FAQs

  • Will my premiums go up because of health care reform?

    Many people will likely see their rates go up a bit. But the good news is that the reforms mean thousands more Louisianians will now have health coverage.

    The challenge comes from the fact that insurance companies must take all customers, no matter their health condition. It costs more to cover people with pre-existing conditions. That's why rates will go up for just about everyone.

    Plus, the new law says all plans must include a minimum amount of coverage, called essential health benefits. That means we will add to all plans such things as: ER services, maternity care, mental health, lab services, pediatric care and vision services. Most plans will see this coverage added starting in 2014. More benefits add to the cost of a plan. Grandfathered plans will stay the same, though their rates may still change because of new rating rules.

  • Am I forced to have health insurance? Will I be penalized if I don't have it?

    Individual Mandate

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    Yes, everyone must have health insurance. You will be penalized if you don't.

  • What are the penalties if I don't buy insurance?

    The minimum penalty is $95 per adult in 2014. This will increase if you have minor children and do not buy insurance for them. That amount will go up each year after that. It could go up to a maximum of $695 per adult, per year, or 2.5% of your wages. Of course, only the government can fully evaluate what fees and penalties it charges you. It's important to remember that someone who pays the fee won't get any health insurance coverage and will still be responsible for 100% of the cost of their medical care.

  • How do I get health insurance?

    Health Insurance Marketplaces

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    You can start enrolling in October 2013. The easiest way to get coverage will be at www.bcbsla.com.

  • How is the government paying for health care reform?

    Health Care reform will be funded in part by cuts in some programs and by taxes and fees on insurance companies, drug manufacturers, individuals, businesses, certain medical devices and equipment, and certain services.

  • How do I know if I can get a subsidy to help pay my premiums?

    Health Insurance Marketplaces

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    When you apply for insurance on the Health Insurance Marketplace, you will enter your personal information and income. Then the site will let you know if you qualify for a subsidy. If you do qualify, the site will tell you how much you can get.

  • Is it true that you have to cover me even if I have pre-existing health conditions?

    Starting in 2014, when you purchase coverage, you will not be denied coverage for a pre-existing condition and insurance companies cannot exclude your pre-existing condition from what it covers in your plan.

  • I'm on Medicaid. Do I have to also buy insurance from the exchange or marketplace?

    No. If you are on Medicaid, you do not have to buy insurance.

  • I have an individual policy with Blue Cross. Will my plan change because of health care reform?

    The reform law says that plans must have a specific set of benefits. The law calls these essential health benefits. It is possible that the plan you now have does not include these Essential Health Benefits (EHB). If your plan does not include these Essential Health Benefits, we will soon let you know about our new plans that meet all of the government's new rules. You will be able to pick from one of those.

    Grandfathered plans are exempt from many of these changes.

  • I've had the same health insurance plan for several years. Am I grandfathered?

    If your policy was in effect on March 23, 2010, and you made no changes to it since that time, your policy is a grandfathered policy.

    If your policy was in effect on March 23, 2010, but you made significant changes to it since then, such as increasing your deductible, coinsurance, or copayments, or dropping maternity coverage, then your policy is no longer a grandfathered policy. It is a reform policy.

    If your policy was not in effect until April 1, 2010, or later, you do not have a grandfathered plan. You have a reform policy.

    A detailed chart on what provisions apply or do not apply to grandfathering is available in the HHS regulations.

    Check your plan's materials to determine grandfather status. You may also need to check with your employer or your health plan's benefits administrator at 1-800-785-8364.

  • What are the main reform changes in 2014?

    • Your plan has no annual limit.
    • You can still have coverage if you have a pre-existing condition.
    • You must have insurance.
      • Depending on your annual income, you may qualify for government assistance.
    • You can buy online at www.bcbsla.com, or the government's Health Insurance Marketplaces.
  • When will the exchange or marketplace open?

    Individuals and small businesses can shop for insurance on the online marketplaces starting October 1, 2013. The policies will not go into effect until January 1, 2014.

  • Will I be able to keep my current doctor after health care reform is completed?

    You always choose your own doctors. How much your insurance pays will be determined by whether the doctor you choose is in the provider network used in your insurance plan.

  • Will people still use brokers or agents to buy health insurance or will they just shop on the exchange or marketplace?

    You can still work with brokers or agents to help buy insurance. They can help you sign up on the online marketplace.

  • What are the essential benefits?

    The government is requiring that every health insurance plan in the new marketplace offer complete coverage - from doctors to drugs to hospital visits. The law says that all health insurance companies must offer the same set of basic benefits in all of their plans. We call these essential benefits. Some of these essential benefits include emergency room services, maternity care, mental health, lab services and some kinds of pediatric care.

  • I'm covered by a large company. How will all this affect me?

    Large employers will run their health plans as they do now, so you won't see much change.

  • I have health coverage with Blue Cross. Will my plan change because of health care reform?

    Most plans will change. If you are covered under your employer's plan, it may be "grandfathered" and not be required to include additional benefits. The reform law says that plans must have a specific set of benefits, called Essential Health Benefits (EHB). It is possible that the plan you now have does not include these Essential Health Benefits (EHB). If your plan does not include these benefits, and your employer group plan is not "grandfathered," we will soon let you know about our new plans that meet all of the government's new rules. You will be able to pick from one of those.

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