Aetna pulling out of ACA

[Texas Proud]

Quote:

Originally Posted by timo2 We are seeing the same thing in Colorado, new hospitals, and lots and lots of urgent care centers, sometimes within a few blocks of each other.

Oh yea, forgot about all the urgent care and even an emergency care facility... not a hospital...


First Choice Emergency Room: 24 Hour ERs in Dallas, Houston, Austin & San Antonio


I probably got 10 to 15 hospitals or emergency rooms I can visit within say 10 or so miles of me...

[GTFan]

Quote:

Originally Posted by MichaelB The issue we have is not only how to prevent costs from rising, it is also how to deal with costs that are now unaffordable for so many. And how to reconcile a system where insurers demand that the population be subject to a "must insure" regulation but won't accept to the same extent a "must insure" requirement.

The latter is at the heart of the problem - if people accept that everyone should be able to get insurance (I think this is the consensus now) then there must be some system that ensures that all, or most all, have insurance. Without a wide risk pool the market fails.

And there's been no serious ACA replacement proposal that I've seen that addresses this.

[MBSC]

Quote:

Originally Posted by Ian S With Aetna leaving Arizona, Pinal County is apparently left with no plans whatsoever in the exchange. The Arizona Republic reports however, that BCBS of Arizona may rethink their own decision to leave Pinal County. Goodness, I'm so glad I went on Medicare this month!

BCBS-AZ has reconsidered and will stay in Pinal County for 2017 at a 51% average rate increase.

Details: Blue Cross to keep health exchanges in Pinal County | News & Observer

[MichaelB]

Quote:

Originally Posted by MBSC BCBS-AZ has reconsidered and will stay in Pinal County for 2017 at a 51% average rate increase. Details: Blue Cross to keep health exchanges in Pinal County | News & Observer

That's good news, although it will be painfully expensive for residents.

[GTFan]

My guess is that they were highly 'encouraged' to stay in the market with some sort of quid pro quo. BCBS in particular is one of the big government employee/retiree HC insurers, don't know if they handle AZ or not.

[FUEGO]

Quote:

Originally Posted by GTFan My guess is that they were highly 'encouraged' to stay in the market with some sort of quid pro quo. BCBS in particular is one of the big government employee/retiree HC insurers, don't know if they handle AZ or not.

51% increase is quite a lot of quid in itself!

[RockyMtn]

BCBS is still dumping out of the rest of Az other than Pinal County!

[MBSC]

Quote:

Originally Posted by RockyMtn BCBS is still dumping out of the rest of Az other than Pinal County!

Source?

These say otherwise for 2017 and are consistent with notices from the Blue Cross Association.

Quote:

Cigna: Sole carrier in Maricopa only Blue Cross Blue Shield of Arizona: Sole carrier in all remaining Arizona counties, except Pima, where it competes with HealthNet. https://www.thehertelreport.com/phoe...-the-2017-him/ Adding Pinal County means BCBSAZ will sell plans in 14 Arizona counties, and be the sole carrier in 13 of them. "We are committed to serving these areas in 2017," said Rich Boals, president and CEO. Blue Cross Blue Shield of Arizona to Offer ACA Individual and Family Plans in Pinal County in 2017

[InTheSticks]

I got my official letter from Coventry today. I hope I can find a plan on the exchange that has my wife's specialist. Now, I have to wait until November 1.

[Clone]

A year ago when companies started to drop out, this was called letting the market work, and thinning the weak competitors from the herd.

[MBSC]

Baptist Health Plan will not offer individual plans in KY for 2017.

Quote:

Baptist Health Plan will withdraw from Kentucky's individual health insurance market for the 2017 plan year. Before the withdrawal, Baptist Health Plan had products available in 20 counties on the insurance exchange and 38 counties off the insurance exchange for the 2017 plan year. Kentucky now will have 59 counties with only one health insurance option on the exchange for 2017. Off the exchange, most Kentucky counties will have only two options. Reference: http://www.bizjournals.com/louisvill...insurance.html

[Car-Guy]

Quote:

Originally Posted by InTheSticks I got my official letter from Coventry today. I hope I can find a plan on the exchange that has my wife's specialist. Now, I have to wait until November 1.

