By Ken Esten Cooke —
Even as health insurance costs rise with the Affordable Care Act, healthcare options for some local customers are being limited.
Blue Cross Blue Shield (BC/BS) discontinued its preferred provider organization (PPO) plan for individuals, claiming they lost more than $400 million in the Texas market last year.
As of Jan. 1, BCBS is transferring its customers to a health maintenance organization, or HMO, plan. But the company did not warn customers in its letter in a July newsletter.
Yet Hill Country Memorial Hospital and many local doctors have historically not accepted HMO plans, citing high costs and low reimbursements.
The BC/BS plan cuts won’t affect everyone though. Grandfathered individual plans issued prior to March 23, 2010 are exempted, as are employer-sponsored group plans or Medicare-supplement plans issued through Blue Cross.
But it is individual healthcare customers new to the market who may be up a creek or find they’re paying for plans they can’t use locally.
“Thousands of people in our community are going to have a shock,” said Wayne Harrell, a local Farmers Insurance broker. “Brokers represent a lot of people, but not even half of the community. Many of these sign up online through the state or federal marketplaces or through Blue Cross’s website.”
Keith Stehling, local insurance broker, agreed. He said he has been proactive and sent two letters to his customers, one explaining the BC/BS change, and the other last week, telling them the local hospital would not accept HMO plans.
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