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Finally an Easy Way to Apply for ObamaCare

November 13, 2013

By Katie Banks+

As you have probably heard, the ObamaCare website has had some serious glitches, but now there is a way to avoid all that. Medicoverage announced today that they are able to quickly submit paper applications for ACA Bronze, Silver, Gold, and Platinum plans in most states.

finally-an-easy-way-to-apply-for-obamacare

ObamaCare ACA Paper Application

The Affordable Care Act paper application is now available for individuals and families in the following states. This is the easiest way to apply for health coverage. Click on your state below to access the application.

Alabama ObamaCare Application
Alaska ObamaCare Application
Arizona ObamaCare Application
Arkansas ObamaCare Application
California ObamaCare Application
Delaware ObamaCare Application
Florida ObamaCare Application
Georgia ObamaCare Application
Indiana ObamaCare Application
Illinois ObamaCare Application
Iowa ObamaCare Application
Kansas ObamaCare Application
Louisiana ObamaCare Application
Maine ObamaCare Application
Michigan ObamaCare Application
Mississippi ObamaCare Application
Missouri ObamaCare Application
Montana ObamaCare Application
Nebraska ObamaCare Application
New Hampshire ObamaCare Application
New Jersey ObamaCare Application
North Carolina ObamaCare Application
North Dakota ObamaCare Application
Ohio ObamaCare Application
Oklahoma ObamaCare Application
Pennsylvania ObamaCare Application
South Carolina ObamaCare Application
South Dakota ObamaCare Application
Tennessee ObamaCare Application
Texas ObamaCare Application
Utah ObamaCare Application
Virginia ObamaCare Application
West Virginia ObamaCare Application
Wisconsin ObamaCare Application
Wyoming ObamaCare Application

Need Assistance filling out the Application?

You can call an agent to receive help while filling out the app or selecting the right plan by calling 800-930-7956. We are here to help you. Many people don’t realize that there is no fee to work with an agent. With our help and the new paper application you won’t experience the ObamaCare website timing out nor the long wait times for hotline assistance (apparently reported up to 45 mins!). And, not to worry, you will be still be eligible for ObamaCare subsidies if you qualify.

When you’re done with your application fax it to 310-765-4136 or mail it to the address on the cover sheet of your application.

 

 

 


Final Days of Tonik Health Plans: CO, GA, NV

December 13, 2013

By Ray Wilson+

Tonik health plans, which are popular with the younger crowd due to their relatively low monthly premiums, are seeing their final enrollment dates in Colorado, Georgia, and Nevada. The final day to enroll is December 30, 2013. For all other states enrollment for Tonik is closed.

Tonik

Choosing a Tonik plan will provide coverage through 2014. Some people are opting to take off-Exchange plans, like Tonik, because of the larger network of doctors and hospitals rather than choosing one of the new ACA plans: Bronze, Silver, Gold, or Platinum.

If you live in CO, GA, or NV and want a new Tonik plan call 800-930-7956 or go to HealthApplication.com.

 


ACA: Fed SHOP Delay, Small Businesses Enroll Through Agents

November 30, 2013

By Amy De Vore+

Healthcare.gov delayed the Affordable Care Act federal SHOP* exchanges purchased through their site till 2015. However, small businesses, if they qualify, may still receive SHOP tax credits when they enroll through insurance agents or brokers for the new ObamaCare small business plans.

*SHOP stands for Small Business Health Option.

This is just one of many delays, including the employer requirement that employers with 50 or more full-time equivalent employees must offer insurance or face a penalty. This was also delayed until 2015.

aca update

SHOP Employers Enroll Through Agents

Agents, like the team at Medicoverage, will be able to help employers find a plan(s) and enroll them, even though they cannot use the federal website. For employers to get an idea of plans click here to see the individual and family ACA Bronze, Silver, Gold, and Platinum plans available. Employers will need to contact their agent directly at 800-930-7956 to find out what works best for them.

If Your Employer Chooses Not to Enroll in SHOP

If you are an employee who will not receive job-based health insurance you are still mandated to have health insurance or pay an ACA penalty (tax). If you need your own health insurance go to HealthApplication.com to fill out your individual or family application. Once you send in this application your agent will inform whether you are eligible for federal subsidies and explain the plans to you.

