all questions to consider. And Virginia Medical Plans is here to help you make the best decision for you. We can explain your options and how they fit with your goals.
We will also help you fully understand the provisions of any 2014 plan available to you. This is critical, as there are many things to consider when selecting a new plan.
Give us a call or send us an email.
We appreciate your patience as we manage an extremely high volume of calls and emails!
Click for more specific information for current Anthem and Carefirst policyholders.
