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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

I need to change my plan. How?

By on | 4 Comments

Question: I signed up for Blue Shield enhanced PPO through CC. But, my OBG does not seem to be getting paid from them so they do not take this insurance. How do I change my plan so I am covered with her? She is in the Cedars Network I believe.

Answer: From what you've said, It's possible that your doctor is in the Anthem Pathway network. In any case, you have to find your doctor in the right network before you change carriers. At this point-in-time, it is difficult to search the right carrier networks for a doctor. No offense, but you are not likely to do it right. You could use the assistance of a Certified agent. Go to coveredca.com, select "Find Local Help", then select, "Agents".


I just noticed that Covered California is attaching a “Subscriber ID” number to completed online applications. You will find it on the “Household Enrollment Summary” page. Hopefully this is something that can be tracked from CC to carrier. Anybody know?

Agent Sunday …

If you filled out the client’s app through your agent portal, your client was (or will be) sent a login code that can be used to access the application from their computer.

But from what you’ve written, there does not seem to be any particular urgency. OK, so you cannot contact her today, but what about M-T-W-T-F? You have until next Saturday to make any changes for an effective date of March 1.

I noticed in one of your recent blogs on CC a question about getting to an OBGYN at Cedars Sinai. It’s my understand that Cedars Sinai will not be accepting CC patients under Anthem or Blue Shield as well has off exchange individual plans. I could be mistaken but that the latest I’ve heard. Clients in LA interested in Cedars are all rushing to sign-up for off exchange plans with Assurant. In addition, in my area, Sansum Clinic in Santa Barbara is not accepting Blue Shield under CC or off exchange individual policies. It’s now apparent that more physicians and medical groups will not be accepting or participating in these EPO networks with CC or EPO networks with off exchange plans. I guess keeping your doctor and your plan in California is going to take some real creativity. Very disappointing and very troubling! Individual health commissions dropping to almost nothing or maybe 2% at most and individuals not having access to full PPO networks. I don’t see much incentive for any licensed insurance agent to spend all this research time and energy when the commission is $18 or whatever.

Cedars Sinai Hospital recently sent an announcement that it was part of the HEALTH NET PPO network, but I think the only HN PPO available through CoveredCA is at the bronze level, and that’s a lot of money to pay for a $5000 deductible.

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