Remember before you do anything, check with your employer to see if they enroll you in a plan. If your employer offers you qualifying insurance you cannot receive subsidies. For further questions contact Medicoverage.


Fed’s ACA Website Will Not Be Fixed by Dec 1st, CMS Says

November 27, 2013

By Katie Banks+

The federal website, Healthcare.gov, “will not work perfectly on Dec. 1,” per CMS spokesperson, Julie Bataille. The spokesperson went on to say, “periods of suboptimal performance” will still be present due to high traffic and technical difficulties, according to The John and Rusty Report.

The website has been plagued with long wait times and the system timing out when people try to apply for one the new ACA plans: Bronze, Silver, Gold, and Platinum. Bataille’s announcement came after the federal website had an unexpected one hour outage on Monday, November 25, 2013.

aca update

How to Avoid the Federal Website

Many people may not realize that they do not have to use the federal website to be insured and receive federal subsidies on January 1, 2014. Agents and brokers are able to help people enroll in plans without the consumer having to go onto the fed’s site. All federal applications should be in as early as possible to have coverage on January 1, 2014. Below you will find the application:

At anytime if you have a question while filling out your application or to learn about which plan is right for you call 800-930-7956 or contact Medicoverage.


ObamaCare: Federal Enrollment Extended Till Dec 23rd

November 27, 2013

By Ray Wilson+

The federally run Obamacare plans have received an extension till December 23, 2013 for a January 1, 2014 start date. This gives consumers in those states an extra 8 days to decide on one of the new Bronze, Silver, Gold, or Platinum plans.

aca update

ACA Applications

Go to Healthapplication.com to get your paper application. Once you fill out the application and send it in, you will be contacted to discuss plans and informed if you qualify for subsidies. Remember to fax, scan and email, or snail mail your application in as soon as possible.

To learn if your state has extended its deadline call 800-930-7956 or contact Medicoverage.


Do you Live in one of the 24 States Not Expanding Medicaid?

November 07, 2013

By Amy De Vore+

24 states have decided not to expand Medicaid to about 5.4 Million eligible residents. The Affordable Care Act presented a plan to the states that 100% of the cost of Medicaid would be covered by the federal government for the first three years, after that the states would pay 10% of the cost in the fourth year. However, some states did not think was advantageous to its citizens. Individuals are still able to purchase the Bronze, Silver, Gold, or Platinum plans, but they would not be eligible for subsidies if they fall below 100% of the poverty line ($11,490 for 2013).

ACA Update

The following states have chosen not to expand Medicaid: Alabama, Alaska, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine,  Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Wisconsin, and Wyoming.

For further questions call 800-930-7956.


Non-ACA plans for Anthem CO, GA, NV, VA: Enroll Til Nov 15th

October 29, 2013

By Katie Banks+

Anthem is allowing residents of Colorado, Georgia, Nevada, and possibly Virginia to enroll in non-Obamacare plans until November 15th. This means that all current clients can renew their current plan for another year, as well as anyone can apply for a December 1, 2014 policy end date.

Anthem Facts for those who want to Enroll in non-ACA plans

There are few things you should know when applying for these plans:

  • The premiums may be less expensive
  • May have a larger network
  • May have added benefits
  • These plans do not necessarily cover the ACA essential health benefits
  • Preexisting conditions may disqualify you (if enrolling for the first time)

If you live in one of these states and would like to learn about your options call 800-930-7956 or contact Medicoverage.


Georgia ObamaCare Rates

October 02, 2013

By Ray Wilson+

Georgia has released its ObamaCare Health Insurance Marketplace rates for the new Affordable Care Act plans: Bronze, Silver, Gold, and Platinum.

Georgia ObamaCare Rate Chart

The chart below lists rate premiums for different counties of Georgia. It is important to remember that these prices are only a sample of possible pricing. The reason for this is not every age is listed, as well as they do not include subsidies. For your specific premium cost and to find out if you qualify for premium subsidies or cost-sharing subsidies call 800-930-7956 or contact Medicoverage. Scroll to the right to see prices.

