FAQs

FAQs

Since Congress is proposing legislation to change the Affordable Care Act, is my health plan changing?

• No, your health plan is not changing because of this. Keep in mind that legislation is a lengthy process, and any act would need to pass both houses of Congress, then go through several other steps in the legislative process, including being signed by the president, before it becomes law.
• You should refer to the information you received about your plan to see what is covered. This is current information and doesn’t change because of proposed legislation. You can also check your health plan coverage and benefits through your online member account.
• Blue Cross and Blue Shield of Louisiana, like other insurance companies that sell plans on healthcare.gov, is closely tracking this legislation, and will keep monitoring anything the president or Congress does that could affect the plans we sell on healthcare.gov or your coverage.
• We will keep updating you as more information becomes available.
• At this time, the Affordable Care Act, in its current state, is the law of the land.
• Blue Cross and all other insurers selling health plans must meet the terms of that law, including the requirements about covering people who have pre-existing conditions.

Why can’t health insurance work like car insurance?

• Car insurance rates are set based on many factors, including a person’s driving history/behavior, where he/she lives and even credit rating.
• Health insurance has to follow federal requirements under the Affordable Care Act that car insurance does not, and they don’t get to factor in those kinds of things, which means risk isn’t calculated the same way.
• Read more on this here.

What is Blue Cross doing to keep my costs in line, while improving quality?

• The biggest factor affecting what health insurance costs (premiums) is the cost of medical care.
• Blue Cross has several programs under way to get better health results for our customers, and hold the line on costs.
• Blue Cross’ Quality Blue Program doctors work to make patients healthier before they need expensive treatments. This allows us to keep costs down and help you get healthier.
• Read more about why healthcare quality and our Quality Blue Program here.

How can businesses tell if the employer mandate applies to them?

• The Affordable Care Act changed requirements for which businesses must offer health insurance to their employees.
• There are also updated definitions for how many employees equal small and large businesses.
• Read more on the overview of the rules and regulations here.

Why can’t everyone who has a Blue Cross plan use the same doctors/clinics?

• Blue Cross and Blue Shield of Louisiana offers many different types of health plans, and not all of them have the same in-network healthcare providers.
• There are key differences for networks between people who buy their own health insurance (individual customers) and those who get health insurance through work.
• For those who do get health insurance through work, different employers offer different benefit packages.
• Read more on the differences among Blue Cross health plans and their affiliated networks here.

Why is the drug my doctor prescribing me so expensive?

• Drug companies have to follow fewer regulations than insurance companies when deciding how much they spend and their profit margins.
• While some drugs prices are justifiable because of all the research and time it took to create the drug and the number of lives it will save, others are not because they are just a mix of lower-priced generic drugs that already existed.
• Read more about how drug companies set prices here.

Why do insurance companies with millions in the bank keep raising my rates?

• We have to keep our reserves, also known as our savings account, safety net or rainy-day fund, strong to make sure we can take care of our members when unexpected events and disasters happen.
• Also, rates increase to help cover the cost of our members’ healthcare as the prices of hospital bills, doctor bills, prescription drugs, tests and scans steadily increase.
• Read more about why you need us to keep a strong safety net here.