Consumers are currently in the process of enrolling in new health coverage or switching plans for 2016, so Consumer Watchdog has offered tips to help avoid pitfalls and urged them to report any problems to Consumer Watchdog on the group’s consumer complaint page by clicking on this link.
Top challenges to look out for:
➢ Narrow “Provider” Networks: Limited doctors and hospitals (“providers”) are available in-network and as a result consumers face large unexpected medical bills.
TIP: Check your insurer’s website to confirm your doctor or hospital is in-network.
➢ EPO Plans Provide No Out-of-Network Coverage: Many consumers do not know that EPO health plans provide no out-of-network coverage, leaving consumers to pay the full cost of care.
TIP: If you choose to buy an EPO plan, only visit in-network doctors and hospitals.
➢ Multiple Deductibles and Skyrocketing Costs: Consumers now face “out-of-network” deductibles that require them to pay far more before insurers contribute toward the cost of care.
TIP: Check your policy to determine if you will face higher costs when visiting out-of-network doctors and hospitals.
➢ Cancelled Plans and Fewer Options: Companies are cancelling plans leaving consumers to scramble to find replacement coverage with fewer options.
TIP: Don’t be left without coverage – the deadline to enroll or switch is January 31, 2016.
➢ Insurers Enjoying Big Profits While Shifting the Cost of Care to Consumers: California insurers have made big profits by cutting access to doctors and hospitals.
TIP: Take “screenshots” of your health insurer’s website listing your doctor as in-network in case your claim is denied.
“In order for Obamacare to succeed, consumers need coverage that actually gives them affordable access to doctors and hospitals,” said Laura Antonini, staff attorney at Consumer Watchdog. “But consumers face threats to their health and financial well-being as a result of new narrow networks, high deductibles, and limited coverage options.”
During the Open Enrollment period (which ends January 31, 2016) in and out of Covered California, consumers may purchase health insurance either through the state health insurance exchange, known as “Covered California,” or directly from health insurers. Consumers who want coverage starting January 1, 2016 have until December 17, 2015 to sign up.
