Here are all the articles I've written about Anthem Blue Cross. Enjoy!

October 20th, 2014

Will YOU Be My Doctor?!

ALL networks are getting skinner and anorexic, reducing your choices for 2015.

In 2014, the biggest problem with doctor networks came with plans purchased on Covered CA.   It was hard to determine if your doctor took the Covered CA plans.  The Covered CA search engine was incorrect and removed from the website.    Some doctors only participated in networks used by off-exchange plans.

The same problem may continue in 2015.  It could be tricky to navigate for consumers who get a plan through Covered CA.   For a little bit of guidance with Covered CA doctor networks, the LA Times created a map for you.  Click here!

But remember, not all plans/networks are available in all geographical areas.  And, networks can change from day-to-day.

One bit of good news:   Anthem Blue Cross has made it clear that doctors MUST be in both off-exchange individual networks AND on-exchange Covered CA networks,  or they will not be doing business with Anthem Blue Cross at all!

Double check with all your doctors in which networks they will be participating for 2015 before making a decision about your health insurance!  Listen to your Insurance Mom . . . mother knows best!…

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October 20th, 2014

Rates, Schmates! What About Doctor Networks?!

With all the changes in health insurance, everyone seems to be talking only about monthly premiums.   But what about access to your favorite doctors who may not be in your plan’s network anymore?

You may be seeing a lot of ads on Proposition 45, which has to do with how rates are regulated (see my most recent blog with my position on the matter).  Everyone seems to be crying “lower premiums,” but no one seems to think about what effect that will have on the rest of the picture.

One of the biggest unintended consequences created by the Affordable Care Act (aka ObamaCare) is that doctor networks are shrinking.

Although we may not like it, health insurance companies are businesses too (just like your ISP, CPA, HBO or DDS).  They calculate how their business will survive next year.   They review rates, benefits, drug plans and networks.   Large doctor networks and rich benefits cost money.

Enter the new world order, the Affordable Care Act.   It’s great that anyone can have health insurance regardless of pre-existing conditions, but it creates a lot of cost and financial risk for insurance companies.  Again, we may not like it, but it is what it is.

Rates will continue to go up.    To offset costs, the insurance companies are shrinking benefits and doctor networks.  It’s the new normal.  Gone are the days that you could have a low monthly premium and any doctor you wish.

Now you have to make a choice . . . are you looking for affordability OR a wide range of choices?  That’s making it very black and white, and of course there are individual exceptions.  But when thinking about your choices for 2015, don’t just look at the numbers.  Look at the whole picture.

What do you think?  What will be …

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October 20th, 2014

How Much Will it Cost to Get Covered in 2015? 

If you know anything about the Affordable Care Act (ObamaCare), you know that the next Open Enrollment period is coming up (Nov. 15th – Feb. 15th for a Jan. 1st and later start date.)

Everyone’s first question to me is “how much will my monthly premium be?”

We don’t have enough info yet to compare.    Not all of the rates have been approved by the CA Department of Insurance.    But we do know the word on the street from going to conferences and doing lots of reading.  The Insurance Mom is here to translate!

There were a couple of great articles by Chad Terhune in the LA Times on 10/3/14 and 9/28/14.   For plans purchased through Covered CA, weighted increases in 2015 will range from 4.2% to 8% statewide (depending on where you live, it could be lower or higher).

But… actually using the plans is a whole different story!  That prompted two blog more posts about doctor networks AND why everything is so different after the ACA.  Click the links to read all about it!…

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May 1st, 2012

Kids, kids, kids…

If you’re in California and have health insurance in California, then this one’s for you.

As of 7/1/12, you’re all going to have maternity benefits added to your existing coverage.  Wahoo!

Yes, it’s true… SB 222 and AB 210, passed last year by our illustrious governor, are going to give each and every one of you this brand new benefit in your health insurance.

The new benefit will include, office visits, prenatal care, delivery and postnatal care.    The benefits for maternity costs will be treated just like any other benefits under your plan… deductible and co-pays will still apply.

And to reassure your pretty little heads, because this benefit is being added to all plans – and, therefore, the cost risk is spread over many, many more policies – your monthly premiums should not be affected.

Babies for all!…

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April 6th, 2012

UPDATED – Anthem Blue Cross In-Network Hospital Update

*******************I M P O R T A N T****I M P O R T A N T****I M P O R T A N T****************

Good news!  Anthem Blue Cross has announced that Hospital Corporation of America’s California hospitals once again participate in Anthem BC’s’ network.

