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North Carolina consumers who buy their own health insurance through the federal Health Insurance Marketplace may notice some changes to the plans BCBSNC is offering for 2017.

One critical factor when choosing a health plan is which doctors and hospitals are in the network. Another is the cost of premiums and out-of-pocket expenses. That’s why we regularly assess the health plans we offer to ensure they fit customers’ needs and provide access to high-quality doctors and hospitals at reasonable costs.

What we learned about offering coverage through the Affordable Care Act in 2016 has led us to make some adjustments for 2017. These changes fall into three categories:

  • Changes to the mix of types of plans we’re offering to customers who buy their own insurance
  • Changes to which health care providers are in-network for certain types of plans
  • Changes to the benefits we offer, like deductibles and out-of-pocket maximums

 

Changes to Types of Plans

We will no longer sell Platinum plans – ffwhich typically offer the highest level of benefits, but also have the highest premiums – on or off the Health Insurance Marketplace.

Last year, only 3 percent of our ACA customers chose Platinum plans. Since the ACA began with the 2014 coverage year, the vast majority of our customers have chosen more affordable plans. That’s where we’ll put our focus for 2017.

If you currently have a Platinum plan, and you purchased on the marketplace, we’ll automatically move you to a Gold plan for next year. However, you can still choose a different plan during open enrollment. If you have a Platinum plan but didn’t purchase coverage from the marketplace, you’ll need to reapply.

Regardless of plan level, existing ACA customers looking to renew their coverage for 2017 might find large increases in their monthly premiums – an average of 24.3 percent compared to this year’s coverage.

But that’s before taking the federal subsidy into account. After completing the process and finding out the subsidy amount, about 72 percent of existing customers will actually see their costs decrease, according to our internal data. That’s because the subsidy amount rises as premiums go up.

The 2017 subsidy will be updated for you when you renew during open enrollment, as long as you’ve provided required information to the marketplace, including any updates to income. BCBSNC will include the subsidy amount when we send an updated rate notice to you in November.

 

Network Changes

Each year, the doctors and hospitals that are covered as in-network change. We encourage our customers to check that their doctors and hospitals are in-network on the health plan they’ve chosen, note any changes that have occurred and explore the different plans and networks available.

In some regions of the state, we offer a limited-network option. These arrangements help control out-of-pocket expenses for cost-conscious consumers, making them a popular choice among individuals who buy their own insurance.

One change for 2017 customers in the Triangle area is that WakeMed Health and Hospitals will no longer be in-network for our Blue ValueSM product. You may stay with Blue Value and choose a different in-network provider, or choose Blue LocalSM with Duke Medicine and WakeMed to keep seeing your current doctor. Note that the Blue Local choice is available for all Triangle counties except Alamance, Franklin and Lee.

Another difference for next year’s ACA plans involves pharmacies. Those changes are detailed in a recent blog post.

 

Changes to Benefits

Some benefits and out-of-pocket payments are changing for 2017. These depend on the type of plan you have.

Before selecting a plan, please review the renewal information you should have received in the mail, including the link to a website for your specific situation. Another resource is our ACA Open Enrollment frequently asked questions.

 

What ACA Customers Need to Know

We’re always working to offer plans that fit our customers’ health care and financial needs. Evaluating our plan offerings and networks is just one way we do that.

If you’re considering buying your own health insurance through the federal marketplace, you can purchase a 2017 plan beginning Nov. 1. Be sure to compare plans and provider networks as early as possible to avoid any surprises or stresses at the enrollment deadline.

 

 

About Kyle Marshall

Kyle Marshall, a senior communications specialist at Blue Cross and Blue Shield of North Carolina, writes about the health care industry and provides communications counsel and support to the company's executive team.