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Why Should You Consider Getting Health Insurance?

Why Should You Consider Getting Health Insurance?

Having health insurance is an opportunity not everyone thinks or considers risking in. It’s a risk also for those individuals opting to have a health insurance since there’s a lot of health insurance agencies nowadays. Ordinary people will think that they cannot afford to pay for the health insurance plan, or practical thinking will consider instead of considering having a health insurance, they will just save the money they have and use it once they are in the situation where they are in need to spend it. Like the quote, “save for the rainy days” dependable insurance agency will offer suited health insurance for individuals capacity or situation or even plan for the near future.

Why Consider a Health Insurance?

Evaluating oneself in our present situation, where people work hard to sustain their needs, the needs of their family. Choosing to have a health insurance is a wise choice, with the current strains of viruses or diseases worldwide, it may be scary. Having a health insurance will give security and peace of mind to the insurance holder. Health care cost presently is costly add to it the prescribed medicines that will surely be given to the person who is undergoing a routine check-up, that if that person has a current medical condition.

Taking the Plunge

Health insurance is a secured insurance contract from your chosen Health insurance agency or health insurance company. Which, they will provide specific health insurance coverage or hospitalization expenses. Health Insurance is an assurance that the insurance holder or dependents can avail proper medical procedures at all expense as per stated in their health insurance contract. Nobody likes being sick, a small sacrifice in our financial aspect is given to our health insurance a small sacrifice to have a better health and well-being.

Understanding Health Insurance

Understanding the use of health insurance is complicated, each health insurance plan has specific rules. That’s why health insurance agency must give or send the health insurance holder the detailed information on their specific health insurance plan. Some health insurance holders frequently find some information difficult to comprehend. That’s why it’s very important that in choosing health insurance agency we choose who really knows the in’s and outs of the health insurance.

Building Relationships

Health Insurance Agency needs skills and ability to communicate and build relationships with their health insurance holder. Not only should a Health Insurance Agency navigate the aspects of the health insurance holder and dependents they should also ensure to help once their client is facing penalties they should suggest and provide options and offer an extension. That’s why it’s important that the Insurance agency we chose have a competitive advantage and intimate knowledge of the business like the Blue Store South Charlotte NC.

Health Insurance Plans: Securing Your Future

Health Insurance Plans: Securing Your Future

Health Insurance, do we need it?

No one wanted to get sick. But do we know when illnesses will strike us? If that happens, are we ready to pay for bills that are keep on increasing each day we stay at the hospital? Older people tend to rely on monthly pensions. What if you become sickly and your monthly pension already cannot cover the medicines you need to buy.

Especially if it will come to the point where your doctor issues medicines that should be taken daily and will continue as long as you are living. As your health maintenance grew, your finances will be affected as well. The next thing you will have to do is to ask from relatives for a financial support for all of the expenses you have. Even for your other needs like your food, clothing, house rent, electric and water bills since all your money was exhausted by your medical needs you will depend on the help they can extend.

Make a Health Status Check

All of these are unwanted expenses that can be addressed if you already look into the root cause of your future problem which is your health. Our health is important to us in order to continuously do our daily activities we should stay healthy. We also should always consider our family since they will have to carry the burden of helping us pay our bills and hospital expenses to be incurred if we will get sick.

These future concerns can be easily addressed if you thought of getting a health insurance plan as early as now. A time when you are still healthy and have a job and earns a wage that will consider you as a capable person to pay for a health insurance plan that you know will address your future medical needs.

Here are some tips to consider and things to do in order to identify a health provider and health plans that are suited for you:

1. Make a list of all the health problems your family or relatives already encountered in their life. Look for the oldest person in your family that can give you details on illnesses he/she experienced before until now. Take note of these illnesses as these are your references in checking the inclusive services an insurance company will offer to you.

2. Do your homework. Make a research on other illnesses that you are not familiar of and as to what degree it will cause a person to be sickly. Is it impairment for life or it will take long treatment procedures to undergo. In this way, you can automatically inquire to the insurance provider if this can be covered as well.

3. Make a list of insurance companies that you are familiar of but also ask for opinions from your co-workers or directly from your relatives who already have health plans. You can assess if they are satisfied with these companies or not.

4. Make an actual canvass and give time in doing this. Make a schedule and get an appointment for a meeting to properly discuss the inquiries you’ve listed. In this way, you can gauge which insurance company to choose and if they can openly discuss to you in details the things you wanted to know.

5. Discuss the payment in details. Some insurance companies can give you a coverage for some type of illness only then make you pay an additional fee for other illnesses you like to be included in your policy. Some can offer it in a package set-up. You will pay this certain amount already for covering all that you’ve requested of. If you don’t understand what they mean about a certain coverage or a payment scheme, ask them in a detailed manner.

6. Get a copy of your health insurance policy and safe keep it. These are agreements you’ve made with your chosen insurance company. Review your policy list of medical benefits and the covered services you will be getting when the time comes if you will use it.

Consider Health Insurance as an Option

Consider also that future misunderstandings with insurance companies will be a big issue especially if you are already in a hospital bed. Do it right from the start. It will all be depending on how you lay down all your concerns to them so that they can also properly and correctly address it. Sometimes, proper and open communication is the key.

Always keep in mind that you are getting a health insurance plan and you are doing this not only for yourself but also for the future of your family. Securing yours and their health plans can greatly help in addressing future medical needs and financial issues.

A Look Inside Our 2015 Rates: What They Mean for Our Individual Customers Under Age 65

A Look Inside Our 2015 Rates: What They Mean for Our Individual Customers Under Age 65

BlueCross BlueShield of North Carolina store front

A Look Inside Our 2015 Rates: What They Mean for Our Individual Customers Under Age 65

Every year, we inform our individual customers about their premium rates for the coming year with a letter. As our company’s managing actuary, I want to take a moment to explain what went into determining 2015 premiums so you have a better understanding when you receive that letter.

