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BCBS Texas to stop offering PPO Plans in 2016


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I think that the policies they are discontinuing are the individual PPO policies that where grandfathered in when ACA started and they had so many problems.

 

Reading the Dallas Morning News article, BCBSTX is eliminating all Blue Choice (PPO) plans with the exception of employer group plans. They state they will only offer HMO plans in Texas beginning in 2016. So it's not just the grandfathered (non ACA) plans, but all PPO plans enrolled in directly or through ACA rather than through employer-provided group insurance.

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Reading the Dallas Morning News article, BCBSTX is eliminating all Blue Choice (PPO) plans with the exception of employer group plans. They state they will only offer HMO plans in Texas beginning in 2016. So it's not just the grandfathered (non ACA) plans, but all PPO plans enrolled in directly or through ACA rather than through employer-provided group insurance.

Before I would believe any news article or anyone on the net I would check out myself, the way things stand right now the healthcare.gov site would be the first place to start.

 

Denny

Denny & Jami SKP#90175
Most Timing with Mac our Scottie, RIP Jasper our Westie
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This seems like an issue where legislative advocacy would be of the most benefit by state and/or federal legislation. The intent of the Act was to get people covered but it is easy to see how a group without a traditional residence could fall between the cracks. Remember, a national insurance option was initially proposed but killed to get the rest of the Act passed. We need to raise awareness of this issue and look for a legislative solution. Texas and Florida are reluctant brides when it comes to the ACA so it may be the answer lies with other states. Also. exemptions have been created to the ACA for the religious groups etc, so it seems a concerted effort could be made to find a federal legislative solution to this very specific issue.

Dave and Lana Hasper

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This seems like an issue where legislative advocacy would be of the most benefit by state and/or federal legislation. The intent of the Act was to get people covered but it is easy to see how a group without a traditional residence could fall between the cracks. Remember, a national insurance option was initially proposed but killed to get the rest of the Act passed. We need to raise awareness of this issue and look for a legislative solution. Texas and Florida are reluctant brides when it comes to the ACA so it may be the answer lies with other states. Also. exemptions have been created to the ACA for the religious groups etc, so it seems a concerted effort could be made to find a federal legislative solution to this very specific issue.

 

 

Good point Daveh, as FT rver's we may be a small group but I am sure there are other individuals not necessarily RV'ers that would fit in our group that could add to our numbers and our voice.

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This issue is going to get more and more critical as more "Xscapers" enter our FTing lifestyle. The gap before Medicare eligibility is growing and hopefully our Texas legislators eyes and ears can be opened to our needs and legislation can be introduced that would help bridge this gap.

 

This is no easy solution since it involves private/ public companies working in the free market.

 

The biggest problem is that in the "free" market you are not going to be able to force a company like BCBS to offer PPO's if they cannot make money. If you can get something similar to a policy similar to what Healthcare Solutions offered yet be ACA compliant that would be a start, but not a final solution.

 

The farther this train goes down the tracks it is only a matter of time before it derails as it is designed to do.

http://ramblingrvrat.blogspot.com/?m=1

GOD Bless America!

GOD Bless Texas!

GOD Bless All of our Troops!

"CHARACTER is doing the right thing when no one is looking"

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Good point Daveh, as FT rver's we may be a small group but I am sure there are other individuals not necessarily RV'ers that would fit in our group that could add to our numbers and our voice.

I find when I explain my situation of traveling to others and make the analogy to traveling nurses I get a much better response. I have contacted these agencies to see what they do but have not had much success so I think they could be in the same boat as RVers.

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From when this started we only had a few companies to pick from because our home base is in a small rural town, now the last I looked we were down to two because the others went broke. We had to stay with the overpriced BCBS option because of national coverage, we are glad we decided to keep our house for a home base just because of health care.

 

Denny

And I am in the process of selling my sticks and bricks earlier than expected because of the lack of national plans in my area. Just finding another place to be a home base is an issue. The waiting list for the Escapees co-ops is at least a couple of years long is a few places I am looking.

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Brother's keeper (CHM) looks like an ad.

 

Brother's Keeper is an awesome program that is an option offered by Christian Healthcare Ministries. We are Gold members of CHM and Brother's Keeper, both of which are very, very affordable... For the two of us, our Gold membership is $300 total, not each. I don't think we've ever paid as much as $50/quarter for B.K., and many quarters we pay nothing at all.

