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BCBS Texas to stop offering PPO Plans in 2016


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Fortunately for me I'll go on Medicare in July 2016, and it looks like I'll be grandfathered into the PPO since I had it before March of 2010. We will see.

 

This is not good news for anyone that travels....or even for those in fixed locations since it is VERY difficult to now find a Dr. that will take on an HMO. Mine will not.

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This is not good news for us and I suspect it will affect many other full-time Escapees not yet on Medicare.

 

 

Thank you for posting,

 

We only get our mail once or twice a month and if my insurance is affected I want to get started on whatever I need to keep my health insurance. I just sent an e-mail to my insurance broker in Houston for clarification with my policy as I still have a couple years to go before I am eligible for medicare.

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“Losses that high are unsustainable, and we have adjusted our offerings – as many insurers have – to be sustainable in the new market reality,” the company said in a letter to insurance agents.

This is more of the impact of the added cost to insurance underwriters from the recent changes in health care laws and regulations. I'll be very surprised if we do not see much more of this sort of thing and in other states as well. TX has been one of the states with many companies participating in writing of coverage so it seems to me that if it is happening to one of the largest underwriters in TX it will be happening to others and in other states.

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It's not like this sort of thing should surprise anyone. It was on the horizon from the beginning of the ACA.

 

No surprise as not many people pay their own way for health insurance as it is usually tied to employee benefits. We saved up so we could quit our jobs early and travel full time while we had our health. We have paid our own insurance premiums since 2001 but now it appears we will no longer have the option to pay our own way. Though sad I am an optimist and sure there will be a loop hole somewhere. This news just broke this week and there are many creative Escapees and Texans that may just come up with a solution.

 

The concept of insurance is to have it pay for what you can't afford. I don't believe premiums have ever equaled expenses and the system is finally catching up.

 

Hopefully Medicare will still be there for future seniors?

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The ACA is working its wonders. You have to have insurance, but no companies will cover you should you wish to like the fulltime RV lifestyle. Hopefully someone will come up with something.

Has anyone found other companies with similar coverage?

Thanks

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Unfortunately this does look like it will be the new trend in health insurance as insurance companies figure out how to stay afloat under the new Affordable Care Act. PPO plans are very costly to insurance companies as they can not control costs as well as they can with HMO/EPO network plans. Most insurance companies are losing money and only the very large ones are able to stay solvent in this environment. Assurant Health could not handle the losses it incurred so, yes, they are out of the individual health insurance market in 2016--after 120 years of profitable business. BCBS of TX might have followed suit if it did not have it's other products to prop it up as it lost $400 Million on it's PPO plans in 2014.

 

Will there be other comparable options in Texas in 2016? That remains to be seen. Plans will not be revealed until October more than likely. Nothing like last minute, huh? I can't even venture a guess at what will be available in Texas now that Aetna has bought Humana and Anthem has bought Cigna. Anthem is a BCBS company so it is unlikely Cigna will have any PPO offerings in Texas since BCBS companies can not compete against each other. Then again, the acquisition isn't supposed to occur until late 2016...so I am speculating here.

 

Whatever is available rest assured we are committed to helping the RV community, and Escapees members specifically, to find the best option available whether you are in Texas, Florida, or South Dakota.

 

The RVer Insurance Exchange (rverinsurance.com and rverinsuranceexchange.com) will launch August 1, 2015 (look for forthcoming announcements about this from Escapees RV Club). We will post updates to the site about 2016 health insurance options as soon as information is made available to us! Note that if you currently have a BCBS of TX PPO plan then you will be able to keep that plan through 2015 (longer if you have a pre-2011 grandfathered plan)

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A Medicare issue we ran into a few years back.

Three doctors offices we called would not accept Medicare because the reimbursement rate was too low. Even though we had a AARP supplement.

Had to find a medical group associated with a hospital that accepts federal money. Any medical facility that accepts federal money must accept Medicare/Medicade.

 

This was all before ACA.

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The RVer Insurance Exchange (rverinsurance.com and rverinsuranceexchange.com) will launch August 1, 2015 (look for forthcoming announcements about this from Escapees RV Club).

Kyle,

 

While the exchange will provide a valuable resource to inform folks of their options, it will not change what is available on the market. What is the possibility/feasability of creating a group plan for say Escapees/FMCA/etc, members?

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Kyle,

 

While the exchange will provide a valuable resource to inform folks of their options, it will not change what is available on the market. What is the possibility/feasability of creating a group plan for say Escapees/FMCA/etc, members?

 

JMO, but I don't think you'd want to be in a group with nothing but old folks in it.

 

The ACA was conceived and designed to eliminate insurance companies. Many have said that it would become like Medicare with a single insurer (the Federal Gov't). It looks like this will happen sooner than later.

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......... What is the possibility/feasability of creating a group plan for say Escapees/FMCA/etc, members?

The idea of a group health insurance plan has been considered by Escapees in the past but there was not enough support for it. Several years ago the FMCA did so as well. At the time there were not enough members who indicated that they would join such a program. Many of us have insurance through a former employer or are now eligible for Medicare. Since we are now increasing the numbers of membership who are still employed and not retired that could change things but such a group plan would have the same sort of problems that BCBS-Texas has had. You must be able to take in enough in premiums to be able to pay out all claims each year as well as to pay your employees and other administrative expenses. With medical costs soaring and governmental regulations increasing with it's accompanying paperwork and record keeping, that is getting to be more difficult all of the time.

 

At the same time, you may want to suggest the idea to the office of Escapees or any other RV group that you are a member of since increasing numbers could change the situation. If enough members were to ask for such a plan they would likely consider it once more. There is also the alternative of programs such as Liberty Health-share, Medishare, as well as other health-sharing programs. While I have no personal experience with these programs, I do know a couple of families who are members and I know that there are one or two on these forums who belong to one of these groups.

 

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JMO, but I don't think you'd want to be in a group with nothing but old folks in it.

 

The ACA was conceived and designed to eliminate insurance companies. Many have said that it would become like Medicare with a single insurer (the Federal Gov't). It looks like this will happen sooner than later.

 

Good point the group needs healthy low cost individuals to offset the less healthy high cost individuals.

 

Whether it is the government or the insurance company we all pay for it in the end.

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JMO, but I don't think you'd want to be in a group with nothing but old folks in it.

The folks having the most problems are those that are not yet eligible for Medicare. I don't recall many if any issues with Medicare and Medicare supplements other than some doctors not wanting to accept Medicare patients. Escapees is trying to attract a younger group through the Escapers program. I would think this would be attractive to at least some of that age group.

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