Seems I recall that we were told that if you like your doctor you can keep your doctor.

[easysurfer]

Quote:

Originally Posted by Car-Guy Seems I recall that we were told that if you like your doctor you can keep your doctor.

But will the doctor want to keep you?

[Car-Guy]

Quote:

Originally Posted by easysurfer But will the doctor want to keep you?

I'm sure you can keep your doctor if you really want to keep him/her. Just pay them full price directly. It's probably in the fine print.

[Fermion]

I wonder how safe Alaska is on this. Premiums there for a couple in their 40s are around $1700 a month for a silver plan.

[Mulligan]

Quote:

Originally Posted by InTheSticks I got my official letter from Coventry today. I hope I can find a plan on the exchange that has my wife's specialist. Now, I have to wait until November 1.

I got my Dear John letter from Coventry last week. They should have just kept me and dropped everybody else. I gave them 3 years of premiums and didnt even use the crap plan.

[MBSC]

In South Carolina, both Blue Cross and its subsidiary BlueChoice offered exchange plans. BlueChoice will not offer 2017 exchange plans. Members with BlueChoice, Aetna, or UHC exchange plans will be mapped to a Blue Cross plan with the option to change.

Quote:

BlueChoice HealthPlan to Exit Federal Exchange for 2017 BlueChoice HealthPlan will not offer any health plans for 2017 on the federally facilitated marketplace (FFM), also known as the “exchange” or Health Insurance Marketplace (www.HealthCare.gov). This change impacts members who enrolled in BlueChoice products through the FFM, as well as members who purchased a gold level BlueChoice plan off exchange. BlueChoice® will continue to offer silver and bronze products off exchange. Both BlueCross BlueShield of South Carolina and BlueChoice HealthPlan have participated on the exchange since its inception. After an exhaustive internal analysis, however, a decision was made to offer health plans on the exchange under a one-company approach. Selling exchange products exclusively through our BlueCross line of business will allow us to achieve financial and operational efficiencies and reduce redundancies. Most importantly, it will allow us to continue to provide access to health care for people in this market — especially since many insurance companies have since exited or have announced plans to exit it. BlueCross and BlueChoice are working under the guidance of CMS and the S.C. Department of Insurance to transition BlueChoice exchange members to a comparable BlueCross plan for 2017. These BlueChoice members will receive a letter explaining that they will be auto-enrolled into a similar BlueCross plan and what they need to do to make sure they will have coverage for 2017. Of course, these members may choose to shop from all of the plans available to them and make their own selection if they decide the plan mapped to them does not meet their needs. As you know, the BlueCross plans are very similar to BlueChoice’s plans, since the Affordable Care Act mandates a core set of essential health benefits. The BlueCross provider network also includes the same South Carolina providers as the BlueChoice network — so patients will not need to select new doctors or facilities when they switch. In addition, since Aetna and United have announced that they will exit the exchange for 2017, their 2016 ACA exchange plans have also been mapped to comparable 2017 BlueCross plans. This was done to make sure South Carolinians do not experience any gaps in coverage during the transition from 2016 coverage to 2017 coverage under different carriers.

[ziggy29]

Quote:

Originally Posted by MBSC In South Carolina, both Blue Cross and its subsidiary BlueChoice offered exchange plans. BlueChoice will not offer 2017 exchange plans. Members with BlueChoice, Aetna, or UHC exchange plans will be mapped to a Blue Cross plan with the option to change.

Is this another example of PPOs being shut down with members forced into an HMO?

[MichaelB]

Quote:

Originally Posted by ziggy29 Is this another example of PPOs being shut down with members forced into an HMO?

I was wondering that, but browsing the plans, it doesn't seem to be the case. Difficult to tell, though, they (BCBS) really don't share much info on their offerings.

[MBSC]

Quote:

Originally Posted by ziggy29 Is this another example of PPOs being shut down with members forced into an HMO?

No changes to the plan type or provider network during the switch from BlueChoice to BCBSSC. They can keep their doctor. BCBSSC requested a 14.5% average rate increase.