Doctor Network Matters For Health Insurance

With the loss of the individual and family PPO health insurance networks coming in 2018, and those who are under the age of 65 and buying their own health insurance, making sure your doctors are in your health insurance plan network matters more than ever.  The plans in our area that are going to be offered are of the HMO, EPO, or other type of networks.  This means that you will not have the freedom to get your non-emergent care out of network, go anyplace you want, and many plans require you have a referral from your Primary Care Physician.

Here is what we recommend you do to prepare yourself for this change:

  • Make a list of the doctors, clinics, and hospitals that you are seeing or want to see if something were to happen to your health.
  • Make a list of the Rx you are currently being prescribed.
  • Talk to your doctors and ask them who they are contracted with, or dropping their contract with for 2018, or simply don’t like to deal with.

Advise your broker of this info and have them research what networks hopefully have everyone and everyplace in network.  Keep in mind that your broker will not be able to research this until Open Enrollment begins AND that the networks can change.  The change can occur for many reasons – the facility and health insurance carrier cannot come to an agreement or the facility purchases another clinic/facility and the network changes, etc.

We had a client who chose a plan that his doctor was in network with the carrier.  When the client went to visit the doctor, the doctor advised him that if he had a choice between the health insurance company he chose and the plague, he should have picked the plague.

The individual and family health insurance market open enrollment begins on November 1st, 2017.  This is the time for you to make your health insurance plan selection for 2018.



Is Your Short Term Medical Insurance ending?

At our agency we have seen a rise in the number of folks who are looking for health insurance right now since their short term medical insurance ended.  None of them realized that they did not have ACA compliant health insurance.  This means that they do not have a qualifying event to sign up for health insurance and cannot sign up for an ACA complaint health insurance plan.

ACA compliant health insurance is referred to as Obamacare and this health insurance covers the 10 essential health benefits and covers pre-existing conditions.

One of the folks told us that he thought he found a good deal when he signed up and didn’t really know it was even a short term medical plan.  This is particularly worrisome since the health issues he was diagnosed with while he was on the plan are not covered on a new short term medical plan (they are now a pre-existing condition).  Since he is responsible for his own health insurance, he will have to wait until Open Enrollment to sign up for an ACA compliant plan to help him.

Short term medical plans do have a place for the right situation.  For example, a healthy person needs coverage for 30 days while waiting for their work benefits to begin.  They are just not the deal some folks think they are.

Remember, there are no deals when it comes to health insurance premiums.






You may have recently been notified by your health insurance carrier that your current individual and family health insurance plan is going to be leaving the county you live in for 2018

There is nothing that you can do right now

• The health insurance plan you have now will provide your benefits until December 31, 2017
• The health insurance carriers that are offering plans in the individual and family market have submitted their 2018 plan designs and rates to our insurance commissioner. We are all waiting for the final decision.
• As a health insurance agency, the carriers will notify us with your options. We will then be prepared to review them all during Open Enrollment.
• Open Enrollment begins November 1st

 We are your health insurance partner and looking forward to assisting you with ALL your insurance options for 2018

BIG Insurance will help you with your strategy and keep you moving forward for 2018

Contact us:
Theresa Baker
Michelle Larson
BIG Agency 425-292-0004