Now, before I dive into this post, I want to cover the difference between individual and group customers – two terms that are used a lot around BCBSNC but aren’t as common in everyday conversations about health insurance.

  • Individual customers are those under age 65 who buy their own health insurance from an agent, directly from an insurance company or from HealthCare.Gov. People might buy their own health insurance because they work for a company that doesn’t offer health insurance or because they are self-employed.
  • Group customers, on the other hand, are enrolled in a health insurance plan that is offered by the place they work.

A lot of number-crunching is involved in determining health insurance premiums and the implementation of the Affordable Care Act (ACA) has made it even more complicated. With multiple plans, changing regulations and ever-rising health care costs to consider, determining rates isn’t a simple process.

One reason that determining rates is more complicated this year is because the ACA created three categories for our individual customers who are under age 65. Each category was priced separately based on unique considerations and what we know about its customers. Here is a quick definition of each category:

  • Grandfathered plans are plans that went into effect prior to March 23, 2010. If you bought an individual plan with us prior to then and still have that same plan, you are “grandfathered.”
  • Transitional plans (sometimes called grandmothered plans) are non-grandfathered plans that the administration announced could be extended last November. If you were informed late last year that you could keep your planeven though it was not ACA-compliant or grandfathered, then you are on a transitional plan.

Here’s an overview of how individual rates will change for these plans in 2015. Please note that everyone will be impacted differently depending on each customer’s unique situation–age, plan, tobacco use and where customers live may be reasons a customer’s percentage rate increase is different from what I’ve outlined below:

ACA Plans

ACA plans will see an average increase of 13.5 percent in 2015. Why?

Back in May, we talked about our new ACA customers after the first Annual Enrollment Period. We enrolled more than 232,000 customers in ACA plans on the Health Insurance Marketplace, and our new customers are older and less healthy than we anticipated. That means we have a large pool of older, less healthy customers, and rates will increase partly to help cover the high health care usage of these customers.

Enrollment graph

 

Grandfathered Plans

Grandfathered plans will see an average increase of 13.4 percent.

Enrollment graph

The grandfathered pool is closed to new customers, meaning new, younger customers can’t enroll to help offset the rising medical costs of existing customers. When we set prices for this group, we expected that many of the older and less healthy customers with these plans would move to ACA plans. Some did, but not as many as we expected. The result: Our customers with grandfathered plans are now older and less healthy than we anticipated. As existing grandfathered customers age, they face higher medical costs and use more health care services, all of which contributed to these rate increases.

Transitional Plans

The transitional plans will see an average increase of 19.2 percent.

Enrollment graph

Tansitional plans will see rate increases for a few reasons. As with grandfathered plans, the customer pool for transitional plans is also closed. Other contributing factors, including treatments for heart disease, cancer care and procedures for bone and joint issues, have also resulted in higher medical costs for this group. Further, we’ve seen many of the healthier customers leave this group at a rate higher than we expected.

The chart below shows how the percentages I just covered translate to premium prices.

Graph of expected rate changes to healthcare costs in 2014 and 2015

Helping you make the best decisions about your health insurance

We’re committed to helping consumers have the best possible experience when buying health insurance on the Health Insurance Marketplace. Some of the issues related to the Health Insurance Marketplace are out of our hands, and a technical problem in one area can have a domino effect on other areas of the enrollment process. But no matter what, we’ll be here for consumers to provide information and assistance in any way we can.

Here at BCBSNC we have a variety of tools and resources to help you choose the right plan to meet your health and wellness needs. Check out some of the links throughout this post for more information, visit your neighborhood agent or use our online tools to guide you through the enrollment process. And don’t forget to enroll by Dec. 15 if you need coverage by Jan. 1, 2015!

Brian Tajlili

About Brian Tajlili

Brian Tajlili is the Managing Actuary for Blue Cross Blue Shield of North Carolina leading rate development for the Individual Under 65 and Small Group market. Brian has been involved with various projects involving the Affordable Care Act since it was passed and is passionate about how his work as an actuary impacts North Carolinians. Brian is a Fellow of the Society of Actuaries and Member of the American Academy of Actuaries, and outside of work is actively involved in the Raleigh-Durham area’s running community.

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BlueCross BlueShield of North Carolina store front

A Look Inside Our 2015 Rates: What They Mean for Our Individual Customers Under Age 65

Every year, we inform our individual…

 

FPL (Federal Poverty Levels) Used To Calculate Subsidy Amount

Eligibility for an APTC (advanced premium tax credit) is based on household size & household AGI (adjusted gross income) when filing your annual federal income tax. When filing your federal income tax, if your household income based on your household size falls above 100% but below 400%, you will most likely qualify for an APTC amount that will reduce your monthly health insurance premium.

 Household
Size
 100%
 133%
 150%
200%
250%
 300%
400%
 1
$11,670
$15,521
$17,505
$23,340
$29,175
$35,010
$46,680
 2
15,730
 20,921
23,595

31,460
39,325
47,190
62,920
 3
19,790
 26,321
29,685

39,580
49,475
59,370
79,160
 4
23,850
 31,721
35,775

47,700
59,625
71,550
95,400
 5
27,910
 37,120
41,865

55,820
69,775
83,730
111,640
 6
31,970
 42,520
47,955

63,940
79,925
95,910
127,880
 7
36,030
 47,920
54,045

72,060
90,075
108,090
144,120
 8
40,090
 53,320
60,135

80,180
100,225
120,270
160,360