FAQ Friday: Rate Changes and Getting Financial Help

Ashley Hennen

| 3 min read

Why is my rate changing?

Your rate change will depend on rate factors such as the age, tobacco use, county, and any financial help you are receiving from the government. Each year, health insurers also evaluate their current rates to determine whether these rates will be sufficient to cover future claims and expenses. Just as the cost for common consumer goods like food and clothing increase, so too do costs associated with medical services and prescription drugs. BCBSM and BCN, as well as every other carrier who offers Affordable Care Act (ACA) plans in the individual market, have to file any annual rate changes at the product level. Although some contracts will experience more or less of a change, we do not single out or target individual members for higher rate increases.

What can I do if I can’t afford my monthly payment?

Financial help is available for those who qualify in the form of reduced cost-sharing and/or tax credits (subsidies) through the Federal Government. For starters, here is a great primer on subsidies and how they work. There are two Blue Cross tools to help you quickly estimate if you might be eligible for a subsidy. The first is simply texting 4Subsidy to 222-752. The second is an online subsidy estimator. Want to talk to someone about your options? Call a Blue Cross health plan advisor at 855-237-3501

If I got a subsidy last year and my income hasn’t changed, will it be the same this year?

No. Subsidies are calculated using a “benchmark plan,” which is the second lowest priced silver plan available to you. Even if your personal information stays the same, the benchmark plan has likely shifted. If you receive tax credits, it’s important that you go to HealthCare.gov by Dec. 15, 2014 and log into your Marketplace account. Your 2015 application should be pre-filled, but you’ll have to click through each page and make a few updates to your financial and dependant information. Even if your income hasn’t changed, your costs may have changed since last year. Updating your information also helps you avoid being impacted at tax time. Need help? Call a Blue Cross health plan advisor at 855-237-3501.

What do I have to include when reporting household income?

When you apply for tax credits and other savings through the Marketplace, you’ll need to estimate your income for 2015 by adding up the income of you, your spouse (if you’ll file a joint tax return) and any dependents who have made enough money to file a return. You can also report deductions from your income by logging into your account and updating your application. A full explanation on what to include in your estimated income along with frequently asked questions can be found here.

If I don’t qualify for a subsidy, do I have to shop through the Marketplace?

No. Health care plans offer the same coverage for the same price if you go directly through Blue Cross Blue Shield of Michigan. To start shopping for plans, visit Bcbsm.com/myblue. Health Plan Advisors are also available to help you enroll by phone (885-237-3501), online, or at one of the many walk-in customer service centers around the state. FAQ Fridays aim to answer common questions we receive regarding the 2015 open enrollment period. Submit your questions to the Customer Action Center. To get one-on-one assistance, call a health plan advisor at 855-269-9898 or visit one of our statewide walk-in centers. Photo: Helga Weber
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association