News and Blog

Friday, 14 July 2017
Individual rates soar for 2018

After a very frustrating, strenuous and divisive attempt to overturn ObamaCare, the carriers had to make decisions and get plans and pricing ready for 2018. There are several big unknown factors that could significantly affect carriers, plans, pricing and consumers in the individual and subsidized markets. Will congress approve benefit subsidies, premium subsidies and/or do away with the Shared Responsibility Payments or penalties for not having qualified health insurance? Since we don't know the final answer, carriers are assuming the worst and pricing these changes into thier policies.

Carriers are finally releasing their "requested" rate increases for 2018. In Tennessee, Cigna is asking for a 42.1 percent average increase, while Blue Cross/Blue Shield wants a 21.4 percent increase. While those numbers are down from 2017 (Blue Cross/Blue Shield asked for and was granted a 62 percent increase last year), the marketplace is still unstable, according to Rep. Marsha Blackburn (R-TN), who represents the state's 7th congressional district.

She said it’s "no secret the individual marketplace is collapsing."

"It’s no longer a question of if it will fail, but when it will fail completely," Blackburn told Patient Daily. "These provisional increases are the latest in a long line of examples of why we need to repeal the ACA and address the real cost-drivers of health care and coverage."

"Coverage under the ACA is already unusable for far too many due to sky-high deductibles, premiums or never-ending co-pays." said the Congresswoman. "Now, I fear premiums will continue to rise until Americans are simply forced out of the market."

Insurers said that when they were requesting premium rates, they factored in uncertainty, particularly over cost sharing subsidies and whether the individual mandate will remain in place, the repeal of which could lead to more healthy people leaving the marketplace. However, they also cited increased medical costs and rising drug prices as a reason for the high premium requests.

The deadline for insurers to file their initial rate requests for 2018 was June 21. More rate requests from states may be made public throughout the rest of summer and into fall. However, final rates won’t likely be announced until later in the year.

It is important to note that BCBST is picking up the slack in Knoxville where Humana pulled out leaving no carriers to provide insurance to those residents. This will be the only major market where BCBST is offering individual policies. 

Posted on 07/14/2017 12:10 PM by David Moore
Thursday, 13 July 2017
Saving money on prescription

The cost of prescriptions is the fastest rising cost in healthcare today. Cigna estimates annual trend at over 15% with no sign of slowing down. There are several reasons this is happening: direct to consumer advertising, specialty drugs that were not available in the past, extreme price increases from the manufacturers and lack of knowing your options. 

Just speaking from personal experience when a doctor prescribes a medicine for a specific condition, I generally don't question that decision. Or at least I didn't in the past. The problem I am beginning to understand is doctors have no idea what one medicine costs vs. another and a drug representative is only telling why their medicine is the best. The truth is, for many medical conditions there are numerous different medications that will effectively treat the condition for prices that vary greatly. 

How do you find out what options there are and at what cost?

This is what has helped me and many of our clients - GoodRx is a website with not only great information about every medication, it will show you actual costs from drug stores in your area. A disclaimer here is these prices will be different based on your insurance plan but it will give you a very good idea. 

Coupons, there are many coupons that you can use even if you have health insurance. This will save you real money. 

Knowing the cost of the medicine before you leave the doctors office. GoodRx has an app you can download to your smartphone to see the cost of the medicines the doctor is prescribing for you so you can ask "is there another medicine I can use that does not cost as much?"  I have done this on many occasions and have never had a doctor not try to save me money. 

Another great use of this app is to lookup the cost of the medicines continually advertised on TV. This will give you a much better understanding of why health insurance costs so much. This advertising works! Doctors don't have time to educate you about why an older, lower cost Medlicine will be as effective for you. Unfortunately, it's easier to let you try this new, latest, greatest and very expensive medicine rather than risk losing a patient. 

Increasing prescription costs is a real problem in the cost of health insurance today. By becoming aware and shopping smartly we can all make a difference. 

Thanks for reading, have a great day!


Posted on 07/13/2017 3:38 PM by David Moore