Click here to have a full screen view of the Georgia chart


Georgia Platinum Plan Details

August 15, 2013

By Katie Banks+

Georgia is waiting on final approval of its ObamaCare metal plans. In the mean time, we know that the Platinum plan is the top tier of all the new plans, which has the lowest out-of-pocket maximum, highest monthly premium, and you pay only 10% of your medical costs until meet your out-of-pocket max. Plans are defined by their metal level, all this means is each plan must offer a percentage of coverage from 60-90%. All plans much include the ObamaCare 10 essential health benefits and providers must abide by the 80/20 Affordable Care Act Rule.

GA Platinum Details

Due to Georgia’s Health Insurance Marketplace plans awaiting approval, we don’t have final figures for the state, therefore we are sharing Platinum plan details of two established states: California and Colorado. In Colorado, the Platinum plan deductibles range from $0 to $1,000. Covered California’s has released a breakdown of their Platinum plan with a $0 deductible. The following California Platinum plan chart is illustrative purposes only:

Benefits Platinum Health Plan*
Deductible $0
Preventive $0
Doctor’s Office Visits $20
Specialist $40
Generic Rx $5 or less
Brand RX $15
Lab Testing $25
X-ray $40
ER Visit $150
Urgent Care $40
Out-of-Pocket Max $4,000/$8,000 (ind/fam)

Georgia Platinum Plan Premiums

Not to be redundant, but we don’t have their figures. Instead, we will offer California’s and Colorado’s premium range to get an idea of rates for Georgia. A Platinum Plan for a 40 year old, non-smoker in Colorado has a range of $314 to $499, and in California a range of $285 to $687. These premium rates do not include ObamaCare federal premium subsidies, which can drop the premium significantly. The wide range of plans are based on area and provider. For your specific premium call 800-930-7956.

How Platinum Plans Differ From Other Metal Plans

Due to the Platinum plans $0 to low deductible, lowest out-of-pocket maximums, and members paying only 10% of their medical care, it is expected to attract the sickest enrollees. If this happens, Platinum premiums could increase drastically in the coming years. Click here to compare the ObamaCare Bronze plan, Silver plan, Gold plan, and Platinum plan side-by-side.

For further questions call the number above or contact Medicoverage.


Georgia Gold Plan Outline

August 14, 2013

By Ray Wilson+

As the ObamaCare initial enrollment is less than two months away, Georgia still has not released its Gold plan premiums. However all Gold plans much include the ObamaCare 10 essential health benefits, providers pay 80% of your medical costs while you pay 20% until you meet your out-of-pocket max, and insurance companies must abide by the 80/20 Affordable Care Act Rule, where providers must spend 80% of the plan premiums on health care or refund their policyholders.

Georgia Gold Plan Overview

At this time it is unclear what Georgia’s plan breakdowns are, however we can use California and Colorado, who both have released their figures, as an example of how Georgia’s plans may work.  Colorado Gold plan deductibles range from $0 -$2,000, while the chart below is an example of a California Gold plan, purely for illustrative purposes:

Benefits Gold Health Plan*
Deductible $0
Preventive $0
Doctor’s Office Visits $30
Specialist $50
Generic Rx $25 or less
Brand RX $50
Lab Testing $35
X-ray $50
ER Visit $250
Urgent Care $60
Out-of-Pocket Max $6,350/$12,700 (ind/fam)

GA Gold Plan Premiums

As stated above, Georgia’s plans have not been approved. Georgia’s Insurance Commissioner has stated that some premiums have increased by 198%. While the state’s plans are being approved, once again, we will use California and Colorado as an example. In Colorado the Gold premium for a 40 year old, non-smoker range from about $287 to $551 per month, and in California the premium ranges from $370 to $600. These figures are without ObamaCare federal premium subsidies, which can drop the premium significantly. Remember premiums are based off age, area, and provider. For your specific premium call 800-930-7956.

How the Gold Plan Differs from Other Metal Plans

The Gold plan, generally has the same out-of-pocket maximum as Bronze and Silver plans, however the Gold plan has a higher monthly premium. The majority of policyholders do not come close to hitting their out-of-pocket max each year, so therefore you would also want to look at when does the plan kick in. If your plan kicks in after a hefty deductible, are you really saving money? With the Gold plan, you should, if Georgia follows California’s lead, have your provider pay toward your services before having to satisfy your deductible. Click here to compare the ObamaCare Bronze plan, Silver plan, Gold plan, and Platinum plan side-by-side.

For further questions call the number above or contact Medicoverage.


Georgia ObamaCare Silver Plan Overview

August 14, 2013

By Amy De Vore+

Georgia’s Silver plan has yet to release its premiums for the up coming initial enrollment period of October 1, 2013. However, all Silver plans must include the ObamaCare 10 essential health benefits, providers must cover 70% of your medical costs before you hit your out-of-pocket max, and providers must abide by the 80/20 ObamaCare Rule, where all insurance companies must spend 80% of the aggregate plan premiums on health care or refund their policyholders.

GA Silver Plan Overview

Silver plans are considered the standard of the plans, because it offers many benefits before the deductible is satisfied, as well as having he second lowest monthly premium. Since Georgia’s plans have not been released because of an emergency request by Georgia’s insurance commissioner to delay ObamaCare premiums, below are California’s preliminary breakdown of out-of-pocket costs for the Silver plan.

Benefits Silver Health Plan*
Deductible $2,000 Med
Preventive $0
Doctor’s Office Visits $45
Specialist $65
Generic Rx $25 or less
Brand RX $50 *after $500 Rx deduct
Lab Testing $45
X-ray $65
ER Visit $250 *after deduct
Urgent Care $90
Out-of-Pocket Max $6,350/$12,700 (ind/fam)

Georgia Silver Plan Premiums

Again, since Georgia’s new metal plans are still being approved we do not have preliminary figures. However in California the average Silver premium for a 40 year old, non-smoker is $294, and Colorado’s Silver premiums range from $245-$475 per month for an individual. These premiums are sans the ObamaCare federal premium subsidies, which can make the monthly premium drop to $58 in California. Remember premiums are based off age and area. For your specific premium call 800-930-7956.

Silver Plans in Comparison to Other Plans

Silver is the only plan that offers ObamaCare cost-sharing subsidies to individuals and families making less than 250% of the poverty line: $28,725 for an individual and $58,875 for a family of four. Since Silver, has the second lowest monthly premium and it covers many services before the deductible is satisfied, it may save you more money each year over the Bronze plan -even though the Bronze plan has a lower premium. Click here to compare the ObamaCare Bronze plan, Silver plan, Gold plan, and Platinum plan side-by-side.

For further questions call the number above or contact Medicoverage.


Georgia Bronze Plan Details

August 13, 2013

By Katie Banks+

Georgia requested a 30-day emergency delay on reporting plan premiums and rates, but U.S. Health and Human Services chose not to respond to this request. Georgia’s insurance commissioner, Ralph Hudgens,  claimed that premiums are as high as 198% over currently available plans. Most states that are finding a significant increase in premiums are based off previously approved health plans offering extraordinarily high deductibles and out of pocket maximums, with basic benefits.

The Bronze plan, which is the base model of the ObamaCare plans, still must include all theObamaCare essential health benefits, and must meet cover 60% of medical costs. Therefore, even though this is lowest tiered of all the plans, it offers a lot more coverage than most base plans available currently.Bronze plans should have the lowest monthly premium*.

*Some job-based plans may actually offer lower Silver plan premiums than Bronze.

Georgia Bronze Plans

This article deals with Bronze plans for individuals and families. Click here to learn about how the Bronze plan works for group and small businesses under ObamaCare. These plans must offer a 60/40 split with your insurance company covering 60% of your medical care. All ObamaCare plans must follow the 80/20 Affordable Care Act Rule, where 80% of plan premiums must be spent on medical care or will be refunded to members.

Georgia Bronze Rates

Due to the emergency request, Health and Human Services has until September 1, 2013 to approve plans. Hudgens stated on August 1, 2012, “Yesterday, after not receiving a response to my request for a 30-day delay from the secretary of Health and Human Services, I was left with no viable option but to accept the filings for the federally-facilitated Georgia exchange. Although not surprised, I am disappointed in the unresponsiveness of the Obama administration.” Hudgens has been in staunch opposition of the Affordable Care Act, running for commissioner with an anti-ObamaCare platform. Some believe this is the reason for his emergency request. He insists, as do others, that premiums are just too high for his constituents.

