Insurance word cloud

2017 rates and plan designs have been approved for Indiana. November 1st will be the start of another open enrollment under the Affordable Care Act.

There will only be a handful of carriers on and off the exchange. Anthem will be the only state wide individual carrier for on and off. IU health plans, will only be offering off exchange plans. Then you have a handful of Medicaid type carriers offer coverage on with what I would call suspect networks.

Network Access or Lack of

2017, will bring the death of Individual PPO plan for Indiana. UnitedHealthcare was the last PPO option in Indiana and they are exiting the individual market completely. Current UHC plans on and off exchange, were actually using a commercial network for access. That network allowed Hoosiers to use St. Vincent, St Francis, Community, IU and regionals for health care. With that option gone, people both on and off will have to decided which medical group they value more. They will choose a plan that allows access to that group.

The astronomical disruption to care is coming from Franciscan network. As it stands there are no individual carriers that have access to those medical providers. Franciscan did claim they had individual network access with one of the Medicaid type carriers. Yet, they could explain it if that was true Medicaid, HIP 2.0, off exchange, or on exchange. So what happens to these patients?

Anthem is offering the most network access across the state with St. Vincent’s and Community providers. Anthem is really the only option for someone with a larger network to choose from. They have an HMO/POS, which means you do not need a referral, as long as you stay in network.

Right now is the time to start researching your current physicians for next year. If you wait for open enrollment, network searches will move slow because everyone will be scrambling to see if their doctors are in network.

For those Hoosier that use the IU network, the only off exchange plan will be IU health plans. The good news is that premium will be a lower premium than Anthem.

Medicaid Type Companies

These are companies whose primary business is providing Medicaid benefits. What this means is if you seek medical services from a specialist, they may not be accepting new patients with this coverage. If you go to insurance web sites and the first thing you see is“How to File a Complaint” tab, this is a good indication they are a Medicaid type company. From a price standpoint, Hoosiers will have no choice but to elect coverage with them.

“If you like your plan, you can keep it” and “If you like your doctor, you can keep them”

These statements now are official wrong for Indiana.