With the Affordable Care Act’s implementation of the Health Insurance Marketplace for 2014, more individuals, families, and small businesses have health care coverage than ever before. The Marketplace provides a set of government-regulated and standardized health plans from which an individual can choose.
Open Enrollment in the Health Insurance Marketplace has begun, so now is the time to review your plan and decide if you need to make changes for next year. Insurance companies on the Marketplace may have made changes to premiums, cost-sharing, or the benefits and services they provide, so the plan you chose for 2014 may not be the same at all for 2015.
In order to have your health coverage in effect beginning Jan. 1, 2015, you must select your health insurance plan in the Marketplace at HealthCare.gov by Dec. 15, 2014.
Think twice before you auto-enroll
If you subscribed to a plan in the Health Insurance Marketplace in 2014, automatically enrolling in the same plan may not be your family’s best option.
Why? Some insurance companies have chosen to participate in limited provider networks, narrowing members’ choice of primary care physicians, specialists and hospitals. If you are a member of a plan with a limited provider network, the healthcare provider(s) you prefer may no longer be covered. It pays to compare not only costs and coverage, but also the provider directory because your plan may no longer cover the physicians and hospitals you and your family prefer.
In our area, all Health Insurance Marketplace plans but one accepts Wolfson Children’s Hospital. So, for example, if you choose to enroll or re-enroll in BlueSelect, Wolfson Children’s Hospital (and possibly some of your child’s doctors) would be considered out of network.
According to Florida Blue, if BlueSelect members choose for their child to receive care at an out-of-network hospital, they could be faced with significant out-of-pocket expenses – the difference between what the insurance company pays and what the hospital charges. Depending on the plan you select, if your child needs the specialized care only a children’s hospital can provide, you may have to travel as far as Orlando or beyond to find an “in-network” children’s hospital.
Are your child’s current doctors and Wolfson Children’s Hospital in your plan’s network?
You can shop all 45 Marketplace plans available in 2015 at www.HealthCare.gov. Please visit baptistjax.com/marketplace where you can compare plans you are considering before you apply or renew.
The good news is, during Open Enrollment that ends December 15, 2015, you can enroll in a plan that includes Wolfson Children’s Hospital, if you wish – so you can continue to receive the best care for your child, close to home.
How can I find out more?
If you have any further questions about whether your child’s preferred physicians or hospitals are included in any of the plans you are considering for 2015, please feel free to call a Baptist Health representative 904.202.2092 during normal business hours (after hours, on weekends and on a holiday, please call us at 904.202.2273).Wolfson Children’s Hospital is part of not-for-profit Baptist Health.
We also will be happy to help you determine if your child qualifies for money-saving programs such as Florida KidCare, our state’s Children’s Health Insurance Program (CHIP).
Thank you to Wolfson Children’s Hospital for letting our readers know about this important information and sponsoring this post.
