Medicare Advantage Plans Discontinuation & Open Enrollment

Earlier this month notices began going out to Medicare Advantage customers who are currently enrolled in a Medicare Advantage plan that is being discontinued in their area. An example of this is in Kern County where the Anthem Blue Cross Senior Secure Plan I is no longer available. If you receive one of these notices and need help in obtaining a new plan please contact us. We are a local, independent, family owned agency in Kern County and have been doing business since 1963. We would be happy to answer any questions you may have and to help you get enrolled in an available plan. We work with great health insurance carriers like Anthem Blue Cross, BlueShield, Kaiser and HealthNet. We offer all lines of insurance including Medicare Advantage Plans, Medicare Part D, and Medicare Supplements. You can contact our health insurance agent directly at jenni@crosbyandcrosby.com, 661-327-5531 or by visiting our office at 111 H Street. We hope to hear fromy you soon.

Obamacare System Glitches Continue

In case you missed the Bakersfield Californian story over the weekend on the Covered California glitches here is a link to the article:

http://www.bakersfieldcalifornian.com/health/x558593247/Technical-woes-but-also-interest-in-Obamacare-abound

Crosby & Crosby Insurance continues to work with Covered California and the insurance carriers to try to help as many people as we can. We know you have questions and we are here to help find the answers. Call us today for help enrolling on Covered California or help enrolling off-exchange directly with carriers like BlueShield, Anthem Blue Cross, HealthNet and Kaiser. We can be contacted by calling 661-327-5531, emailing our health agent, Jennifer Crosby, directly at jenni@crosbyandcrosby.com or stopping by our office at 111 H Street.

Obamacare Update: Employer Mandate Delayed

Only 176 Days until the Affordable Care Act health insurance plans (often referred to as Obamacare) are available.  With the constant updates and changes going on we are going to try our best to keep you updated on what this all means and most importantly how it is going to affect you.  One of the most recent changes to the mandate is the extension of the employer penalty from 2014 to 2015.  This extension gives the business owners, employees, health insurance carriers, and government one more year to iron out the details of the mandates and how they will implement them.  Here is a notice from Anthem Blue Cross on this extension:

Employer mandate delayed

July 3, 2013

On July 2, 2014, the Obama administration delayed part of the Affordable Care Act (ACA or health care reform law) that affects employers. The parts of the law listed below will now go into effect in 2015 instead of 2014:

1.        Employers will not have to report certain information to the IRS. This has been referred to as “employer reporting requirements.” We are waiting for the IRS to give details on what requirements this includes.

2.        The rule that says large employers have to offer coverage to full-time workers or pay a penalty. “Large employer” in this case is a business that has 50 or more full-time or full-time equivalent employees (that work an average of 30 hours a week).

3.        The rule that says coverage offered by large employers cannot be more than 9.5% of a worker’s pay for self-only coverage.

The delay notice changes the employer mandate part of the law only. The individual mandate and other parts of the law are unchanged. We are evaluating the impact and waiting for more information. The IRS has said it will release more details about the delay soon. We will share more information as soon as possible.

This article applies to:

  • California, Wisconsin, Virginia, Ohio, New York, Nevada, New Hampshire, Missouri, Maine, Kentucky, Indiana, Georgia, Connecticut,  and Colorado
  • Small Group, Large Group,  and ANA Consultant

We will continue to update you as we receive updates from our carriers and the administration.  If you have any questions or would like to speak to us about health insurance please call our office at 661-327-5531, email Jennifer Crosby at jenni@crosbyandcrosby.com, or stop by our office at 111 H Street.

Crosby and Crosby Partners with Core Health to offer Guaranteed Issue Health Insurance to Those With Health Problems or Pre-existing Conditions

Crosby and Crosby has recently partnered with Core Health Insurance.  Together we can offer a health plan that is guaranteed issue- no underwriting!  Everyone age 18-65 crosbyandcrosbyfacebookautomatically qualifies for coverage.  No pre-existing conditions, no health questions to answer, no medical records. 

There are 4 plans to choose from and coverage is available for individuals, single parents with children, married couples, or the entire family.

  These plans are designed to meet the needs of those who are unable to qualify for traditional health insurance due to pre-existing conditions or other medical underwriting, those who can’t afford traditional medical coverage, or as a supplement to a high deductible and limited major medical plan.  (This option is not designed to replace a traditional policy if available and affordable.) 

The coverage starts as low as $93.95 per month for individual coverage, $150.85 for a single parent and child(ren), $171.33 for a couple, and $242.99 for a family.  The rates are not based on age or medical history.  These plans include benefits for up to 12 doctor visits per year, hospital stays up to 31 days, a trip to the ER, and major medical procedures.  For a more detailed list of benefits and options please contact us at 661-327-5531. 

 Core Health Insurance is underwritten by the United States Fire Insurance Company and is rated A (Excellent) by AM Best.  Crosby and Crosby can offer this guaranteed issue health policy in California, Idaho and Wisconsin. 