For the reasons stated above we do not have concrete Georgia figures at this time. Since California was the first to release its figures we are providing an example for comparison, California’s average Bronze plan for a 40-year-old, non-smoker is $226 per month, without ObamaCare premium subsidies. With subsidies that same plan could cost as low as $0 per month. Below is a chart of California’s figures to give an idea of how a Bronze plan may work in Georgia:

Benefits Bronze Health Plan
Deductible $5,000 Med/Rx
Preventive $0
Doctor’s Office Visits $60 per first 3
Specialist $70 after deduct
Generic Rx $25 or less after deduct
Brand RX $50 after deductible
Lab Testing 30% after deduct
X-ray 30% after deduct
ER Visit $300 after deduct
Urgent Care $120 after deduct
Out-of-Pocket Max $6,350/$12,700 (ind/fam)

For the most up-to-date Georgia premiums and plan rates call 800-930-7956.

Bronze May Not Be the Best Deal

Although the Bronze plan appears to save you the most per month, it cost you more than plans with higher premiums if you seek care. The reason is Bronze plans generally have a higher deductible and you will pay out-of-pocket for most services before that deductible is satisfied.  It is important to note that Silver is the only plan that offers ObamaCare cost-sharing subsidies to help with the costs of deductibles, coinsurance, and copays.  Click here to compare Bronze Plan, Silver Plan, Gold Plan, and the Platinum Plan side-by-side.

For any questions or assistance in applying (enrollment goes from October 1, 2013 to March 31, 2014),  please contact Medicoverage.


BCBS of Georgia to Renew Current Plans Until Dec 2014

June 26, 2013

By Katie Banks+

Blue Cross Blue Shield of Georgia (BCBSGA) just announced that current and new members can lock in a plan this year that will keep the same rate until December 1, 2014. This is for individual and family plan members who joined after March 23, 2010 -as plans initially purchased prior to this date may keep their coverage.

bcbs-georgia-renew-current-plans-until-dec-2014

This is a clever way for people who don’t want to join the new ObamaCare Health Exchange immediately but want to continue coverage. This loophole works because most providers have policy end dates of one year. So if a member renews by December 1, 2013 they would be able to keep their plan for one more year. After one year these plans will automatically be transitioned into an off-Exchange plan. BCBSGA says that members may at that time opt for any off-Exchange plan or for one of the on-Exchange plans:  Bronze Plan, Silver Plan, Gold Plan, and Platinum Plan. This gives members options to merge onto other plans.

Want to Keep Your Current Plan?
If you have a BCBSGA plan and want to keep your current coverage until December 2014, please contact 800-930-7956 for assistance. If you currently do not have coverage with BCBSGA but want this option to have private coverage at least until December 2014, get a Blue Cross Blue Shield of Georgia Quote and apply online.


ObamaCare: 5.7 Million Left Uninsured

June 06, 2013

By Amy De Vore+

With the Affordable Care Act beginning its Healthcare Exchange January 2014, millions of Americans living below the poverty line will be left without access to the new “metal plans”: Bronze Plan, Silver Plan, Gold Plan, and Platinum Plan.

obamacare-millions-left-uninsured
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Who is Eligible for Federal Subsidies?

Federal subsidies begin at the Federal Poverty Line (FPL) of $11,490 and go up to 400% of the FPL at $45,960. These persons may be eligible for federal premium subsidies and possibly federal cost-sharing subsidies.

How many Americans are Ineligible for Subsidies?

Many Americans living below the poverty line will not be able to receive federal subsidies, Medicaid, or other state and federal help with insurance. This leaves an estimated 5.7 million uninsured, because they live in states that have blocked the expansion of Medicaid. Among these states are: Texas, Florida, Kansas, Alabama, Louisiana, Mississippi and Georgia. These Americans are eligible for healthcare insurance help if they lived in a neighboring state.


How the Affordable Care Act Helps the Uninsured

May 31, 2013

By Amy De Vore+

The Affordable Care Act helps the uninsured in a few ways. For instance, in the LA Times today there was an article about a woman making $12.68 an hour, mother of one child, lives in Los Angeles, and recently choose to forego surgery because she was uninsured. As of January 1st this woman would have options for health coverage.

how-the-affordable-care-act-helps-the-uninsured

How the Affordable Care Act Helps Uninsured

She isn’t qualified for Medicaid, however since she works she may qualify for job-based insurance as 2015. Until then and if her employer doesn’t offer insurance she would qualify for premium subsidies and cost-sharing subsidies, and her daughter would qualify for Medi-Cal.