 

My husband is diabetic. It is impossible to get insurance, but CHM's bill sharing program gives me incredible peace of mind that we will be able to get medical care when we need it. Should he ever need catastrophic care, as Gold members Brother’s Keeper provides unlimited cost support per illness (diagnosis).

 

We have submitted bills to CHM and they do exactly what they say they'll do. Our bills were paid, and they even applied our pre-negotiated discounts to our $500 portion... we didn't pay a dime that we weren't reimbursed for when the check came in.

 

http://www.chministries.org/

 

Dranoel, you aren't looking at a Brother's Keeper ad. That's a webpage explaining the ministry program from Christian Healthcare Ministries. It's an unbelievable blessing and not a spammy ad. I hope people who need it will take advantage of the resource. http://www.chministries.org/catastrophicbills.aspx

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We're all pretty much over a barrel since the ACA was made law. The government has decided that we MUST buy a product, whether we want to or not. And now that product is in the hands of an ever shrinking marketplace because of mergers in the healthcare industry. Rates and coverage's are going to be dictated to all of us without any direct competition. I'm not sure where this will end, but maybe, just maybe, 2016 will give us some relief from this govt. intrusion, and we can get back to the free enterprise system. Which might then give us competition across state lines, so we ALL can choose what's right for our particular situation. There is no one size fits all.

Fulltiming since 2010

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ACA is political. Very difficult to discuss this. I have noticed my taxes have greatly increased since ACA and when I was a part of it, was paying very high premiums. I don't see the ACA as being created for our benefit. It is all about control and money. Another reason we are with Liberty heath share..

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Well there you go again Glenn.

 

The ACA is funded by (1) premiums paid (2) an annual fee on health insurance providers (3) an excise tax on indoor tanning salons (4) an excise tax on medical device manufacturers (5) annual fee on importers and manufacturers of branded prescription drugs and (6) excise tax on high cost health insurance plans.

 

NONE of those in any way impact your current income tax rate Glenn and tax rates have not changed since last year in any event. The way to talk about the ACA is to talk facts rather than needless commentary. Whether or not YOU "see the ACA as being created for our benefit" is simply opinion and in no way furthers the discussion.

 

 

 

Dave and Lana Hasper

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I also was referring to a Christian health share. This has been a sore spot with you in the past. I can go to any provider I want and in any state. Does not effect my coverage in any way. Much better than a PPO.

2003 Teton Grand Freedom towed with 2006 Freightliner Century 120 across the beautiful USA welding pipe.https://photos.app.goo.gl/O32ZjgzSzgK7LAyt1

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I have no problem with those arrangements. I posted an impartial article explaining the history to those arrangements in the past. I just want people to understand that those sharing arrangements are NOT insurance. They do NOT meet the minimum standards of the ACA, they are exempt from the ACA. Those are very different concepts.

Dave and Lana Hasper

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The ACA is funded by (1) premiums paid (2) an annual fee on health insurance providers (3) an excise tax on indoor tanning salons (4) an excise tax on medical device manufacturers (5) annual fee on importers and manufacturers of branded prescription drugs and (6) excise tax on high cost health insurance plans.

Of those funding sources, all except the first three are being paid by everyone who has any type of medical care. Number (6) has actually caused many of the best private plans to cease to exist (including mine from 3M company) because of the extremely high penalties that have been assessed for "excess coverage" and number (2) is being shared by everyone who has any sort of private insurance, including those of us with a Medicare supplement. Everything that any government does must be paid for by the citizens in some fashion. Taxes & fees that are charged to any business are ultimately paid by the customers of that business. Good or bad, all governmental programs must be paid for by those who have financial interests in the country.

 

Faith based health care plans tend to be well thought of by their members. I suspect that part of the difference between their supporters and those who doubt is likely in their degree of faith. You will find that same difference if you examine other faith based business operations. I live in a community that is a faith based corporation. We get many of the same sort of criticisms, yet we who own homes here like the concept. A common faith plays an integral part in the success of such operations. It is very difficult for those who share a deep faith and take part in these organizations to explain the operation to others who do not share it.

Good travelin !...............Kirk

Full-time 11+ years...... Now seasonal travelers.
Kirk & Pam's Great RV Adventure

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Kirk, I was responding to Glenn's specific statement "I have noticed my taxes have greatly increased since ACA" when I listed the funding sources for the ACA. The statement makes no sense. Clearly the program is not free and costs are passed through.

