Aetna Expands Obamacare Network In Virginia

Aetna Health Insurance Company is pleased to announce the expansion of there HMO network* in three Virginia locations including:

• Rockingham County
• Culpeper County
• City of Harrisonburg

Aetna has added the providers in these areas into the DocFind, and they are currently showing as participating in the HMO plans* for Aetna.

Aetna/Coventry network consolidation has been an important part of the recent expansion of the Aetna HMO network in VA that now provides a 97% overlap of contracted provider offices with the Coventry HMO/POS (an Aetna company) network in Virginia, excluding Northern Virginia. The area of Central and Southern Virginia has over 3,500 unique Primary Care Physicians and over 6,500 Specialists for Aetna members to choose from.

              A listing of Aetna’s Aetna’s National PPO and HMO Network

Please contact us with any questions.

*Applicable to HMO, HNOnly, & HNOption products.

If you have a health plan through the Health Insurance Marketplace and will soon have Medicare eligibility, it’s not too soon to start planning for your coverage to switch.

If you have a Marketplace plan now, you can keep it until your Medicare coverage starts. Then, you can cancel the Marketplace plan without penalty.

When to apply for Medicare

Once Medicare eligibility begins, you’ll have a 7 month Initial Enrollment Period to sign up. For most people, this is 3 months before, the month of, and 3 months after their 65th birthday.

It’s important to sign up for Medicare when you’re first eligible because once your Medicare Part A coverage starts, you’ll have to pay full price for a Marketplace plan. This means you’ll no longer be eligible to use any premium tax credit or help with costs you might have been getting with your Marketplace plan.

Also, if you enroll in Medicare after your Initial Enrollment Period, you may have to pay a late enrollment penalty. It’s important to coordinate the date your Marketplace coverage ends with the effective date of your Medicare enrollment, to make sure you don’t have a break in coverage.

Learn more about transitioning from the Marketplace to Medicare coverage.

My husband has been a truck driver in Indiana for over 25 years, and up until the last year was with a larger firm, due to cutbacks he moved to a smaller firm and it was then we needed insurance. Thank goodness for Obamacare plans otherwise we would not be able to afford healthcare. When he was trucking for a large company he was paying $580.00 per month, through Indiana Obamacare we found the exact coverage for $142.00. But we had to research and find the right plan for us.

We began the process after they had given him his two weeks notice and their friendly and accommodating agents were so helpful in no time they had the plan we needed and the price we could afford and they did it all as he went from one company to the next with no lapse in health coverage. As an over the road driver he needed the insurance for physicals and medications to continue the job, they took the time and got us what we needed and in a short amount of time. We had to be cautious of the deductibles, what they would cover for preventative, copays and our out of pocket minimum but we worked it all out and he and our family have found peace of mind at a much lower rate.

There are many plans out there and finding one for us was easy. We scheduled a call with an Obamacare agent, and he did all the work for free we just told him what we needed and when. We have outpatient, which we just used on a few tests and made sure our plan fit our doctor which is most important. Some doctors take Obamacare some do not. Our prescriptions we have no hassle in getting and our copays actually went down with Obamacare. with a lower deductible we found that today we are able for him to go get the tests he needs and our doctor is quick to get them all done, before he was hesitant but with the Obamacare he seems to get us in and out. I would have to say though my husband had to switch jobs and we had to go out looking for healthcare it turned out better for our family in the long run. We are getting better care at a lower price to us and so far our Anthem BCBS Indiana plan has all but covered more than we thought. Just do your homework and make plans and talk to the agents and your Obamacare experience can be like ours painless and cost effective for us to live a happy, healthy life.

Applying for health insurance is always a scary ordeal, but with the right information from an easy step by step guide, a difficult decision can be made simple. When my family and I made the group decision to switch to Obamacare we found to be one of the simplest switches in insurance we had ever done.

