Health Care Enrollment for 2017: What you need to know about the ACA and more

The Affordable Care Act (also known as: ACA; ObamaCare; The Federal Exchange) has been characterized as a huge success by some and demonized as an illustration of government overreach by others. Regardless of your opinion or politics, the current health care system has impacted millions of people.

Open enrollment for 2017 began Nov. 1 and continue until Jan. 31, 2017. There are many changes this year and it is more important than ever to evaluate and understand your coverage.

Only one insurance company will be offering plans on the exchange for 2017 in South Carolina – Blue Cross Blue Shield of South Carolina. They will be the only insurance company providing individual health care plans on the exchange. If you have coverage by another carrier and your plan was purchased on the exchange, you will be automatically switched to a comparable BCBSSC plan. Current policy holders will be receiving written communication from their insurance provider with detailed information related to their coverage.

Here’s what to expect:

▪ Changes in coverage: Comparable is not “the same” coverage. Individually insured plans at BCBSSC may have different premiums, deductible, co-pays and max out of pocket expenses than your current plan. Although many preventative measures will remain the same, when and how much you pay will be different.

▪ Changes to physician network: Yes, your coverage will be different and, perhaps more importantly for those who were not in the Blue Essential Network, you may be faced with switching physicians and hospitals, again! Blue Choice members had the Blue Options network. This network was identical to the BCBSSC Blue Essential network but if your current coverage is with a Non Blue company (Aetna or United Health plans) you will need to confirm that your current care providers will be IN-Network. Remember, if you go out of network, you may not be covered by BCBSSC and you will be responsible for all charges personally.

▪ Changes to BLUE CARD: one of the benefits of BCBSSC was the Blue Card Network. This benefit provided in network coverage outside of South Carolina to many BCBSSC members. Beginning Jan. 1, 2017, if you are on an exchange BCBSSC plan, Blue Card will be for Emergency Care only. If you are in York County, SC, BCBSSC has a verbal agreement with CMC to be IN Network but all other out of state providers, physicians and facilities may be out of network.

There is some positive new, too. BCBSSC has expanded their network within the South Carolina borders. They have also developed more plans so that you will be able to tailor your coverage to your needs. In some cases, policyholders may have a lower premium in 2017. Additionally, those who purchase “off exchange” plans will have additional insurance companies to choose from and a more robust network.

With a national election upon us, continued changes to our health care system are inevitable. It is important to proactively manage your health care and be an active participant in choosing the coverage that is best suited for you and your family. Information on new plans will be available after November 1, 2017. If you are going to purchase health insurance on the exchange in South Carolina, call your licensed agent and review the information carefully.

This story was originally published November 3, 2016 at 12:04 PM with the headline "Health Care Enrollment for 2017: What you need to know about the ACA and more."