Call Crosby & Crosby Insurance Services today at 661-327-5531, visit us at 111 H Street or email us at jenni@crosbyandcrosby.com.  Contact us today and you can be covered tomorrow!

Don’t Overlook Preventive Care Coverage When Comparing Bakersfield Health Insurance

Crosby and Crosby logo1In today’s marketplace finding health insurance is far from easy.  There are constant changes as Obamacare regulations take effect and companies try to meet the requirements and deadlines. 

 When looking for health insurance there are many factors to consider besides the monthly premium and deductible. 

One of the most common factors overlooked when purchasing individual or group health insurance is preventive care coverage. 

With the rising costs of medical care continuing to soar it is more important than ever to be proactive about your health care.  Getting the proper preventive care can help you avoid life threatening illness/disease by having early detection and treatment. 

 Many health insurance plans offer preventive care at no out of pocket expense.  For example, Anthem Blue Cross of California, offers preventive care coverage at 100% on their individual health plans. 

This means that if you were covered by an Anthem plan in California and visited your general physician for an annual physical as preventive care the visit would be covered.  Other preventive care coverage may include vision screening, hearing screening, cholesterol screening, PSA test, breast exam and mammogram, PAP test, and many others used in preventive medicine (depending on age and gender). 

Immunizations may also be considered preventive care and covered such as the flu vaccine and HPV immunization.  It is important to speak to your doctor about which appointments and screenings are “preventive” and which are “diagnostic”. 

Preventive care is precautionary and diagnostic care is used to find the cause of existing symptoms.  For example, when your doctor suggests you have a colonoscopy because of your age it is considered preventive care.  If your doctor suggests you have a colonoscopy because of abnormal symptoms you are experiencing that is considered diagnostic care.

  Be sure you speak to your doctor prior to receiving the care and make sure he/she is coding it properly when billing your health insurance, it can make the difference of the bill being covered at 100% by health insurance or going towards your deductible or out of pocket expense. 

Also, make sure to check your health insurance policy to see if your policy covers preventive care at 100%.  

 If you have any questions or would like to review your individual or group health insurance policy with our agency please give Crosby and Crosby Insurance a call at 661-327-5531.

 Crosby & Crosby Insurance Services offers many different health insurance carriers such as Kaiser, BlueShield, Anthem, and Aetna and would be glad to give you a no obligation review of your current medical coverage. To submit your information for a comparion quote please click here.

Confused by Health Insurance? Let Us Provide Some Common Definitions to Help!

crosbyandcrosbyfacebookAt Crosby & Crosby Insurance Services we understand health insurance can be complicated.  There are so many abbreviations and codes used it can be a full-time job just to keep up with the constant changes. 

Here are a couple of definitions that we get asked about most often:

Coinsurance -

  • A form of medical cost sharing in a health insurance plan that requires an
    insured person to pay a stated percentage of medical expenses after the deductible
    amount, if any, was paid.
  • Once any deductible amount and coinsurance are paid, the insurer is responsible
    for the rest of the reimbursement for covered benefits up to allowed charges: the
    individual could also be responsible for any charges in excess of what the insurer
    determines to be “usual, customary and reasonable”.
  • Coinsurance rates may differ if services are received from an approved provider
    (i.e., a provider with whom the insurer has a contract or an agreement specifying
    payment levels and other contract requirements) or if received by providers not
    on the approved list.
  • In addition to overall coinsurance rates, rates may also differ for different types
    of services.

Co-payment -

A form of medical cost sharing in a health insurance plan that requires an
insured person to pay a fixed dollar amount when a medical service is received. The
insurer is responsible for the rest of the reimbursement.

  • There may be separate co-payments for different services.
  • Some plans require that a deductible first be met for some specific services
    before a co-payment applies.

Deductible -

A fixed dollar amount during the benefit period – usually a year – that an
insured person pays before the insurer starts to make payments for covered medical
services. Plans may have both per individual and family deductibles.

  • Some plans may have separate deductibles for specific services. For example, a
    plan may have a hospitalization deductible per admission.
  • Deductibles may differ if services are received from an approved provider or if
    received from providers not on the approved list.

Health maintenance organization (HMO) -

A health care system that assumes both
the financial risks associated with providing comprehensive medical services
(insurance and service risk) and the responsibility for health care delivery in a
particular geographic area to HMO members, usually in return for a fixed, prepaid
fee. Financial risk may be shared with the providers participating in the HMO.

Maximum out-of-pocket expense -

The maximum dollar amount a group member is
required to pay out of pocket during a year. Until this maximum is met, the plan and
group member shares in the cost of covered expenses. After the maximum is reached, the
insurance carrier pays all covered expenses, often up to a lifetime maximum.

Point-of-service (POS) plan -

 A POS plan is an “HMO/PPO” hybrid; sometimes
referred to as an “open-ended” HMO when offered by an HMO. POS plans resemble
HMOs for in-network services. Services received outside of the network are usually
reimbursed in a manner similar to conventional indemnity plans (e.g., provider
reimbursement based on a fee schedule or usual, customary and reasonable charges).

