What You’re Asking Us About Healthcare Reform

Yesterday, October 1,  was a milestone day for the Affordable Care Act—the first day of open enrollment for 2014. We’ve spoken to a lot of consumers in Washington and heard a lot of questions. Here’s what  you’ve been asking us:

Can I only enroll today?

No. You can enroll in health coverage for 2014 until March 31 2014.  (Check out the timeline at the bottom of this page.) If you want your coverage to begin on January 1 and you don’t currently have coverage, you’ll need to enroll before December 24. If you’re one of our existing members, don’t worry, we’ll make sure that you’re covered by automatically moving you to one of the new plans if we don’t hear from you. If you didn’t get around to contacting us in time, don’t worry, you’ll still be able to select a different plan and apply for a tax credit as long as you do so within the open enrollment period.

How can I get help with my costs?

You can get a help with your costs in the form of a premium tax credit or cost-sharing-subsidy, through Washington Healthplanfinder, the state’s healthcare marketplace. There you can buy a Premera plan and register for help with your costs at the same time. We know that some consumers have had difficulty accessing the Washington Healthplanfinder site—don’t worry, you still have plenty of time to sign up for your plan. And, if you’re not sure if you qualify for help with your costs, our team can help you understand more. Call 1-877-PREMERA.

How does the government shutdown affect healthcare reform?

The current government shutdown doesn’t affect consumers’ ability to enroll in health plans or access help with costs in the form of premium tax credits or cost-sharing subsidies. The ACA has been passed into law and the government shutdown hasn’t removed any of its funding. In addition, new rules have been introduced at the state level in Washington which reinforce some elements of the ACA.  We’ll continue to ensure that our members’ healthcare plans are compliant with the ACA.

Do I have to enroll in the plan you sent me information on?

No, you can enroll in any individual health plan that meets your needs. You can find details of all our plans here and you can also select any of our plans through the state marketplace, Washington Healthplanfinder.

Where can I find rates for all the 2014 plans?

The rates for 2014 plans vary by age, location and tobacco use, which means that there are a lot of rates! You can find rates for an individual plan, based on your personal information, by calling our team at 1-877-PREMERA. However, members have told us that they’d like to see all the rates online in one place. We’ve heard you and we’re working to get all this information updated on our website over the next few days.

Why can’t I buy a plan without kid’s dental or maternity coverage?

All plans sold for 2014 have to cover the same 10 “Essential Health Benefits”. These benefits are mandated by the Affordable Care Act. We understand that some consumers may not need all of these benefits but all health plans must include these benefits in all 2014 products.

The 10 essential benefits are:

1. Ambulatory patient services:  Care you receive outside of a hospital, such as within a physician’s clinics.

2. Emergency services

3. Hospitalization

4. Maternity and newborn care

5. Mental health and substance use disorder services, including behavioral health treatment

6. Prescription drugs

7. Rehabilitative and habilitative services and devices: Services and devices to help people with injuries, disabilities or chronic conditions gain or recover mental and physical skills.

8. Laboratory services,  such as blood tests to help diagnose or monitor conditions

9. Preventive and wellness services and chronic disease management, such as annual physicals and immunizations

10. Pediatric services, including oral and vision care

Have more questions? Let us know by calling 1-877-Premera, or asking us directly on Facebook, Twitter or here on the blog.

4 Comments on What You’re Asking Us About Healthcare Reform

  1. Hi James. If you bought your Premera plan through Washington Healthplanfinder, you receive your bill from the Exchange, and will need to ask them for that information. Thanks.

  2. Your bill would come from Washington Healthplanfinder, and not from us, so you’ll need to contact them to learn about when they bill.

  3. I have FEHB but it doesnt cover my prescription pain meds bills. Does Premera help with costs??

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