You’re probably already aware that open enrollment for commercial health insurance plans, including those on the Affordable Care Act (ACA) Exchanges, opened Nov. 1 and will run through Dec. 15.
While some patients won’t make any changes to their coverage, others will make significant changes, including enrolling with a completely different health plan.
The Texas Medical Association recommends that, starting Jan. 1, your reception staff ask all patients for a copy of their insurance card to ensure you have the correct information on file.
Your staff also should be aware that some plans have expanded their presence in Texas starting in 2020. For example, New York-based startup Oscar Health, which currently sells on the ACA Exchange in Austin, San Antonio, and El Paso, will expand to Dallas-Fort Worth and Houston starting next year.
Other plans offering products on the Exchange throughout Texas are:
According to the Centers for Medicare & Medicaid Services (CMS), which manages ACA enrollment, more than 177,000 people signed up for plans during the first two days of open enrollment, including almost 49,000 new customers. That is lower than the first week of open enrollment last year, when more than 370,000 people signed up. CMS reported widespread glitches on the first day of signups, including error messages from the online system, according to news reports. However, CMS said it was moving quickly to resolve the issues.
Your staff also should know that HMO and EPO plans have no out-of-network benefits. Therefore, you must be contracted with those patients’ health plans In order to see them in-network.
Of course, TMA is here to help you resolve any insurance-related problems through its Hassle Factor Log program.
And if you own a practice and are looking to reduce the impact of health insurance on your practice’s bottom line, turn to the Texas Medical Association Insurance Trust to learn about limited-time waivers and other budget-friendly options.