The next Open Enrollment period under the Affordable Care Act (ObamaCare) will begin November 1, 2016 and end January 30, 2017. The earliest an individual and/or family policy can become effective during the Open Enrollment period is January 1, 2017. However, to have a January 1, 2017 effective date the application must be completed no later than December 15, 2016. There are a number of changes in the individual/family health care market in Texas for 2017 that will impact your available options. Examples: (1) Aetna has elected to withdraw from the Texas Government Exchange Marketplace but remain in the private individual/family market (2) United Healthcare and Humana have both withdrawn from all of the Texas market, both ON and OFF the Government Exchange Marketplace (3) Blue Cross has terminated CVS pharmacy as a provider in 2017 (4) The majority of insurance companies will no longer offer plans outside of Open Enrollment during 2017 and many are reducing the number of physician/hospitals available in their provider network. Some insurance companies that offer HMO’s in 2017 will no longer require the member to designate a Primary Care Physician (PCP) and may now offer Open Access, which allows members access to network specialist without a referral. Other key changes include the cost (premium rate, deductible and co-insurance etc.) Insurance regulators and insurance companies will not make final rates available for the market no earlier then 30 days before Open Enrollment.
Under the Affordable Care Act only four basic types of plans are available and all include the required ten essential benefits mandated by the Affordable Care Act. The difference between the plans is based on the “actuarial value“ for each plan. Here’s how the four basic type of plans are broken down:
- Bronze- Pays 60 % of the medical cost. You pay 40 %
- Silver- Pays 70 % of the medical cost. You pay 30 %
- Gold- Pays 80 % of the medical cost. You pay 20 %
- Platinum- Pays 90 % of the medical cost. You pay 10 %
Premiums will generally be lower for bronze and silver plans than for gold and platinum plans, but you’ll pay higher deductibles and co-payments for your medical care.
Additional key points of interest you may want to review are highlighted below:
- Premium Subsidy (Advance Premium Tax Credit)
- Apply For Advance Premium (Subsidy) Tax Credit
- Insurance Companies We Represent
- Apply for Health Insurance
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Our service cost you nothing, and we GUARANTEE your premium, for the same health insurance benefits, will be NO greater than if you purchased your individual and/or family health insurance directly from the insurance company by yourself. To request a free, no obligation, online Quote, Simply click on the blue quote bar above. Should you have questions or need assistance with the online quoting process or like a personal consultation regarding your situation or help in completing your online application for health insurance please give Laura, an RN and experienced career broker a call in the Greater Houston Area (936) 321-6286 or toll free 1 (888) 780-1215 anywhere in Texas.