Health care open enrollment
is going on right now.
You really need to look at what
plans are offered to get the most
bang for your buck and make sure
that you're being covered in the
way that you think you should be.
Consumers for Quality Care Board
member Jason Recendez is joining us to
break down what you need to know about
healthcare and open enrollment and
some pitfalls to watch out for as well.
He is answering your questions too,
so we want you to text your
questions to him at the number 336.
3795775 Remember these are
text only questions.
These are not called questions.
We want to make sure that you
know for sure that you're texting
in these questions and you'll
get your answer in real time.
All right.
So Jason,
let's first and foremost go over
kind of like the basic thing.
Let's just go over the open
enrollment dates and the deadlines.
Sure, so it's important to know that
right now open enrollment is open.
So keep in mind a couple of deadlines.
One December 15th is the deadline
for you to have coverage through the
marketplace starting January 1st and
January 15th is a deadline if you
want coverage starting February 1st.
So really important to know these
enrollment periods really critical.
'cause this is the time that you have
to really think about what options are
best for you and for your family and
what might be either staying with your
plan if that's a good fit or making a
change given all the changes that are
happening right now due to the pandemic.
Alright, so let's talk about some of
those changes and first and foremost,
let's talk about how COVID
has changed health insurance.
I know last year lots of things COVID
related were covered by insurance,
but I'm understanding that this
year there are some changes.
So what do we need to know?
Yes, so a lot of things
are changing right now.
As you know, we're still in
the midst of a global pandemic,
but unfortunately we're seeing a
scaling back of insurance coverage
of things like copays related to
hospital stays due to COVID-19
even testing related to COVID-19
treatment related to COVID-19,
so I think that's really critical,
especially with the rise of variants.
You know, we're also very
much at risk for kovid.
Even in light of vaccinations,
so understanding what your insurer
coverage covers related to COVID is
really critical and you can find
that out by calling your insurer and
asking about whether or not they still
have waivers in place related to COVID.
That's especially important if
you're in a profession with a high
risk of developing COVID you're
in a high risk situation,
so that's really critical.
The other is related to Tele health coverage.
So we've all come, I think,
to rely on Tele health.
Certainly a survey that we did found
that 70% of consumers said they
want to continue to use telehealth
services even beyond the pandemic.
It's really helped to extend access
to coverage in light of the pandemic
and just make accessing health care
more convenient for consumers.
Yet we're seeing insurers start to roll back,
for example, waiving copays.
Related to the use of Tele health services,
so this is another important change
to be aware of.
If you come to rely on Tele health,
or about something that you prefer.
Like many consumers,
it's important to understand whether
or not your insurer is still waiving
copays for utilizing that service.
If you receive your insurance
through Medicare, for example,
it's likely those waivers are still in place.
We've seen those be maintained
during the pandemic.
It's really through private
plans that were stealing.
Seeing a scale back.
Of those services, so again,
the same kind of advice.
Call your insurer and ask about
whether or not waivers are still
in place to cover Tele health
services free of a copay.
OK, and those are specific questions to ask.
All right, let's move on to surprise billing,
so there's been a lot of talk about
how surprise billing is going to
maybe one day go by the wayside.
We have heard all of those horror
stories of people going to the doctor,
thinking that they're
covered with everything.
Then they get this bill in the
mail that they did not expect.
That's right, I mean, these are horror
stories that have really been at the
forefront of a lot of media coverage.
And because of that increase
impact and increased visibility,
Congress stepped in and passed surprise
billing legislation that will help
curb the impact of surprise bills.
But that doesn't start until 2022 and so.
Until then, it's important to understand
as much as you can or you'll receive.
Care, so if you're planning a procedure etc.
Really, it's important to understand
right now about all the care that
you're receiving is within your network.
Well, we've seen a lot of instances of
folks who go to an in network provider,
but maybe while they're there they get
seen by an out of network provider.
So for example,
an anesthesiologist as part of a procedure
while the hospital was in network.
Maybe that one provider was at a network
and that results in a big surprise.
Bill, so as much as you can,
ask questions and understand
whether or not they care,
you'll be receiving is within network
now that's not always possible,
especially in an emergency situation.
So what we recommend is if you get
a surprise bill, really push back,
ask questions,
ask why this is so much higher,
both to the hospital.
Enter your insurer,
and if you're persistent,
what we've seen in a lot of cases is that
bills will either be reduced or waived.
Together because of your advocacy
as a consumer or willingness to
continue to push back against,
you know these high bills,
but thankfully,
starting in 2022,
that burden will be taken off of
the shoulder of you as a consumer
and put between the hospital
and the insurer to figure out,
or their provider and the insurer
to negotiate who's going to pay that
bill as a result of a surprise,
and so that it can be a frustrating
experience having to go round and round with
your insurance provider in the hospital.
But it is worth. Doing that,
especially if you're getting any of those
bills up until the end of this year,
we're going to take a quick break
when we come back,
we're taking your questions.
We're also going to answer
what is a junk plan and why
you need to be wary of it.