Costs for Lower-Income Families

The article doesn’t state how old she is, but if she is 30, her Silver plan premium could be as low as $93 a month and her deductible would be reduced from $2000 to $500, and a reduced maximum out of pocket from $6,350 to $2,250. This would apply to any single parent to one child living in the Los Angeles area, making her salary.

How do Lower-Income Families and Individuals Get Insurance?

First, it’s important to remember for anyone purchasing a plan from the Health Insurance Marketplace you need your W2 paperwork and financial information handy like child support, alimony, assets. Then you can either go directly through your state’s newly established call center’s navigators or you can go through your insurance agent. Many don’t realize that agents can help with on and off-Exchange plans.

Lower Income Seniors

Seniors do not have to do anything as of January 1st. Seniors stay on Medicare and do not apply for the new metal plans. Make sure your friends and parents are aware that there is nothing for them to do, because states are vocally expressing their concerns about seniors being tricked by scammers into giving away personal information due to the lack of awareness in regards to the ACA.

To learn if you qualify for a subsidy call 800-930-7956 or contact Medicoverage.


Healthcare Exchange Georgia: 4 Key Points

May 10, 2013

By Ray Wilson+

Affordable Care Act GA

ObamaCare, AKA the Patient Protection and Affordable Care Act, begins January 2014. Are you in Georgia ready for the changes? We have compiled a list of the important items about the new health exchange.

ObamaCare for Georgia
• All persons in the Peach State must purchase health insurance or owe a penalty by law. There are a few exceptions to this rule including if this goes against your religion. To read more about penalties for the uninsured or to see if qualify for one of the exemptions, please read the article Affordable Care Act: Penalties for the Uninsured.

• The Affordable Care Act guarantees all Georgians eligibility for healthcare regardless of preexisting conditions. To learn more about guaranteed eligibility read the article ObamaCare: Guaranteed Issuance for Everyone.

• Over a million residents of Georgia will qualify for federal subsidies to help cover portions of their premiums, including 94% off the currently uninsured non-elderly. To find out if you are eligible for a federal subsidy in GA Health Care Exchange Subsidies: Do You Qualify?

•  To prepare all citizens of Georgia, the 2014 initial open enrollment period ranges 6 months: October 1, 2013 to March 31, 2014. Contact 800-930-7956 extension 0 for assistance signing up.

Next Steps
For more information about the Health Exchange in Georgia please call 800-930-7956 or contact Medicoverage: Georgia.


BCBSGA Finally Offers Child-Only Health Coverage in 2013

January 04, 2013

Katie Banks+

Blue Cross and Blue Shield of Georgia is offering Child-Only health coverage in 2013. The company has created a new plan with the catchy title of “Georgia Child-Only Health Insurance PPO Assignment Plan” for individuals under 19 years of age.  The good news is that if you’re under 19 and you qualify, you will be accepted regardless of your health history.

How could someone under 19 not qualify for this plan?
A carrier can deny you coverage in a Child-Only plan if you can get creditable coverage somewhere else. This includes enrollment in a high-risk pool plan.  You must apply during an open enrollment period or, if you have a qualifying event, you can apply during a special enrollment period.

When is Open Enrollment?
The Open Enrollment period is January 1-31, 2013 and, if approved, the policy will take effect on March 1, 2013. If you unable to apply during open enrollment you could apply during special enrollment.

What is Special Enrollment?
Two things have to happen to be eligible for Child-Only plans (for children under age 19) during a special enrollment period. First, Blue Cross and Blue Shield of Georgia must receive notice of the qualifying event within 60 days of it happening. Second, you are required to apply within 30 days of sending the notice.

These are examples of qualifying events:

  • Loss of employer-sponsored health insurance coverage
  • Involuntary loss of other existing coverage for any reason other than fraud, misrepresentation or failure to pay premium
  • Loss of health insurance coverage due to a dissolution of marriage.
  • Marriage
  • Entry of a valid court or administrative order that requires that the applicant be covered under a health insurance policy
  • Adoption
  • Birth


The special enrollment period will be open to the applicant for 30 days from the date Blue Cross and Blue Shield of Georgia receives the notice of the qualifying event. 


