Let's look at the some of the
most visable impacts to date
from health reform
It's now been over a year since
health reform or Obamacare was
passed and there have definitely
been some changes with more to
follow. Let's take a quick look at
the more consequential changes we've
seen so far and look at what can be
expected. We'll keep it strictly
politics free and just look at
impacts to California health
insurance shoppers and policy
holders.
One of the big changes that we like
is the PCIP or Pre-existing
Condition Insurance Plan. PCIP, as
it's know, provides a high risk pool
at the Federal level. The pricing
is pretty competitive and you can
qualify without underwriting. They
require a letter of denial from a
carrier at the maximum and there's
talk about just needing a letter
from your doctor saying you will
likely be declined or a letter from
a carrier saying that you will
likely be declined. From dealing
with PCIP clients every day, it's
best to just apply for
individual/family insurance and get
the declination letter back. The
main issue with PCIP is that you
need to have been uninsured for 6
months in order to qualify. This is
fine for people who have been
without insurance for a period of
time but poses an issue for someone
exhausting Cobra, losing coverage,
or moving to California (which is
the typical situation). As a
California health insurance agent
with your client's best interest,
it's hard to recommend going without
coverage for even 6 months. MRMIP
does not have the 6 month
requirement although it can have
waiting periods so you need to check
with the State's site. Make sure
not to lose a Cobra option if
available while exploring these
other options.
Underage dependents on family or
group plans. Another element of the
health reform bill that we like
allows dependents to remain on
parent's California health insurance
until age 26 regardless of student
status. This is great for families
where the dependent child might not
qualify for individual coverage due
to health or where there's a flat
family rate for any number of
children in which case, the family
rate will stay the same with the
addition of the new dependent. By
now, all dependents should probably
be on the family plan where it's
financially advantageous to them.
We can help look at your situation
to see which way works best.
Guaranteed issue for children. This
addition has been a bit rocky but we
now have the rules from all the
California health insurance carriers
on how they're treat them. For the
most part, children up to age 18
will be guaranteed issue for
individual coverage but the rates
can increase based on health. Each
carrier has different ways of
interpreting the laws in terms of
what rates they can charge but the
guaranteed issue availability is
welcomed. Of course, the premiums
have increased as a result.
Maternity health insurance in
California. This is tricky. We
have lost most of our California
health plans that cover maternity in
the last 6 months. There's only one
plan right now (either Shield $5500
or $5000 whichever is less
expensive) that makes any sense at
all. The Blue Cross of California
plans are much more expensive for
comparable coverage. You can split
policies so that the female adult
has a maternity plan and the other
family members are non-maternity
plans to get the best rate.
Preventative coverage is covered at
100% now (in-network and on newer
plans after 9/23/2010). This is
quite a big perk although the rates
have increased as a result so make
sure to take advantage of these
benefits since you're paying for
them.
Those are some of the big changes
that we actually deal with on a
daily basis resulting from health
reform in the California health
insurance market. There's
definitely more to come and we'll
address these as they actually roll
out. Please let us know if you have
any questions going forward. We're
happy to help.
Other
important
concepts
to help
you
understand
your
California health
insurance
quote
are:
Question
on the
individual
health
insurance
application
Individual
health
insurance
underwriting
Enrolling
for
Individual
health
coverage
in
California
Download
the
health
application
or apply
online
What can
delay
your
individual
health
application
Options
for
people
who do
not
qualify
To
run your
instant
health
insurance:
California
Individual
Family
health
insurance
quote
California
group
health
insurance
quote