Dave and Lana Hasper

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Mariner....Facts?????????????????/

 

(1) "We're all pretty much over a barrel since the ACA was made law" Do you believe the 15 million who previously had no coverage consider themselves over a barrel? How are those over 65 who receive Medicare-over a barrel? The majority of the population are on employer plans and have had no disruption due to the ACA. In fact the ACA was mainly focused on a relatively small portion of the population that was under 65 and currently not insured or underinsured. You statement was NOT factual.

 

(2) "Rates and coverage's are going to be dictated to all of us without any direct competition." The ACA is not doing away with the marketplace. The government does not dictate prices sets. Rather, it sets minimum standards for insurance policies to be offered by the private companies . The companies are free to offer the products they want as long as they meet the minimum standards. Your statement was NOT factual.

 

(3) "The government has decided that we MUST buy a product,". Again, the Act only applies to a relatively small percentage of the population. Even with regard to that population your statement is technically not true since they could choose to pay a tax penalty of $325.00 (for 2015) instead of getting insurance or participate in a ministry share plan as discussed by Glenn and Kirk above. Your statement was not Factual.

Dave and Lana Hasper

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Kirk,

 

Thank you. Well said and to the point. The fact will always remain that we as consumers will always be paying for mandates imposed by government. Nothing is paid for be a company or business, it is all passed on to us.

http://ramblingrvrat.blogspot.com/?m=1

GOD Bless America!

GOD Bless Texas!

GOD Bless All of our Troops!

"CHARACTER is doing the right thing when no one is looking"

'09 International Durastar 4400 LP Customized by 2L Custom Trucks

'20 DRV Mobile Suites 40KSSB4, '10 H-D FLHRC Road King Classic, '09 Honda Rebel AmeriDeck M/C Loader in Truck Garage, Polaris RZR 570 EPS 10 - 320W Solar Panels, 4- Simpliphi 3.8 kWh 151A Lithium batteries, Victron Multiplus 3000W inverters, Victron 250/70 Charge Controllers, Progressive hardwired 50 AMP EMS, Class of 2012!

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(2) "Rates and coverage's are going to be dictated to all of us without any direct competition." The ACA is not doing away with the marketplace. The government does not dictate prices sets. Rather, it sets minimum standards for insurance policies to be offered by the private companies . The companies are free to offer the products they want as long as they meet the minimum standards. Your statement was NOT factual.

Daveh, and WHO is deciding what the "miniimum standards are? The government, not the insurance companies. And no the governement isn't dictating the "cost" the are dictating the "product"

 

(3) "The government has decided that we MUST buy a product,". Again, the Act only applies to a relatively small percentage of the population. Even with regard to that population your statement is technically not true since they could choose to pay a tax penalty of $325.00 (for 2015) instead of getting insurance or participate in a ministry share plan as discussed by Glenn and Kirk above. Your statement was not Factual.

Of course his statement is true. The GOVERNMENT says you MUST have insurance, hence the reason for the "tax PENALTY if you do not. That IS the government saying "You MUST buy a product or we will fine you". And that isn't just a small percentage of the population as you claim, that is everyone.

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Glenn if you question my comments on Liberty Health Share, I suggest you read Liberty's own website:

 

The following legal notices are the result of discussions by Liberty HealthShareSM or other healthcare sharing ministries with several state regulators and are part of an effort to ensure that Sharing Members understand that Liberty HealthShareSMis not an insurance company and that it does not guarantee payment of medical costs. Our role is to enable self-pay patients to help fellow Americans through voluntary financial gifts.

 

This program is not an insurance company nor is it offered through an insurance company. This program does not guarantee or promise that your medical bills will be paid or assigned to others for payment. Whether anyone chooses to pay your medical bills will be totally voluntary. As such, this program should never be considered as a substitute for an insurance policy. Whether you receive any payments for medical expenses and whether or not this program continues to operate, you are always liable for any unpaid bills.http://www.libertyhealthshare.org/legal-notices

 

Kirk, You have asserted at least once before, after I have made a comment on health share ministries that: "I suspect that part of the difference between their supporters and those who doubt is likely in their degree of faith." I find these rather thoughtless comments especially coming from a board commentator. For someone so thoughtful and knowledgeable on some issues, I am quite surprised to hear you articulate a position that could be offensive to many. I hope people of faith do not need to check their common sense at the door. I understand we will know Christians by their fruits but I never thought this included whether they participated in a health cost sharing plan. In any event you should be aware that Liberty Health Share does not limit their membership to "people of faith" which undermines the entire premise of your assertion. http://selfpaypatient.com/2013/10/23/liberty-healthshare-a-health-sharing-ministry-for-all-faiths-or-no-faith-at-al Rather than a mater of faith, my concern as a nurse is that people believe they are getting health insurance by paying money to a corporation that specifically disclaims any legal responsibility to cover claims. That is a RISK people should know about.

