Land of Lincoln Healthcare gone - need advice

[CRLLS]

We have been on ACA plans for a couple of years. 1st year was with BCBS. But then they screwed around with hospitals and doctors in 2016. Our drs and hospitals were no longer in network. We chose Land of Lincoln Healthcare this year due them covering our nearest . But LOL has gone bankrupt. We have been notified by our state that they have taken over management and our coverage will cease on Sept 30th. We will need to choose another provider for the last 3 months of 2016. Then we get to choose again for 2017. In 2017 DW will go on Medicare in Feb and I in November.

Last time we had a choice, it took a few days to sort out our best options. I'd like to choose one provider and not have to make continual changes over the next 15 months. But I fear that is not an option. Yet another example of "The only thing constant, is change" I guess! Going without coverage for a few months is out of the question. We are both in generally good health but will not take the chance of catastrophic event(s).

Anyone else caught in this situation. Any advice you'd like to share?

 

[MBSC]

You may be interested in the following posts on another forum.

A LOLH client called the Marketplace today to get covered on October 1st with United Healthcare.

The Healthcare.gov person told him that enrolling before August 15th would automatically get him a Sept 1st effective date.

Client then spoke to a supervisor who told him the same thing, and advised him to call back between August 15th and Sept 15th, if he wanted an October 1st effective date.

So, the bottom line is that Healthcare.gov people are unaware of how the LOLH SEP is supposed to work... that anyone calling in between August 2nd and September 30th, are to receive an October 1st effective date.

Rather than fight a fight that's unwinnable, I'm just advising clients to call Healthcare.gov between 8/15 and 9/15, as suggested, if they want an October 1st effective date.

I have already finished rewriting 4 clients (online), and without a problem got effective date 10/01/2016.

You have to check-mark the question:
Will lose health coverage in the next 60 days,
and put the date: 09/30/2016.
Then you will get effective date for the new plan 10/01/2016.

It's horrible how the Illinois Dept of Insurance lacks influence. LOLH customers with ongoing medical needs, like Dialysis, Chemotherapy, etc., will need to meet their Deductible/OOP again starting October 1st, and then AGAIN starting January 1, 2017.

Three Out-of-Pocket maximums to satisfy over a 24 month period, instead of two.

Reference: Land Of Lincoln - Page 18

 

[ivinsfan]

Call either your doctors office or their business office, explain your problem and and them which insurance companies they work with.Hopefully you will find a plan on the market that is workable.

A second option is to take a policy your docs don't take but still offers coverage in your area. You have till Sept 30th to get stuff done at your regular Doc. It just depends on how much time and money you want to spend.

A third option is to take this mess to an insurance broker and have them take care of it for you.

 

[CRLLS]

Good ideas.

I really feel for those LLH clients that have ongoing medical needs. They are facing a tougher time than I am, for certain.

Already called DW's doctor office. And checked on Healthcare.gov for our dr and hospital coverage. I am considering our options. I have some time.

It would appear that I may have to go HMO, which I hate. If I suspect skin cancer, I go to a specialist in my network. BTDT. If I have knee problems, I contact an orthopedic guy in my network, BTDT. If I have Urinary Retention, I go see a Uroligist...... BTDT. I went right from dr's office on my 2nd visit to emergency surgery. I nearly died on that one. I don't want to wait for a GP to approve me to go to a specialist.

I tell myself it is only for 14 months or so.

As far as brokers go, based on reading deeper in the link posted by MBSC, it would seem that they just might be biased to directing clients to a provider that pays them a commission. And in IL, that would be zero. Maybe I read it wrong.

 

[ivinsfan]

I noticed the zero commission as well, that seems unsustainable, now in your case since you are heading to Medicare soon if you stuck with the broker he would make commission on you eventually. I noticed BC will up to 10% commission on Medicare supplements for the first 2 or 3 years and less as the policy continues.

I wouldn't be comfortable waiting too long.With coverage ending in 45 days sometimes it takes a while for the system to process and update stuff. I'd want my proof of coverage in hand before the switch-over.