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Changes to the Individual Healthcare Marketplace in 2018

For Southern Californians, healthcare and health insurance seem to always be on the move. One of the biggest changes to the Southern California area is the removal of Anthem from the individual and family marketplace. For 2018, we are seeing some major changes to both the available healthcare facilities and the health insurance marketplace.

Existing Anthemindividual and family plan members in the Southern California area will have to find alternative carriers. With the removal of one insurance carrier, new players swoop in for new opportunities. Blue Shield’s PPO network has 79% of Anthem’s EPO provider network and offers a thoroughly rich provider network of its own. Blue Shield includes UCLA Medical, Cedars-Sinai, Providence, Children’s, Keck of USC, Southern California Hospitals and plenty more. However, Blue Shield has higher premiums than other carriers. Oscar is another alternative for these Anthem members and is an EPO like Anthem was for 2017. Oscar has UCLA Ronald Reagan/Santa Monica, Children’s, Good Samaritan, Providence, Keck of USC, Southern California Hospitals in its network. Health Net is another option offering competitively priced HMO, PPO and HSP plans. Health Net’s PPO has Children’s, Good Samaritan, Providence, St. Vincent and St. Francis hospitals in-network.

Oscar offers a unique and fresh spin on the member experience. For one, the carrier has implemented a concierge service where members can find a doctor, call to manage claims, review their medical records, dispute bills, and even get doctor and specialist recommendations. If you are an Oscar member, you will always speak to the same 4 Oscar representatives about your health, 3 care guides and 1 nurse. The benefit of talking to the same 4 people is that they are familiar with your personal medical needs which provides an additional level of service. Oscar also has their own member app from which you can call a doctor 24/7 for no cost, get a diagnosis for common ailments and even get prescriptions filled right to your pharmacy. Oscar is clearly shifting to a more modern approach to healthcare and is a great option for members who are familiar with modern technology. Oscar is even offering a $100 Amazon credit for members who follow their step program and routinely exercise.

Aside from Oscar, Kaiser is adding to their list of medical facilities with 10 new medical hubs in Southern California over the next year. Kaiser is also changing the way they treat patients by adding Thrive Bars, an Apple Genius Bar-like open-faced facility. The Thrive Bars offer information on nutrition and exercise as well as yoga classes, cooking demos and other community-focused health programs to keep your health on the right path. For such a large HMO carrier, Kaiser seems fully capable of adapting to latest the healthcare trends and shifting to a more patient-centered approach.

Health Net is also expanding in 2018 and offers its HMO and PPO plans throughout the Southern California area. In 2017, Health Net had a partial participation in Los Angeles, Orange County and the San Diego area but now is fully vested in those 3 regions for their PPO, HMO and HSP networks. For their PPO plans, Health Net offers competitively priced plans compared to Blue Shield’s PPO plans.

As the healthcare marketplace continues to change and families premiums increase, you might want to rethink your health insurance. Is your health insurance up to date? What is your budget and medical needs? Are you flexible with your providers? You may want to receive advice free of charge from an insurance agent to go over your options and find you a solid plan that best fits your budget and medical needs.

At Solid Health Insurance Services, we specialize in helping individuals, families and small businesses find a plan that best fits their unique medical and financial needs. We are here to help you find the best plan for your own unique needs. Please contact us at 310-909-6135 or at info@solidhealthinsurance.com. You can also visit our website at www.solidhealthinsurance.com to get plenty of information on the health insurance trends along with life, accident, dental, vision and long-term care.

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