Point of View

NC recipients need to dig deeper into their BCBS letters

October 11, 2013 

Recently, many people across the state received a note from Blue Cross and Blue Shield of North Carolina notifying customers that the company is discontinuing the member’s insurance policy. The correspondence has frightened some families because BCBSNC “matches” these letter recipients with a plan that has similar benefits to the policy that will end. Oftentimes the new policy also comes with a heftier premium.

You do not have to buy the policy to which you are matched. The new plans listed in the letters represent only a suggestion from BCBSNC. Instead, everyone should shop around for the best-fitting plan. All of the new policies sold to consumers will be comprehensive, and the insurance companies are not allowed to deny coverage or charge more based on a person’s medical history.

Many people who received letters will qualify for help purchasing insurance coverage as part of the Affordable Care Act. For example, a family of three with one child and two parents over 40 years old earning $45,000 annually can expect to pay about $276 per month for coverage. If the family chooses a lower-cost plan, they could pay about $160 per month. Assistance from health reform will pay the rest of the premium.

This premium help is available to many people earning less than $46,000 per year for an individual or $94,200 per year for a family of four. When the federal healthcare.gov website, which has been overwhelmed in recent days, is running efficiently, folks can check there to see what kind of premium discount to expect. In the meantime, there is a calculator online at the Kaiser Family Foundation site that can estimate potential savings.

Those who receive the BCBSNC letter and earn too much to qualify for assistance should shop inside and outside of the new online marketplace for the best deal available. Those who do not qualify for subsidies then have a broader range of insurance companies from which to choose. You can find out from the N.C. Department of Insurance which companies offer individual and family plans in the state or an agent or broker can help you shop for new options.

Premiums are also steeper in North Carolina because Gov. Pat McCrory and the legislature fought reform at every turn. According to Insurance Commissioner Wayne Goodwin, defaulting to the federal government to run a portion of our insurance marketplace has resulted in less competition and less competitive pricing.

And, as a brief by the American Academy of Actuaries showed, by refusing to expand Medicaid, more costs are shifted to people who purchase private insurance.

Some people are pointing to the letters from BCBSNC as evidence that people cannot keep their plans if they like them. That is not the case here. After health reform passed, BCBSNC offered its customers the option to “grandfather” or keep their plans. If members chose to alter plan benefits then BCBSNC warned that the policy would lose its grandfathered status. It’s true that most people don’t read everything sent to them from an insurance company, and often what they do read is not clear, but there was an option for BCBSNC customers to retain their plans.

Anyone who receives a letter from BCBSNC, or any insurance company, should not stop reading at the new premium prices. Look through the entire document. Shop around for new options. Check out the websites of different insurers, keep checking healthcare.gov and call (800) 318-2596 for assistance.

Insurance is confusing, especially when it is mixed with national policy changes, partisan rhetoric and misinformation. No one should make a decision too quickly based on a single letter. Open enrollment runs until March 31. And consumers have until Dec. 15 to buy a plan that begins coverage Jan. 1.

Adam Linker is a policy analyst at the N.C. Justice Center’s Health Access Coalition.

News & Observer is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service