Can my Health Insurance Plan be Discontinued?

[Jenny Stevens]

Hello Reddit,

I'm considering switching from a costly, grandfathered BCBSIL PPO health insurance plan to a potentially more affordable option on the Health Care Exchange, possibly an Aetna PPO. My primary concern is maintaining access to a wide provider network at major Chicago hospitals due to my having multiple health problems . Here are my key questions:

(1) If I opt for a new plan like Aetna PPO and, in the future, Aetna changes or discontinues their PPO plans with extensive networks, what are my options? Are there any Illinois or federal laws that protect my coverage in such scenarios?

(2) The reason for my concern is because I found out after researching that eight years ago, BCBSIL discontinued certain PPO plans from the Healthcare Exchange, as detailed in this thread:


This situation is a major part of my concern. I wonder if those who had these BCBSIL PPO plans from the Healthcare Exchange before the discontinuation got to keep their health plans because of certain laws or regulations?

I'm trying to gauge the risks of leaving my current plan and what protections State or Federal, if any, are in place for keeping plans from the Healthcare Exchange in the case they get discontinued.Any advice or shared experiences would be greatly appreciated.Thank you!

 

[Yagents]

You have no guarantees on any plan, and there are no regulations in place that require any carrier to keep a PPO network being offered, or contract with any particular hospital. Whether on your employer group, Cobra, or ACA exchange plan. Chances of PPO's being eliminated are VERY high every year on ACA exchange plans. Some states don't have a PPO. Some only have 1 if lucky. Everything changes every year.

 

[Lee Vena]

Yagents is correct. But let me add something else. And BTW, I have been selling health insurance plans since 1982, and network-based plans since 1984. I would not be that worried about your concern. People tend to place too much emphasis on network selection and their current providers, especially in urban areas such as Chicago where there is a large concentration and selection already. Do your research, both in terms disruption to your current panel of providers and to alternatives. Good luck.

 

[LostDollar]

I am a consumer, in KS, not IL. In KS over the last few years, BCBS has gone solely to EPO plans that do not even cover all KS counties.

 

[LostDollar]

Yagents is correct. But let me add something else. And BTW, I have been selling health insurance plans since 1982, and network-based plans since 1984. I would not be that worried about your concern. People tend to place too much emphasis on network selection and their current providers, especially in urban areas such as Chicago where there is a large concentration and selection already. Do your research, both in terms disruption to your current panel of providers and to alternatives. Good luck.

I am not quite as sanguine about that as you are.

 

[STIBROKER]

we lost ppo's in Texas years ago......bcbs just put out a POS on a HMO network.....

 

[David Gustafson]

Your health insurance plan can be discontinued under certain circumstances, depending on the type of plan, the reason for cancellation, and the notice period. Here are some possible scenarios:

• If you have a health insurance plan purchased through the marketplace, you can cancel it at any time. However, you can only enroll in a new plan during the open enrollment period, unless you qualify for a special enrollment period due to a life event, such as losing your job, getting married, or having a childhttps://healthnews.com/health-insurance/guides/can-i-cancel-my-health-insurance-at-any-time/.

• If you have a health insurance plan purchased directly from an insurer or through an employer, you can also cancel it at any time, but you may face penalties or fees for doing so. You may also lose your eligibility for subsidies or tax credits if you cancel your plan before the end of the year [EXTERNAL LINK] - How to Cancel a Health Insurance Policy & Get a Refund?.

• If you have a health insurance plan that has cancellation provisions in the contract, your insurer can cancel your plan on your coverage anniversary date, which is usually the date you first enrolled in the plan. Your insurer must provide you with a written notice of cancellation at least 30 days before the anniversary date https://www.thebalancemoney.com/health-insurance-cancellation-laws-5204912.

• If you have a health insurance plan that does not have cancellation provisions in the contract, your insurer can only cancel your plan midterm if you fail to pay your premiums on time, or if you commit fraud or misrepresentation on your application. Your insurer must provide you with a written notice of cancellation at least 10 days before the effective date of cancellation https://www.thebalancemoney.com/health-insurance-cancellation-laws-5204912.

If your health insurance plan is discontinued, you may be eligible for a refund of the premium you paid, depending on when and why you or your insurer canceled the plan. You can check the terms and conditions of your policy or contact your insurer to find out more about the refund policy. You can also use the web search tool to find more information about health insurance cancellation laws and policies. I hope this helps you. blush