|What you need to know|
Open Enrollment will be here before we know it! Open Enrollment begins November 1st and closes December 15th for a January 1st effective date. You may have received an email from Access Health, letting you know about the option to schedule a “healthy chat” via zoom or phone. You do NOT have to attend this because you have a broker. You can schedule either of those with us. Please call us first as we find that Access Health makes many errors when dealing with income and applications. Please call us first! In the past we have scheduled in person appointments and appointments by phone. Things aren’t going to be all that different this year, but for many reasons we will be doing remote appointments only. As always, we truly appreciate your patience and loyalty to us during these unprecedented times. In years past, Access Health has experienced glitches in the beginning of Open Enrollment. We are going to make appointments for on or after November 4th, and can start scheduling those now! Make an appointment with Ericka or Laura here, Melissa will be scheduling those for us. Access Health will be sending out renewal letters sometime near the end of October. It is very important that you read your letter. Some of you will be auto-renewed into your plan for next year and some of you must make a plan selection in order to be enrolled for a plan in 2021. We prefer for you to contact us before you call Access Health. Avoid long wait times and call us first!
|When to contact us: |
If you have received a letter that says you need to make a plan selection in order to be enrolled next year please contact us. Email is best as we may often be working during non-business hours. Of course, we can still be reached by phone. Melissa will be assisting us in our phone calls, don’t be surprised if you hear back from her first. If you will be turning 65 in 2021, please contact us. Based on your health typically determines what plans we place you on in this transition year. We are fully certified to sell all medicare products and will walk you through the process.If your income needs to be updated, please contact us so we can complete that and go over your options. Please note we will not complete income changes until after December 1st, so that your subsidy doesn’t change for December it will change for January. If your medical needs have changed and you need to make plan changes to accommodate those needs, please contact us. If you have a surgery scheduled for the new plan year or if you know you need one, please contact us.If you are looking to change your plan for any other reason. If your plan was terminated during the year for any reason, call us so we can get you signed up for a new one. We may have an alternative medical product to offer you. Please reach out to us for details, not everyone will qualify for this option. It is a cost effective alternative.If you know of any friends or family that are on Access Health and need a broker, or that need help with Medicare, please let us.
|Updates to Anthem & Connecticare|
*This is an update to the post*
Having just finished up our broker webinar’s we have some news to share with you. We know that subsidy amounts are going up and the income thresholds have been raised. We do not yet have exact threshold amounts for 2021.
Individual plans are, yet again, going through many changes. Here is what you need to know:
– They are offering HMO plans ONLY. This means no plan in the individual market will have out of network benefits.
– They have also changed the networks they are offering. This year they will offer Pathyway Enhanced (the best one), Pathway Enhanced Tiered (2nd best) and lastly Bluecare Prime (the most narrow and restrictive). With the Bluecare Prime network you must select a primary care physician and you need referrals for a specialist.
-The individual out of pocket maximum is rising to $8550 per individual. — The lowest out of pocket available is $7000 per individual. Deductibles are ranging from $2000-8500.
– If you live in Litchfield County and are on the Anthem Silver PPO Standard Pathway plan, the same exact policy is now better priced with Connecticare not Anthem. Please let us know if you would like to make this change.
We will discuss other counties on an individual basis. Lastly, Anthem is no longer participating with Walgreen’s or affiliated pharmacies.
Connecticare has not given any official updates, but we can see some changes that have been made on Access Health to their plan offerings.
Some changes have been made to the Passage Bronze Alternative PCP POS plan:
– Their is still no copay at an IN-network PCP visit for either preventative or sick care.
– It is still the lowest cost plan on Access Health.
– The deductible for individual & family is $7000/$14000, the out-of-pocket maximum is $8550/$17,100. Tier 1 generic prescription is $25. Urgent care copay is $100. ALL other services, you must first cover the deductible and then a 50% coinsurance until you reach the out-of-pocket maximum.
They are now offering a tiered plan, similar to Anthem’s. It is only being offered on a Gold level. It is called the Compass Gold Alternative POS plan. This plan likely utilizes the Passage network for Tier 1 and Choice network for Tier 2. Again, Connecticare has not offered us any official updates at this time so this is conjecture.
The Choice Silver Standard POS plan has remained the same with NO changes to deductibles and co-pays overall.
The Choice Bronze Standard POS plan is now Bronze Virtual Alternative POS plan. The structure is still basically the same with changes to co-pay amounts. The IN-network PCP copay is now $30 copay. Tier 1 generic prescriptions are now $25 copay. Urgent Cares IN-network are $100 copay. They have added unlimited Teladoc IN-netwokr virtual visits are $0 copay.
If you have not yet scheduled a appointment with us and need to, please go to this link here, Melissa will be scheduling those for us.
|Access Health – Renewal Notices|
Access Health CT will send (or has already sent) a letter to customers currently enrolled in a Qualified Health Plan by mail (and in their account inbox) that confirms the information they have on your household and tells you if your coverage can be renewed automatically for 2021. These renewal projection notices include important information about the your household, current coverage and next steps for renewal.
For our renewing customers, your first step is to make sure we have the most up-to-date information on your household.
That includes:Where you liveHow much you earnYour contact information (email, home and mobile number)
If you receive an advanced premium tax credit (APTC) you must make sure that your income is listed accurately with Access Health. You Must file taxes to receive an APTC. If you have not filed 2019 taxes you will have issues receiving a tax credit from Access Health. If you are married, you must file together. If you do not you will not be able to receive a tax credit. Please note we are not tax professionals. If you have tax related questions you should contact your accountant or other tax professional. It is our understanding that the stimulus check will not count towards your income but the extra $600/ weekly will in terms of your tax credit.The following is a list of what Access Health considers to be income:Wages Salaries Taxable interestTaxable amount of pensionAnnuity or IRA distributionsSocial Security benefitsBusiness incomeUnemployment compensation
Ordinary dividendsRental real estatePartnerships Trusts S Corporations Other income
|Federal Poverty Line Chart 2020|
This is the Federal Poverty Line Chart for 2020, the numbers will change for 2021. If your income is above the Subsidy Limit Line or below the FPL 2020 Line you will not be eligible for an APTC.
|Anthem – Discontinued Plans with Access Health|
If you have an Anthem plan through Access Health, this information is for you. Anthem is discontinuing six (6) plans. IF you are currently enrolled in one of these plans, you will not be eligible for an auto-renewal and you will need to select a new plan. Gold PPO Pathway X (4FB7). This includes two (2) CSR plans, LCSR (4FB8) and ZCSR (4FB9).Bronze PPO Pathway X (4G78). This includes two (2) CSR plans, LCSR (50ZZ) and ZCSR (4FAV).
If you have had changes in providers please be sure to check that they participate in-network for your plan. Melissa will send links to anyone who needs them, please Email Melissa Here
|Connecticare Auto Pay|
We have recently learned that Connecticare does not notify you if your auto-payment has not been processed. Specifically, if your card expired, they will not send you any notifications in regards to it not going through. Please plan accordingly.