It’s that time of year: Time to prepare for enrolling in your health insurance plan. If you’re under the age of 65 and seeking individual coverage through the Affordable Care Act exchange, the Annual Enrollment Period begins Nov. 1 and closes on Jan. 31, 2016.
Existing Blue Cross and Blue Shield of North Carolina customers with an ACA plan, as well as those with so-called grandfathered and transitional plans, will start to receive renewal packages with 2016 rates in the mail beginning this week. The information in the letter is specific to your plan and can help you make your enrollment decision.
As with any individual plan, monthly premiums are a key consideration. Several factors impact rates, including the number of people on your plan and the medical services they’re using. Many ACA customers will benefit from federal subsidies(1) that are available to people who qualify based on household income and determined through the Marketplace (or Exchange). It’s important to note that subsidies do not change the price of health insurance, but they do lower the out-of-pocket monthly payments you pay.
What to Consider for Open Enrollment 2016
Before choosing a plan, remember to evaluate the total package of the plan in selecting the best plan for your situation, including:
Monthly premiums: The amount paid each month to keep plan active
Doctor and hospital network: A doctor or hospital that participates in the health plan, keeping your out-of-pocket costs lower
Copayments: The set amount paid at time of service
Deductible limit: The amount you must pay for services before the insurer covers the remaining amount
Prescription formularies: The list of preferred medications
We’re offering coverage in all 100 North Carolina counties on the Health Insurance Marketplace – offering up to 32 ACA plans both on and off the exchange.
For 2016, we’ve made some changes in our product offerings in certain regions of the state. One change to look for is that, in some locations, not all of our products are available, including the Triangle and Charlotte regions. Customers in these areas will have the option to choose a lower-cost, limited network plan with their preferred health system of choice through Blue Local℠and Blue Value℠.
If you live in the Charlotte area (Anson, Cabarrus, Mecklenburg, Rowan, Stanly and Union, counties) and currently have an ACA Blue Advantage or Blue Select plan, you will have the choice of the following plans:
- Blue Value℠: This plan provides access to health care providers in the Charlotte area including Novant Health.
- Blue Local℠ with Carolinas HealthCare System: This plan provides access to Carolinas HealthCare System.
In the Triangle area, customers in Caswell, Chatham, Durham, Johnston, Orange, Person and Wake counties who currently have an ACA Blue Advantage® or Blue Select℠ plan will have the choice of the following plans:
- Blue Value℠: This plan provides access to popular health care systems in the area including UNC Health Care, Rex, and WakeMed.
- Blue Local℠ with Duke Medicine and WakeMed: This plan provides access to health care systems including Duke Medicine and WakeMed.
For ACA customers in Alamance, Franklin or Lee counties, we will only offer the Blue Value℠ plan.
What to do Next
Choosing a health plan through the ACA is an important step for you and your family. Multiple options are available to you. As you get ready to make your choices, here is a good starting point:
- If your 2015 plan is still offered and you want to keep it, you aren’t required to do anything. You will be automatically re-enrolled for 2016. However, before putting your renewal on auto-pilot, it’s a good idea to review your options to see if you’re getting the best plan for your situation.
- If the changes for 2016 outlined above mean that your existing plan has either changed or is no longer available, focus on reviewing your options for in-network doctors and your hospital system of choice.
Keep in mind that if you receive a subsidy to help purchase coverage, you must file a tax return for the year you received the subsidy.
Current customers can learn about 2016 BCBSNC plans through information and tools available online at BlueConnectNC.com as well as BCBSNC retail stores and in-person events with local agents and company representatives.
(1) Final determination of eligibility and/or amount of government financial assistance can only be obtained through the Health Insurance Marketplace.
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