In Southern California:

  • Los Robles Regional Medical Center
  • West Hills Hospital
  • Riverside Community Hospital
In Northern California: 
  • Regional Medical Center of San Jose
  • Good Samaritan Hospital in San Jose

Despite the terminations announced in March, both parties continued active negotiations with the hope that the hospitals would again participate in Anthem BC’s’ network.    These ongoing discussions resulted in the successful negotiation of new multi-year contracts effective April 1, 2012.

The reason an insurance company negotiates provider contracts is simple – to provide you with a broad network of providers who have agreed to accept negotiated rates — for you that means discounts — lower out-of-pocket expenses, more bang for your buck.

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March 20th, 2012

Anthem Blue Cross In-Hospital Network Update

IMPORTANT IMPORTANT IMPORTANT IMPORTANT

Anthem Blue Cross has been unable to re-negotiate its contracts with the following hospitals, so they are now considered out-of-network.

In Southern California:

  • Los Robles Regional Medical Center
  • West Hills Hospital
In Northern California:
  • Regional Medical Center of San Jose
  • Good Samaritan Hospital in San Jose
If you are currently in the middle of treatment at one of these hospitals and are concerned about the disruption of care, please let me know and I’ll tell you how to handle it.

But, just because there is no contract with these hospitals right now, doesn’t mean there won’t be one in the future.   Negotiations continue behind the scenes.

To find alternate hospitals in your area, go to www.anthem.com/ca and click on Find A Doctor.

Sometimes I just hate being the messenger!

 

 

 …

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October 21st, 2011

Wanna Save Some Money (part 2)?

Need to get lab work done, such as blood or urine tests, PAP test or biopsy?

Think about using a lab that isn’t located in or part of a hospital.

They’re often way less expensive than a hospital lab, and some health insurance plans have a lower co-pay for outside labs.

And many outside labs have more flexible hours, like when you need to go early in the morning before your half-caf-half-decaf-low-fat-vanilla-with-a-hint-of-cinammon-latte.

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October 20th, 2011

Wanna Save Some Money (part 1)?

If you have a health problem that isn’t an emergency and you can’t see your regular doctor, think about going to an in-network retail clinic, walk-in doctor’s office or urgent care center.

They can take less time than an emergency room, are open nights and weekends and could save you a TON o’money!…

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October 18th, 2011

What does it cost to…

… die?   It’s expensive!  Cedars Sinai Medical Center billed Medicare $132,000 (yes!) for ONE week of care.    I don’t want this to be morose but I do want to use my father’s death a couple of months ago as a life lesson about how to be pro-active in your own medical care.

The doctors wanted to run every diagnostic test they could think of, often more than once.   They suggested all sorts of treatments and medications.  And they knew he was terminal.

Although we kept the procedures to a minimum, the costs mounted and Medicare wound up with that outrageous bill.  What’s important here in addition to the insane cost of medical care (which the health care “reform” doesn’t even begin to address), is that Medicare reduced the hospital’s bill to $14,000 and Cedars Sinai had to write off the rest.   Really.

All PPO plans work this way!  It’s why I tell my clients to avoid paying a provider in full for medical expenses before the insurance company processes your claim.  Otherwise, it’s more than likely that you’ll overpay for your medical services and getting a refund from a provider is painful!

Fight for your money!  S/he who writes the checks has the power… not the receptionist behind the front desk or the provider’s billing service.

Talk to me about other exciting discussions you should be having with your providers… it’ll open your eyes and maybe even save you some money.

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June 5th, 2011

ZocDoc — sort of like OpenTable, but not

OpenTable for MDs

This recently came across The Insurance Mom’s e-desk and, although I can’t give it a thumbs up or down, it does look intriguing!   Let me know how it works for you.

Waiting days for a doctor’s appointment can make you extremely uneasy — not only do you not know what that lump is, but, more importantly, how are you ever going to find out what sort of crazy situation Goofus & Gallant have gotten themselves into now? Giving you near-immediate answers to the first of those questions: ZocDoc.

Just launched in LA, ZocDoc is exactly like OpenTable for MDs, w/ over 100,000 appointments available right away, which means you can get checked out far more quickly than the alleged average of 24 days.   Using it’s simple: first, input your insurance provider, then ZD’ll spit back a list of docs with available times (possibly as soon as that very day), brief bios, and user reviews, because, who better to turn to for advice on a doctor than “MoneyRashHoes69”? Guys/girls with stethoscopes and white coats are also searchable by specialty and are updated in real time, and once you pick the doc you want, all you need to do is let them know why you’ll be visiting, or to save time, just say “symptoms comparable to user name MoneyRashHoes69”.

Of course, they’ve also got an iPhone app, which also allows you to book outside of LA — so if something happens in Tucson, you can always Ask (for) Arizona.

Hit it (but not too hard or you’ll have to make a second appointment) at ZocDoc.com

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