 

See also: http://charityreports.bbb.org//cleveland/liberty-healthshare-inc-in-independence-oh-39055 http://khn.org/news/paying-on-faith-ministries-offer-alternative-to-health-insurance/

Dave and Lana Hasper

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  1.  

     

    (2) "Rates and coverage's are going to be dictated to all of us without any direct competition." The ACA is not doing away with the marketplace. The government does not dictate prices sets. Rather, it sets minimum standards for insurance policies to be offered by the private companies . The companies are free to offer the products they want as long as they meet the minimum standards. Your statement was NOT factual.

    Daveh, and WHO is deciding what the "miniimum standards are? The government, not the insurance companies. And no the governement isn't dictating the "cost" the are dictating the "product"

     

    (3) "The government has decided that we MUST buy a product,". Again, the Act only applies to a relatively small percentage of the population. Even with regard to that population your statement is technically not true since they could choose to pay a tax penalty of $325.00 (for 2015) instead of getting insurance or participate in a ministry share plan as discussed by Glenn and Kirk above. Your statement was not Factual.

    Of course his statement is true. The GOVERNMENT says you MUST have insurance, hence the reason for the "tax PENALTY if you do not. That IS the government saying "You MUST buy a product or we will fine you". And that isn't just a small percentage of the population as you claim, that is everyone.

     

    Big 5er, Yes I specifically said the government is setting the minimum standards. I agree. I did not say otherwise.

2. Well on your second issue, not really Big 5er. Compulsion to buy a product would involve a criminal penalty, ultimately jail time if you don't comply. The ACA specifically says there is no criminal penalty for non compliance. Yes you need to pay a civil fine but not paying that fine does not equate tax evasion. Also, if money is not available you can apply for a hardship exemption from the obligation to purchase. Also, there are many exempt groups like the Amish and those like Glenn participating in health share ministries. Also, the over 65 crowd for the most part gets medicare so it is inapplicable, there are watered down provisions applicable to the under 30 crowd and the vast majority of americans are covered by employer plans.

Dave and Lana Hasper

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All this ACA rehash is truly beating a dead horse. ACA is the law of the land and likely to be so for at least a couple of years. Faith-based plans? We'll see.

For RVers, particularly full timers under 65, I would think the focus should be on how to get the best heath care deal which is no mean task.

For example, it looks like health care companies found that ACA costs more -- sometimes much more (like Assurant) -- than they had planned. Hence, a couple of repercussions:

  • In order to save money, ACA Exchange plans are becoming inferior to their out-of-exchange counterparts. (Can't find the article for this one.) Though you may be able to get more of what you want from a non-Exchange plan, you forfeit any subsidy you would be entitled to with an ACA Exchange plan.
  • ACA Exchange plan rates are going up -- though competition helped federal exchanges, exchange rates are going up.

Since health care costs for those RVers under 65 can represent a significant amount of money, the old full timer domicile trio of South Dakota, Florida, and Texas may deserve reexamining. Lack of a state tax may now be secondary to the availability of quality state health care plans.

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
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  • I agree Zulu. What interests me is that the three big full timer states, Florida, South Dakota and Texas have refused medicaid expansion and consequently are strongly resisting the implementation of ACA in those states. (someone mentioned Wisc offered no PPO national plans and I note Wi has also refused Medicaid expansion). I do not know to what extent, if any, this impacts the insurance options under the exchanges in those states but it certainly raises the question in my mind. I am out of Michigan (which did accept Medicaid expansion) and have seen nothing which would indicate that my ppo will be discontinued. Nevertheless, I want to be prepared for all eventualities and am interested in the options available in states that are actually friendly to the ACA. If the Escapees can identify a state that would be friendly to the health care needs to under 65 RVers, the availablilty of a health care insurance option would probably override all other domicile concerns. I am interested in hearing from anyone currently on a PPO plan from non traditional full-time rver states.

Dave and Lana Hasper

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