Preferred provider organization (PPO) plan -

An indemnity plan where coverage
is provided to participants through a network of selected health care providers (such
as hospitals and physicians). The enrollees may go outside the network, but would
incur larger costs in the form of higher deductibles, higher coinsurance rates, or non-discounted
charges from the providers.
For additional definitions please see http://www.bls.gov/ncs/ebs/sp/healthterms.pdf

Contact Crosby and Crosby to help with your health insurance needs.

If you have any questions or would like Crosby & Crosby’s help in finding you or your family health coverage please call us at 661-327-5531, complete a quote online, email our health department at benefits@crosbyandcrosby.com, or stop by our office at 111 H Street. 

Crosby and Crosby Insurance Services offers health insurance plans through great carriers like, Anthem/Blue Cross, Blue Shield, Aetna and Kaiser. We have been helping families in Bakersfield and throughout Kern County since 1963!

Confused with your Options on Bakersfield Health Insurance?

crosbyandcrosbyfacebookWith all the talk of Obamacare and health care reform it is easy to get overwhelmed.  PPOs, HMOs, HSAs… there are enough abbreviations and codes to make most people just give up.  If you are frustrated and confused with your health insurance let us help.  At Crosby & Crosby Insurance we offer quotes on all plan types available and help you pick the one best for you or your family. 

 Depending on your need we can find a plan that fits both your coverage needs and your budget.
 At Crosby & Crosby Insurance we work directly with Anthem Blue Cross, Blue Shield, Aetna and Kaiser to provide you with a perfect fit.  Many of our plans now cover preventive care at no additional charge to you—that’s right, the deductible and/or co-pay may be waived for routine preventive care depending on the plan you choose.  Plans are also available that cover up to 4 doctor visits per year with a small co-pay, no deductible applies. 

Not interested in doctor visits or preventive care?  We also have plans available with high deductibles and low monthly premiums for you.  These plans are better suited for those that are more concerned with a major illness or accident being covered than a routine doctor visit.
 Let us take the confusion out of health insurance for you.  Start by getting an online quote , call us today at 661-327-5531, email our health insurance department at benefits@crosbyandcrosby.com, or stop by our office at 111 H Street.

Tuesday Insurance Questions… Are insurance policies all the same, Best Bakersfield Health Insurance, ATVs in a Garage

We have another batch of our “Tuesday Insurance Questions”. If you have questions about insurance send us an email at agent@crosbyandcrosby.com.

Question: Are all insurance policies the same?

The answer is loudly a big shouting “NO”!!! On the basic level of the actual policy contract and how it is written companies use a similar form. The key word is similar. How does your policy wording cover things like- water backup, valuable items like your jewelry and firearms and your liability? Especially with so-called “tiered” policies the policy contract can vary drastically even within the same company.

It pays to speak with a knowledgeable agent like Crosby and Crosby to discuss specific contracts and policy coverages.

Some policies are the Motel 6 of the insurance world and some are the Ritz. Spending a $100 per night at a Motel 6 is probably a rip-off but probably is a great  deal at the Ritz. The same goes with insurance. Make sure you are getting a great deal at the Ritz and not paying for bargain basement coverage. And never forget to watch for bedbugs!

What is the best health insurance company in Bakersfield?

Health insurance is one that we have seen a ton of changes within the last few years and the markets can change literally overnight. Depending on your individual situation and the coverages that you are looking for the company may be different.

We offer coverage from Anthem, Blue Shield, Aetna and now Kaiser. These 4 companies can give us a great snapshot of the best company for your needs.

To get a health quote you can complete the online form, email our health agent Jennifer Crosby at jenni@crosbyandcrosby.com  or give us a call 661-327-5531.

Are my ATV’s covered under my homeowners insurance while they are in my garage?

This is a very common question and usually gets lumped in with dirt bikes, off-road vehicles,  personal watercraft, and power boats. Your homeowners policy very specifically excludes  coverage for, “Motor Vehicles or all other motorized land conveyances”.

If you vehicle is not subject to motor vehicle registration and is used for service at your residence or for the assistance of the handicapped it may be covered.

If you have a ATV or off-road vehicle such as a dirt bike or dune buggy please speak to us about coverage.

Coverage is very affordable and you do not have coverage on your homeowners policy even while in your garage.

That wraps up this “Question and Answer”. Make sure to send us your questions! 

 

Mandatory Health Insurance vs Auto Insurance

Obama’s Interview

When asked if possible jail time was appropriate for failing to purchase mandatory Health Insurance President Obama said, ” What I think is appropriate is that in the same way that everybody has to get auto insurance and if you don’t, you’re subject to some penalty…”

What is so fundamentally wrong with this statement is that auto insurance is not mandatory. You have two options besides traditional auto insurance…

  1. In California you may post a $35,000 cash deposit with the DMV, a DMV Self-insurance certificate or a $35,000 surety bond. CA DMV
  2. Don’t drive.

What options will there be to opt out of a plan either from the government or endoresed by the government?