5 Cool Hikes in NC this Summer

Joe Miller from Blue Cross NC found some great hikes to try out this summer!  I love that he found some places that are less likely to be crowded.  So put on some good walking shoes, take a nice drive and enjoy the fresh air and the energy of the earth.  It's good for mind, body and soul.

5 COOL HIKES

Stay well,

❤

Tara

Health Insurance Premium Rebates

Under the Affordable Care Act, health insurance providers are required to submit annual data to the Department of Health and Human Services (HHS) regarding use of premium payments.  It’s a protection that ensures customers get value for their health insurance and is referred to as the “Medical Loss Ratio” standard or the” 80/20” rule.  At least 80% of premiums received must be spent on medical care services, including doctor and hospital bills as well as activities to improve health care quality and patient safety.  Only 20% can be used for administrative costs and profits, including executive salaries, overhead and marketing.

In 2019, Blue Cross NC spent 79.9% of premium dollars on health care and activities to improve health care quality.  Since it missed the target by 0.1%, Blue Cross NC must rebate 0.1% to its 2019 ACA members.  Emails went out August 3^rd encouraging members to log in to Blue Connect to make sure their address on file is correct.

Here are the key points listed in a recent Agent News article made available to appointed agents.

• Rebates will be issued to all eligible subscribers by September 30^th.  Rebate notifications will be mailed to some customers in August.
• Eligible individuals will receive either a rebate check in the mail, or a credit on their October bills.
• We will issue credits to individual, under-65 customers who have a monthly premium that is larger than their refund amount.
• We’re sending checks in the mail to those who:
• have a monthly premium that is less than the amount of the refund, or
• are no longer with Blue Cross NC, or
• are Student Blue members
• Customers can refer to bluecrossnc.com/MLR for more information.
• If customers have questions, they should call 1-866-669-6258.

Stay well,

❤

Tara

A Message of Hope

This is such a great article by Blue Cross NC employee Brian Edmonds.  2020 was supposed to be a great year.  The challenges we face have really come to the surface in the past few months.  And mental health is an important part of of well being.  Please take care.

Racial Injustice and Mental Health Blog by Brian Edmonds

Stay well,

❤

Tara

Turning 65? The ABC and D of Medicare

If you’re turning 65, you’ve been inundated with correspondence from insurance companies offering supplements and prescription drug plans.  Here is why.  Original Medicare only covers about 80% of many healthcare services.  

Original Medicare includes Part A and Part B.  

Part A is hospital insurance that helps cover inpatient hospital care, skilled nursing facility care, hospice and home health care.  If you or your spouse has paid 40 quarters into the Social Security Program, then Part A has no monthly premium.

Part B is medical insurance that helps cover medically necessary doctor services and outpatient care.  It also includes some preventive services to help you maintain good health.  There is a premium for Part B.  The premium is based on your household income.  In 2020, the base premium is $144.60 per month.  This premium may be waived if you are eligible for assistance like Medicaid.

Part C is a Medicare Advantage health plan, such as an HMO or PPO, which replaces Original Medicare.  These plans are offered by private insurance companies that are approved by Medicare.  You are still responsible for the Medicare Part B premium.  Most plans also include the Part D prescription drug benefit.  Premium amounts vary by carrier. 

Part D is prescription drug coverage that helps cover the cost of prescription drugs.  These plans are offered by private insurance companies that are approved by Medicare.  With Part D, the government pays a portion of certain prescriptions.  If you don’t enroll in a Part D plan during your initial enrollment period or don’t have creditable coverage like through an employer or through the VA, you will have to pay a premium penalty when you enroll in the future.  Premiums vary based on your prescription drug needs.  You may also pay more based on your income.

Medicare supplement insurance also known as a Medigap policy helps cover expenses such as copayments, coinsurance and deductibles that Original Medicare does not cover.  It does not include Part D Medicare prescription coverage so a Part D plan must be purchased separately.  Medicare supplement plans are standardized plans and are regulated by federal and state law.  For example, a Plan G offered by any insurance company provides the same standardized benefit.  The difference is premium cost, customer service, and attractive extras like exercise programs and hearing aid discounts.

Bottom line... in order to fill in the gaps of Original Medicare, you will need a supplement along with a Part D Prescription Drug Plan, OR switch from Original Medicare to a Medicare Advantage plan.  

I will help you decide whether Original Medicare or a Medicare Advantage plan is right for you.  I am happy to help!

Stay well,

❤

Tara

$25 Blue Rewards Incentive Still Available

Interested in a virtual doctor visit?  Go to mdlive.bcbsnc.com — or text “bcbsnc” to MDLIVE (635483) to set up your account with help from Sophie, MDLIVE’s personal health assistant chatbot.  You will earn a $25 gift card from Blue Rewards.

Read more about the Blue Cross NC virtual doctor incentive program along with  additional resources to support you during COVID-19.

Call me with questions!

Stay well,

❤

Tara

Blue Cross NC Virtual Doctor Visit Incentive

Blue Cross and Blue Shield of North Carolina  (Blue Cross NC) sent emails to members to address concerns about access and affordability due to COVID-19.  One of the highlights included earning a $25 gift card from Blue Rewards when you activate your MDLIVE^® account if you haven't already signed up.  

Excerpts from "Count on the Support of Blue" email.

• Virtual doctor visits are covered the same as face-to-face visits according to your health plan. (This applies to all members.) Virtual visits include appointments with primary care providers, specialists, behavioral health providers and any North Carolina-licensed providers who can deliver services via secure video or telephone.
• Call your doctor to ask about virtual options - or if an upcoming visit or procedure should wait.  It's not just for doctor visits when you're feeling sick.  Ask about virtual options for wellness visits, behavioral health visits and physical therapy, too!
• You also have additional telehealth benefits through MDLIVE^®. Blue Cross NC is waiving cost-sharing (such as deductibles, copays and coinsurance) for services provided through MDLIVE. This includes behavioral health consults.

Many doctors are already encouraging virtual visits due to the COVID-19 outbreak.  If you don’t have a doctor, or your doctor is not set up for virtual visits, take advantage of MDLIVE.  This is a new benefit for 2020 members.  

Visit mdlive.bcbsnc.com — or text “bcbsnc” to MDLIVE (635483) to set up your account with help from Sophie, MDLIVE’s personal health assistant chatbot.  You will earn a $25 gift card from Blue Rewards.

Here are additional resources:

Benefits of Telehealth

COVID-19 Resources for Members

Stay well,

❤

Tara

BCBSNC Extends Deadlines for Customers

BCBSNC is taking steps to ensure customers can maintain their coverage and access to care during the COVID-19 public health emergency.

BCBSNC will allow a 30-day extension to pay premiums.  Members are encouraged to notify customer service if they need assistance.  888-206-4697

In addition, 30-day extensions will be added in relation to:

• Claims submissions
• Appeals filing
• Authorization requests
• Additions of newborn and adopted children to a policy

Additional provisions apply.  For more details you can visit BlueCrossNC.com/Coronavirus.

These measures are in accordance with requirements from the North Carolina Department of Insurance following a State of Disaster declaration and are effective March 27th for 30 days.  BCBSNC will continue to monitor for extensions.

If you have a plan through Healthcare.gov and are experiencing an income change, please call me.  I can help you update your application to get a subsidy increase if available.  704-436-4136

Take care,

Tara