We began by researching Obamacare over the internet as well as other articles we found through news websites. After finding out a good amount of information we went to www.applicationforobamacare.com and followed the links for open enrollment and ended up signing up in December of 2014
Our Families situation is not unlike many others in the world today. So many people are left struggling and finding it very difficult to keep up with the daily expenses of life. We in particular have difficulty taking care of doctors’ bills as well as dental visits. Obamacare care helped us take care of this by providing us with affordable healthcare and a plan that was easy to understand. It also helps that it is accepted at many offices around our area.

We were given several options for healthcare plans but ended up choosing Ambetter Health Plan. The federal subsidy covers the majority of the Doctors’ visit, with us only having to pay a small copay for primary visits and little higher copay for a specialist visit.

We use our plan often as we have two children who need frequent doctors’ visits due to being in public school and being exposed to yearly illnesses. I myself have to go to the doctors often due to chronic sinus infections and high blood pressure issues. I also suffer from mental illness which requires medication, so I need to visit a doctor every three months to re-evaluate my mental health. I did have to buy a separate dental policy through Dental Insurance TX.

The plan from Aetna health has been nothing short of amazing and it is definitely the best health insurance offered in Texas. I honestly don’t know what we would do if it were not for Obamacare having passed through legislation. The range of doctors we are able to visit is vast compared to what we had previously had years ago with the insurance through the state of Texas.

The silver level plan that we chose for a family of four with a median income cost us One-Hundred forty-three dollars a month, with an annual deductible of four-hundred seventy-nine dollars. Compared to most other health plans, provided through private companies and through Obamacare as well, this was an absolute god sent and has helped my family immensely and I will be forever grateful for the opportunity.

As a health insurance agent I can’t help but find it interesting that same sex marriage became legal within 24 hours of the Supreme Court’s ruling to uphold Obamacare subsidies. Could there be a link between the two?

The Supreme Court sometimes goes for long intervals without seeming to decide much on important issues and then we get a flurry of activity including upholding State’s execution methods for lethal injection drug/procedures, overturning landmark EPA anti-pollution regulations for nuclear power plants based on the costs outweighing the benefits in terms of the billions of dollars it would cost businesses and the American people, and continuing to allow abortion clinics to stay open in Texas.

Much of the Supreme Court’s activity is over my head, but I understand Same Sex Marriage and I understand Obamacare. Let’s follow the money and see how this shakes out!

Suppose we have a same sex unmarried couple who are both 58 years old. They each make $32,000 a year. Neither of their employers offers benefits, so they both receive federal Obamacare Subsidies of a little over $300 a month from the Federal Government in the form of APTC (Advance Premium Tax Credit) to help pay for their health insurance. Based on their income level, they also receive a cost-share reduction of $2,000 to $3,000 per year in reduced deductible. For this example we will just stick to the APTC to keep it simple. At this income level, the $300 a month multiplied by 12 months is $3,600 per a year, per a person subsidy. Or $7,200 federal money received per a year per a couple.

HOWEVER, once the two are married, their combined joint household income would be listed as $64,000, which is above the federal subsidy level. These newlyweds would lose their subsidies and owe back the money they had collected. For this reason, the Obamacare law is heavily weighted toward individuals as opposed to married couples or families.

The newlyweds would have to each pay an additional $300 per a month to have the same health insurance they had before they were married.
While we used $32,000 annual income for our example, many combinations of income could lead to a loss of income (example $20,000 and $43,000 income). Here are some helpful pointers if you and your significant other are both on Obamacare.

If you are considering getting married (same sex or not), take a look at the combined household income. If the new number is over $62,920, then you will lose your Federal subsidy.

Question 1: Can’t I file a single return after I am married?

Yes, but filing as a single individual would make you ineligible to receive federal subsidy money. Anyone married must file a Joint return to be eligible for Federal Obamacare subsidy.

Question 2: What should we do?

First, you may want to talk to an accountant. Second, you may want to open a bank account for your honeymoon and save the $600 a month while you have it. If you wait until 2016 to get married, you could both ride out the rest of 2015 without owing back the 2015 subsidy you are currently receiving. It would be a shame to get married and then find out next tax season that you earned too much money and you each owe back the $300 per a month subsidy.

So I don’t know if there is any government conspiracy here or not, but I think it would be a pretty sad story if a couple waits 20 years to get married and the government says, “OK Get married!” Then six months later the IRS sees the combined income and comes knocking in search of the $7,200 repayment for the Obamacare subsidy.

While this situation could unfold for any couple, same sex or not, I expect there are a great deal of same sex couples who are between the 50 – 65 year-old age  bracket and are excited to finally be married. Those ages create very high health insurance premiums. The general public should be aware of this potential pitfall and prepare accordingly.

The Supreme Court made a decision about the Health Insurance Marketplace. Consumers will continue to receive Federal Subsidy no matter what state they reside.

American’s will experience no change in their coverage through the Health Insurance Marketplace. 2015 plans will remain in place. President Obama’s address can be viewed here:

The Supreme Court ruling can be read online.

I purchased a Health Insurance Marketplace plan from ApplicationForObamacare.com.

Your affordable quality coverage has not changed. The Supreme Court has confirmed that if you qualify, you can still get financial help to lower the costs of your health care no matter where you live. This means that consumers in every state will continue to be eligible for premium tax credits, lowering the average consumer’s costs by $272 each month.

So, nothing has changed for you. You can still use your health insurance as long as you continue to pay your bills. As a reminder, tell the Marketplace about any changes to your household, income, and insurance status to get the most accurate tax credit.

I have health insurance, so now what?

While the Supreme Court case did not directly impact you, you are probably already benefiting from increased financial and health security because of the health care law. These provisions include: banning discriminatory practices such as denying coverage to people with pre-existing conditions and dropping people from coverage when they get sick; guaranteeing access to insurance when you change jobs , lose a job, or strike out on your own; providing better benefits like guaranteed access to free preventive care; preventing medical bankruptcy by banning annual caps on coverage of essential benefits and requiring new annual limits on out-of-pocket costs; improvements in the care you receive through incentives that promote quality of care and time spent between patients and doctors; and allowing young adults to stay on their family’s plan.

I don’t have health insurance, can I get a plan?

Visit ApplicationForObamacare.com or schedule a call to see if you can still get coverage for 2015. You may qualify for a special enrollment period due to a life change like marriage, having a baby, or losing other coverage.

The Supreme Court confirmed that if you qualify, you can receive financial assistance, including a premium tax credit, to make coverage more affordable no matter where you live. On average, consumers enrolled in the Marketplace are receiving $3,260 per year in tax credits, or $272 each month. About 8 in 10 consumers could find coverage for $100 or less with tax credits through the Marketplace. 

The Open Enrollment period for 2015 is over. Open Enrollment for 2016 starts on November 1, 2015.

 You may also be eligible for Medicaid or your family could be eligible for the Children’s Health Program (CHIP). There is no deadline to enroll so if you qualify, it’s never too late to get coverage. Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities. People qualify for these programs based on their household size, income, and other factors, like age and disability. When you fill out your application you’ll find out if you and your family qualify. Visit HealthCare.gov or your State Medicaid office for more information.

Aetna and the individual health insurance marketplace have been evolving at record speeds. As an industry leader Aetna is committed to building a healthier America. Aetna is  in the process of launching new products in the following markets:

• Arizona county: Maricopa
• North Carolina counties: Anson, Cabarrus, Cleveland, Gaston, Lincoln, Mecklenburg, Stanly, and Union
• Pennsylvania counties: Bucks, Chester, Delaware, Montgomery and Philadelphia
• South Carolina counties: Lancaster and York

Aetna or Coventry plans currently in those counties will transition to new Aetna Leap^SM.  Current MarketPlace enrollees do not have to do anything to transition to these new plans. However, federal subsidy recipients should review their tax credits this fall to make certain the right federal subsidy amount is being received.

Nothing changes for current Aetna and Coventry 2015 coverage.

Aetna subscribers will not be able to renew their current plan when the policy term ends on December 31, 2015, but they will be offered the new Aetna Leap plan that most closely matches their current Aetna or Coventry plan.

Some key points to new Aetna Leap plans are:

• A policy that’s easy to understand and simple to use
• A new Aetna program where members earn rewards for healthy activities
• A great Aetna network of doctors and hospitals.
• Affordable plan options
• Excellent family coverage

If you are interested in learning about the new Aetna plan options, you can complete an Obamacare Application to get started.

If you do not have Obamacare you may be missing out on an average of $3264 per a year in government hand out money.

For the 2015 enrollment about 11,700,000 people living in America chose a plan through the Obamacare website. In 2014 about 6,300,000 shoppers enrolled in health insurance coverage and paid their premiums. Thanks to Obamacare 8,700,000 shoppers receive an advanced premium tax credit (APTC) to make their premiums affordable. The average APTC for the financial assistance was $272 per month, or $3264 per a year.

Correct. The average applicant received $3264 per a year! Some families received as high as $15,000! Contact Us for Obamacare Assistance.

HHS Secretary S. Burwell commented on the ACA. “…millions of Americans now rely on the health and financial security that comes from affordable coverage through the Marketplaces. We’ve seen a historic reduction in the uninsured and consumers are finding the coverage they need at a price they can afford.”

In 2015, 85 percent or about 8,700,000 consumers are receiving an advanced premium tax credit to make their premiums more affordable. In addition to the 8,700,000 shoppers getting subsidies, 57% or 5,900,000 applicants received cost-sharing reductions to decrease out-of-pocket costs for deductibles, co-insurance, copayments, etc. The cost-sharing assistance is generally household income levels between 100% and 250% of the federal poverty level (about $12,000 per an individual), the shopper is otherwise eligible for APTC, and the individual chooses a health plan from the silver plan category. For example a $2,500 deductible may turn into a $500 deductible due to cost-sharing reductions, a $2,000 savings to add to the $3,264 APTC. This would equate to $5,264 of government money received by the applicant.

The top ten states with the highest percentage of Obamacare applicants who receive financial assistance are:

• Mississippi 94.5%
• Florida 93.5%
• North Carolina 93.2%
• Wyoming 92.9%
• Louisiana 92.0%
• Arkansas 91.1%
• Georgia 91.1%
• Alabama 90.7%
• Wisconsin 90.7%
• Alaska 90.5%

The states with the lowest rate of Obamacare applicants receiving money include:

• District of Columbia 10.0%
• Minnesota 49.5%
• Colorado 55.3%
• Hawaii 59.3%
• Vermont 64.3%
• New Hampshire 65.8%
• Massachusetts 66.7%
• Utah 67.3%
• Maryland 68.2%
• Kentucky 69.3%

It is important to know that 90% of the ten states with the highest rate of financial assistance have not taken the Medicaid expansion option under the Affordable Care Act. All states, excluding Arkansas, allow for maximum federal subsidy for Obamacare applicants with income levels from 100% to 133% of the federal poverty level. Essentially, these state residents with the lower income are not forced on to Medicaid. For large states like Florida, Georgia, North Carolina and Alabama, this is a huge benefit for the 100% to 133% poverty level.

For states with the lowest rate of Obamacare applicants, it is often due to expansion of Medicaid. So for example the state of Kentucky has expanded Medicaid and in the process has move a huge portion of the state into Medicaid. Places like DC are very wealthy and most residents are not part of the Obamacare system and have to rely on private health insurance.

Obamacare premiums will be increasing next year. It is also expected the insurance mandates will drive premiums up even higher. Essentially, the more people to participate the more upside-down the system becomes.

State DOI (Department of Insurance) have been releasing the rate proposals they’ve received from insurers for the next open enrollment in 2016.

BCBS of Tennessee wants to move its Obamacare premiums up 36%. So now the family of four paying $1200 a month will increase to $1632. Other states like Oregon have reported as high as 50% increases by MODA health. CareFirst of Maryland, one of the most backward companies in America, has another 30% increase scheduled. A sad statistic from a state handling their own exchange with low enrollments. North Dakota has seen great job growth but greater rates with a 43% increase expected, the Kansas at 38% and Iowa is expecting 18%.

Much of the problem stems from the governments underlying belief that a healthy public has yet to enroll. Evidently, they have yet to accept that this “healthy” public does not exist in the numbers that they need to offset the huge cost of medical care for the overwhelmingly unhealthy population riddled with obesity and diabetes.

The next president is expected to inherit quite a mess. Essentially, the Obamacare is working in that people are getting covered, but like a  college kid with a credit card, a day of reckoning will arrive. Eventually, the government has to decide how much money it wants to print, or what additional huge taxes does it want to implement to help dump money into the system.

Today it is estimated the Federal government squanders over $1300 for each new enrollee. Money that could be going toward education and exercise programs. Some would argue the TV show Biggest Loser has done more to help healthcare in our country than the entire Obama administration. However, with this being said, it is still advised to quickly sign up for Obamacare and get your hand out money. The site www.ApplicationForObamacare.com has hands out millions of dollars a day during Open Enrollment, which is slated for 11/01/2015 to 01/31/2016.

My family uses the Affordable Care Act for our insurance. We have a family of 4, but our 2 boys were adopted and receive medical cards. We are both self-employed and getting insurance is rather costly to us. I had a horrible time getting signed up. The web-site didn’t seem to work. My friend referred me to www.ApplicationForObamacare.com, which is a free site with privately licenses and certified agents to handle enrollment. I originally signed up when everyone was mandated to do so by a certain date. I had tried to call the federal government but had to wait on the phone for hours to get through and the rep was not smart. Then I got the referral and the ApplicationForObamacare agents were easy to get a hold of and knew exactly what to do. It only took like 20 minutes. Thankfully, my representative did right by me without any hassle.

I have had my coverage for 2 years nearly. At first my premium was $47.82 and it was through Medical Mutual of Ohio. My deductible for my husband and myself was $200. All the prescriptions and metal health also counts toward that deductible too. I was at my deductible in no-time and then the company paid 80/20. The first year went over pretty good and without any problems. I attend counseling every week and I am one of the lowest that has to pay. The counselor said my $9.66 co-pay is unbelievable. Also my prescriptions are so low too. I usually pay between $.57 to $1.05 for a script in generic form. This is a small cry from what I was paying when we had traditional insurance.

I guess my views of the program are good, but I have friends and family who got stuck with a horrible policy. AT the end of the first year, we didn’t need to do anything to stay on the same plan, as we were still within the same income structure. Together my family makes around $42,000 a year. As a family of 4, this allows us to get great rates. This year our carrier notified us that our premium would go up. In fact, it took a huge hike from $47 to $187. Now, this is the amount that I have to pay out of pocket. I do receive a federal subsidy to offset this amount. My subsidy is $862 a month. Without this subsidy, I couldn’t afford this plan at all.

My husband was hospitalized and had emergency surgery last month. The cost of everything was over $30,000. We only have to pay $1,000 out of pocket. Our max out of pocket is $2,000 and we have already used most of that on prescriptions and other visits. Now, all of my prescriptions and medical visits are free until the end of the year. It’s like a gift to be able to have such great insurance. Yes, I hate dealing with the website, the customer service department and filling out all the information on the taxes, but we couldn’t have insurance any other way for this price. I feel like we get great coverage and every doctor in our area, as well as medical centers, are on our policy.

With a low max out of pocket, super low deductibles and a monthly premium that is affordable, I have found Obama Care to be a great thing for my family.