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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.

How Can I Handle a Rate Increase?

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Question: I can barely pay my Anthem Blue Cross monthly bill now and that’s with a subsidy. I need the health insurance since I have diabetes.

Answer: If your current plan becomes unaffordable after the 2017 rate increase, you have a couple of options available to you without losing your health insurance, but both options involve trade-offs.

  1. If you have a Silver or higher tier plan, you can downgrade, for example from Silver to Bronze. If you stay with the same insurance carrier, Anthem Blue Cross in your case, you will stay in the same provider network of doctors and hospitals. The trade-off is higher out of pocket medical expenses because of higher deductibles and copays.
  2. Shop a cheaper Silver Plan with one of Anthem Blue Cross’s competitors. For example, you may find that you can change to an 2017 Oscar Health Silver EPO plan at the same rate as you had for Anthem Blue Cross Silver PPO plan in 2016. However, you will have to check carefully to make sure your doctors and other providers are in the Oscar health network. The trade-offs in this example are loss of out-of-network coverage in switching from PPO to EPO plans as well as the network considerations.

If you do not already have a Certified Health Insurance Agent now is the time to get one. Your agent can help clarify your options, guide you through the application process, and if subsidies are involved, make sure you get the best outcome possible.

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