Monthly Archives: November 2014

Avoid This Mistake During Open Enrollment Before December 15th

California insurance consumers should avoid this mistake during open enrollment before December 15th, in the event their doctor has been dropped by their health plan (see related story about the thousands of California HealthNet plan members who are forced to take action by December 15th).

For everybody else, there are also lot’s of doctors, coming and going from these networks…some accept group plans and others accept individual plans, but the names are confusing for them, too.  We strongly advise you to hook up with a local Certified Agent (it’s a free service from Coverage California) and make sure you don’t make a big mistake for all of 2015.

Remember, Open Enrollment began November 15th:  Changes are coming to certain PPO & HMO networks.  Read a related article about CoveredCA here.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Coverage California and are here to help.

Covered CA Website Causes Suffering During Open Enrollment

Covered CaliforniaCovered CA website causes suffering during open enrollment this week after being fortified for high utilization.  An interview with a San Jose-based Certified Agent provided the following observation:

Today, I assisted at least 4 different clients on their renewal process and/or to start a new application.  The website directed all of the clients into Medi-Cal, even if their income was well above 140% FPL

Calling Covered California directly is not an option, due to five-hour wait times.  Cases such as these require special handling, which is a free benefit of Certified Agents.  For example:

I had a family of three come in with a total annual household income of $49,666.73 and they were placed on Medi-Cal.

Certified Agents can provide local assistance with such glitches, and often times are willing to meet you in person. Read our related article about avoiding Open Enrollment mistakes.  Open Enrollment is here, changes are coming, and websites are frustrating.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Obamacare: Not Easy!   ............  Cake Pop, Anyone?

Obamacare: Not Easy! ………… Cake Pop, Anyone?

Kaiser California Individual Members Pay Twice in December 2014

California Marketplace

The Affordable Care Act hits Kaiser Members hard

Yes, Kaiser California Individual members pay twice in December 2014, in order to help Kaiser Permanente catch up with industry standards.

As explained in a Kaiser Permanente November news briefing to its marketplace partners, Kaiser’s status as a prepaid health plan requires monthly payments before the last day of each month. Apparently, throughout 2014 Kaiser has not been billing its members for prepayment, and now plans to catch up in time for January 2015.  Read our related article about avoiding Open Enrollment mistakes this year.

What Kaiser California Individual & Family members need to know:

  • You will receive two separate bills in December- one for the December 2014 premium and a second bill for the January 2015 premium
  • Both bills must be paid by December 31st.

The news briefing goes on to say certain members may have extra time to pay, based on their Evidence of Coverage or Membership Agreement.  To get free assistance from a California Kaiser agent, send a request to info@coverage-ca.com or phone 1 (408) 641-8950.

Remember, Open Enrollment begins November 15th:  Changes are coming and websites are frustrating. Read our related article about CoveredCA’s problems. If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Anthem Blue Cross Doctors & Hospitals

Which Anthem Blue Cross network accepts your plan?

Covered California

Covered California

Deciphering the confusing Anthem Blue Cross Doctors & Hospital networks [This story was updated in December 2014]

California insurance consumers should be extra cautious during open enrollment season (November 15, 2014 to February 15, 2015) that their doctor was not been dropped by their health plan (see related story about the thousands of California HealthNet plan members who are forced to take action by December 15th).

Don’t ask your doctor- he or she probably won’t even know it happened, due to the confusing network games that insurance companies play.  For example, see the confusing Anthem Blue Cross Doctors & Hospital network references in the table below…

Provider Directory Reference Guide

PLAN NAME AT COVERED CALIFORNIAOR IT MAY LOOK LIKE THIS ON YOUR ID CARDOR LIKE THIS ON THE ANTHEM WEBSITE
Anthem Silver 70 PPOAnthem Silver Direct AccessPathway X-PPO via Exchange/Silver Direct Access
Confused?Call for free assistance:1 (408) 641-8950

For what its worth, we are providing a link to the entire directory guide from Covered California:

PROVIDER DIRECTORY GUIDE

There are lot’s of doctors, coming and going from these networks…some accept group plans and others accept individual plans, but the names are confusing for them, too.  We strongly advise you to hook up with a local Certified Agent (it’s a free service from Coverage California) and make sure you don’t make a big mistake for all of 2015.

Remember, Open Enrollment began November 15th:  Changes are coming to certain PPO & HMO networks.  Read a related article about CoveredCA here.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Coverage California and are here to help.