Column 30 Another Extension?

Another Extension?  Yes!  Anthem has agreed to extend the payment deadline to 1/31/2014 for effective dates of January 1.2014.  As of this writing, the February premium is still due by 2/15/2014.  We have been advising our clients that while they may have mailed in premiums for January to go ahead and pay online for January.  By the time the mailed in premiums have been located, hopefully, it will be applied to the February premium.  They are not matching these premiums well and unless you have proof of mailing, I would not take the chance.

                    

 

You will need your Anthem Application ID number provided by Anthem.  https://shop.anthem.com/sales/eox/ABC/ca/en/payment/direct/validate/landing?execution=e3s1

Or  www.anthem.com/ca/paymentlanding

For Blue Shield Covered CA is directing to: http://service.healthplan.com/blueshieldca/binder.

 

A different  extension was granted to March 31, 2014 for those in the PCIP(Pre-Existing Condition Insurance Plan). These are very low priced plans for folks that had health problems and had been without coverage for 6 months or more. If you are in that group you should have received a notice. It's a little late if you have already made other arrangements.

 

Some clients who have purchased plans off the exchange or had a prior plan that with Anthem are confused by the Covered CA logo on their Anthem correspondence.  All I can say is that Wellpoint, the parent of Anthem has made a huge commitment to the Exchange business, and as far as I can tell this is simply a marketing move.  Unfortunately, they did not think about the confusion it will cause. I suggest you reference your policy numbers once you have them to differentiate between the two.

 

I wish I could report that things were running smoothly on the individual side.  But they simply are not.  Most agents who are handling this for the clients are in the same place -stretched to the max.  Hold times of hours are not uncommon, only to be disconnected.  Patience is still the order of the day, exhaustion after 12 hour days is the icing on the cake.  I cannot stress enough that your agents are working as hard as they possibly can.

 

 

Some good news! Preventive Care under the new plans is an important benefit.  These benefits are essentially covered at 100% assuming you use a Preferred Provider.  For those who have been without insurance for some time, it's likely a good idea to schedule your preventive care.  This is a good way to get acquainted with a new primary care physician.  Following is a summary of benefits that are available under the plans and are not subject to deductible or coinsurance.  When you finally get an ID card you will be able to access these benefits. 

 

Well Baby and Well Child Preventive Care

*Routine physical exam including medically appropriate laboratory tests, procedures and radiology services in connection with the exam.

*Screenings including blood lead levels for children at risk for lead poisoning; vision (eye chart only); and hearing screening in connection with the routine physical exam.

*Immunizations including those recommended by the American Academy of Pediatrics (AAP) and the Advisory Committee on Immunization Practices. Hepatitis B and varicella zoster (chicken pox) injectable vaccines and other age appropriate injectable vaccinations as recommended by the AAP and the Office Visit associated with administering the injectable vaccination when ordered by Your Physician.· Human papillomavirus (HPV) test for cervical cancer.

Adult Preventive Care

*Routine physical exams.

*Medically appropriate laboratory tests and procedures and radiology procedures in connection with the routine physical exam. · Cholesterol, osteoporosis (periodic bone density screening for menopausal or post-menopausal women), vision (eye chart only), and hearing screenings in connection with the routine physical exam. Immunizations including those recommended by the Advisory Committee on Immunization Practices for Members age 19 and above.

*Preventive counseling and risk factor reduction intervention services in connection with tobacco use and tobacco use-related diseases. ·

*FDA-approved cancer screenings including pap examinations; breast exams; mammography testing; ovarian, colorectal and cervical cancer screening tests, including the human papillomavirus (HPV) test for cervical cancer; prostate cancer screenings, including digital rectal exam and prostate specific antigen (PSA) test; and the Office Visit related to these services.

 

Other items not likely subject to deductible or coinsurance are:

a. Women's contraceptives, sterilization procedures and counseling.

b. Breastfeeding support, supplies, and counseling.

c. Gestational diabetes screening.

d. Well woman visits that are age and developmentally appropriate, including preconception and prenatal care.

e. Screening and counseling for sexually transmitted infections.

f. Screening and counseling for Human Immunodeficiency Virus (HIV).

g. Screening and counseling for interpersonal and domestic violence.

 

*Information provided in this column is "to the best of my knowledge based on press deadline. Submit your questions to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it to be answered in the paper.