Anthem Leads Insurers In Exchange

Anthem Blue Cross leads insurers in numbers of people who have signed up for Health Insurance Plans through Covered California, followed by Blue Shield, Kaiser, and Health Net. Thousands more have been signed up for Medi-Cal, the state’s equivalent of the Medicaid program.

The rocky rollout of Covered California continues, however, with long wait times to talk to a “live person” when calling the customer service numbers and a website that is less than user-friendly.

While the exchange addresses these problems by adding additional staffing and working on improving technology, assistance can be found on the website. Users can can click on Find Local Help to direct them to a certified insurance agent in their area who is trained in navigating the system and answering  questions. 

Open Enrollment ends March 31, 2014.

It’s All In the Code

Those free preventative services you are supposed to be getting with your new and improved health insurance plan don’t always come without some out-of-pocket costs.  Many are finding when they go to get these services, they are being billed for such things as “facility fees” or other related expenses.

Under the Affordable Care Act, preventative services are those recommended by the U.S. Preventative Services Task Force, an independent panel of physicians who specialize in maintenance of health and quality of life. There are currently fifteen Covered Preventative Services for Adults including Aneurysm, Cholesterol,  Colorectal, Depression, Blood Pressure, HIV, and Type 2 Diabetes  screenings, as well as many immunizations like Hepatitis A & B, Influenza, Measles, Mumps, Rubella, and Pneumococcal. Women and children have additional services recommended by the panel.

Preventative Care is a key element of the ACA, with the belief that if people take the appropriate precautions to maintain health and detect disease early, it will do much to control health-care costs.  People might not use them, however, if they continue to get billed for services that are not actually “free.”

The problem stems mainly from a lack of guidance in the medical coding of such services. One procedure can have many different codes associated with it and generate many different billings. New covered services are being added to the list, making providers and insurers even more confused. While the Department of Health and Human Services continues to find a way to streamline the system, one way you can protect yourself from being billed for preventative services, is to talk to your health-care provider beforehand so there will be no surprises. Ask your doctor what the procedure involves, what happens if something is found as a result of the procedure, and if there are any additional costs you might have to incur.

For a list of covered preventative services you can click on the link below: