What are my health insurance options in 2017? This is a question that many people are asking after the presidential elections and the newly elected government announced that it would repeal Obamacare. Healthcare providers, who rely on insurance verification services to check patient benefits before providing care, also need to know the answer to this question. Here is a list of the coverage options that physicians can expect their patients to retain in the coming year:
- Medicare: As one of the country’s most important social programs, Medicare will continue providing health coverage for millions of Americans. However, in 2017, premiums are expected to rise for receipts that pay premiums for Part A coverage as well as for Part B coverage, which covers the costs of services and supplies needed to diagnose and treat diseases. Medicare recipients are also likely to see higher deductibles and copayments in 2017.
- Medicaid: Medicaid provides health coverage to millions of eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. The Children’s Health Insurance Program (CHIP) covers eligible children, through both Medicaid and separate CHIP programs. Beneficiaries of these programs will continue to retain coverage in 2017.
- Employer-sponsored health insurance: Nearly 60 percent of Americans are covered by an employer-sponsored health insurance plan. Under the Affordable Care Act, many workers enrolled in these plans to avoid paying a penalty. According to a report in the Houston Chronicle, health insurance paid by a company for its employees is expected to remain stable in the coming year – as long as the company remains in business and premiums are paid.
- Private health insurance: There are several private health insurance companies operating in the US market today such as UnitedHealth, Kaiser Foundation, Wellpoint Inc., Aetna and Humana Group. Though the individual market is more complex than group insurance, consumers who pay the full price for private plans will most likely continue to be covered.
- Health insurance exchanges under the Affordable Care Act: For those who enrolled in a plan offered by the Obamacare health insurance exchange by December 15, coverage will start January 1, 2017. The last day to enroll in or change a health plan is January 31, 2017. Health coverage obtained via Healthcare.gov is likely to be valid even beyond 2017, say experts.
Given the volatile health insurance scenario, the American College of Physicians (ACP) advises physicians to educate themselves about the coverage options available for patients. Many patients do not understand concepts such as deductibles and copays, which can pose collection problems. Physicians can direct them to consumer-assistance resources. The ACP also endorses patient benefit verification at the time of service and recommends that physicians tell their patients at this juncture what their cost-sharing obligation will be.
Many practices opt for comprehensive insurance verification services to manage this task. An insurance verification specialist contacts the insurance company directly to check patients’ coverage. Enquires are made about the patient’s un-met deductible, co-payment, and co-insurance responsibilities. A critical element of physician billing services, such support allows physicians to check patients’ eligibility ahead of their appointment and be transparent with them about their cost sharing responsibility. This will allow patients to make necessary financial arrangements to pay deductibles. In addition to avoiding surprise bills and increasing patient satisfaction, insurance verification helps providers improve collections and revenue cycle management.
To learn more about health insurance in 2017, see our new blog “How the New Senate Health Care Bill Proposes to Change Coverage“, published on 13 July 2017.