Bad news for individuals and families who want choice for doctors and hospitals.
All PPOs and POS individual ACA plans will be canceled December 31, 2015. No plans will have out of network coverage except for emergencies in 2016. Blue Cross Blue Shield of Texas (BCBSTX), Humana, Baylor Scott and White will only be offering Health Maintenance Organizations (HMOs) plans for 2016.
United Healthcare will be offering their own brand of HMO called Exclusive Provider Organization (EPO) which works like an HMO providing only in network benefits. United Healthcare uses two EPO networks. If you purchase a health plan with United Healthcare through the marketplace and get a tax credit you will use their Compass Network. If you get your plan with no tax credit directly through United Healthcare you will use their Choice Network.
I have included links to see if your providers are in any of the networks for 2016. Do not assume because your current provider was in the PPO network they will be in the HMO network. Plus make sure they are accepting new patients.
- Only United Healthcare Choice Network includes both Seton and St. David’s hospitals. As of today United Healthcare Choice Network will have most provider options in the Austin Texas area for 2016 individual plans.
- If you choose a Baylor Scott & White plan you must use their network of providers and hospitals.
- If you use choose Humana or BCBSTX you must use the Seton Hospital Network.
- If you choose United Healthcare Compass plan you must use the ST. David’s Hospital Network.
Open enrollment starts November 1, 2015 call for HELP you will need it. (512) 900-3008