What is Covered under the Child-Only Plan?
The new plan has a $2500 deductible, 30% coinsurance and an out-of-pocket maximum of $5500.  This plan does not charge for preventive visits and has no lifetime maximum payout. Contact us to access a summary of benefits and to discuss how the plan works.

How much does the New BCBSGA Child-Only plan cost?
The price for the under 19 plan is not available using our online quoting tool and requires a special application. Call us at 800-930-7956 to get a quote and access the application.  Child-Only applicants who do not have creditable coverage within the 63 days preceding the application date will be assessed a surcharge of 50%, billed as a part of the monthly premium. Because of the impact to your rate, it is important to provide prior coverage information on your application if you had prior coverage.

How do I Apply for this plan?
Contact our office to get the new child-only application: 800-930-7956

 

 

 

 

 

 

 

 

 

 


Tenet and Blue Cross Blue Shield of Georgia finally come to an agreement

June 25, 2010

By Mike Solis

After months of negotiations, Blue Cross and Blue Shield of Georgia (BCBSGA) and Tenet Healthcare have finally agreed to work together again.  The new agreement covers Tenet’s five acute care hospitals in Georgia (Atlanta Medical Center, North Fulton Hospital, South Fulton Medical Center, Spalding Regional Medical Center, and Sylvan Grove Hospital) as well as freestanding outpatient centers and physicians who are employed by Tenet subsidiaries.

According to BCBSGA’s Amy Cheslock, “We are pleased to continue our relationship with Tenet. As the state’s largest health benefits provider, we strive to create the best health care value for our customers through a broad network of quality health care providers.”

The financial terms of this agreement have not yet been disclosed.

For questions, please contact Medicoverage using the contact tab above.


Tenet Health Systems terminates contact with BCBSGA

May 13, 2010

By Medicoverage Staff

Tenet Health System has terminated its contract with Blue Cross Blue Shield of Georgia effective 7/1/2010.  Tenet Health System is comprised of several health care providers including five hospitals: Atlanta Medical Center, North Fulton Hospital, South Fulton Medical Center, Spalding Regional Medical Center and Sylvan Grove Hospital. According to BCBSGA, the company knows that their customers “value the care Tenet Health System provided to our members and we made considerable effort to keep them in our network.” However no agreement was ever finalized. 

BCBSGA has ensured its members that services rendered by Tenet providers are available from other in-network area providers in the area. According to the company they have implemented several tools to assist their clients with this network change. The company stated that the termination does not impact any of the more than 185 hospitals that are part of extensive BCBSGA networks throughout Georgia. If you are considering BCBSGA insurance and have specific questions about the Tenet Health Systems terminated contract, please contact Medicoverage Inc.

UPDATE: http://www.medicoverage.com/health-insurance-blog/news/tenet-and-blue-cross-blue-shield-of-georgia-finally-come-to-an-agreement/



Will Georgia’s “Any Willing Provider” law apply to Blue Cross Blue Shield of Georgia’s HMOs?

February 18, 2010

Author: Medicoverage Staff

The Georgia Commissioner of Insurance is meeting today to determine whether Georgia’s “Any Willing Provider” law applies to HMOs.

Background into the Any Willing Provider law

In 2007, Northeast Georgia Cancer Care, LLC (NEGCC) decided to end its HMO provider contract with Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSHP) after a reimbursement dispute.  NEGCC subsequently requested a significant increase in its reimbursement rates.  As a result of NEGCC’s abrupt contract termination, BCBSHP negotiated an agreement with the largest oncology provider in the State to ensure that continuous cancer care could be provided to Athens’ area patients at a reasonable cost.  In the intervening time, NEGCC contracted to participate in Blue Cross and Blue Shield of Georgia’s (BCBSGA) Indemnity and PPO networks. After ending its HMO contract, NEGCC later tried to re-enter the HMO network after they realized that these services would be provided by another provider.

Today’s Insurance Meeting

NEGACC now wants the Court to apply the Any Willing Provider law and force Blue Cross Blue Shield of Georgia to offer HMO contracts to their medical oncologists. Today’s decision will show us if the ‘any willing provider’ statute is applicable to HMOs.  Stay tuned….

 





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