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Please be aware of changes in the Blue Cross insurance plans available on the Idaho Health Insurance Exchange

To our valued patients,

The following message is intended for those of you that purchase insurance on Idaho’s health insurance exchange (www.yourhealthidaho.org), especially those of you who subscribe to Blue Cross Qualified Health Plans (insurance on the exchange and individual plans). This message does not pertain to those of you who participate through your employer’s Blue Cross group plan or Blue Cross managed Medicare. Open enrollment on the health insurance exchange ends on January 31, 2017. At this point, we are not sure if there is going to be a repeal or if a repeal and replace is waiting in the wings. Either way, we want to share some things we have learned regarding health insurance sold on the exchange that affects our communities:

 

  • If you were enrolled on the exchange in 2016, you may have been automatically renewed under the same insurance plan you had last year. If you are happy with that plan, carry on. If not, please contact your insurance broker to review alternatives available to you. Even though you automatically renewed, you still have until 1/31 to select your plan.
  • If you subscribe to a Blue Cross Qualified Health Plan, and you live in Bonneville or Jefferson Counties, you are automatically part of the Mountain View insurance network. If your Primary Care Provider practices in Madison County, you have two options: find a new Primary Care Provider practicing in Bonneville or Jefferson Counties who participates in the Mountain View insurance network, or select a different insurance product sold on the health insurance exchange that has your provider in network. If you stay with Blue Cross insurance sold on the exchange, you can be referred to Primary Care and Specialty (e.g. surgeons) Providers practicing in Madison County that are members of the Mountain View insurance network. However, that referral must be approved by Blue Cross. If you see a provider that is not in-network based on the county where you live, you may/will be subject to the Blue Cross out-of-network deductible of $50,000.
  • Madison Memorial Hospital is a “back-fill” hospital for the Mountain View insurance network. This means you can have all the services offered by Madison Memorial Hospital, and not be subject to the $50,000 Blue Cross out-of-network deductible even if you live in Bonneville or Jefferson Counties.
  • If you subscribe to a Blue Cross Qualified Health Plan, and you live in Madison County, you are automatically part of the Hometown East insurance network. If your Primary Care Physician practices in Bonneville or Jefferson Counties, you have two options: find a new Primary Care provider practicing in Madison County who participates in the Hometown East insurance network, or select a different insurance product sold on the health insurance exchange that has your provider in network. If you stay with Blue Cross insurance sold on the exchange, you can be referred to Primary Care and Specialty (e.g. surgeons) providers practicing in Bonneville or Jefferson Counties. However, that referral must be approved by Blue Cross. If you see a provider that is not in-network based on the county where you live, you may/will be subject to the Blue Cross out-of-network deductible of $50,000.
  • Madison Memorial Hospital is in-network for the Hometown East insurance network. This means you can have all the services offered by Madison Memorial Hospital, and not be subject to the $50,000 Blue Cross out-of-network deductible.

 

This is what we know for now, and we hope this information will be of assistance to you as the open enrollment period on Idaho’s health insurance exchange comes to a close for 2017.