What the following announcement from Blue Shield means is
that you will no longer control who your primary care physician is – something that
has always been a significant benefit of a PPO plan.
Will all the others (including Anthem) follow suit? Don’t
bet against it.
We chose to get out of individual insurance when the ACA
became effective solely because of our prediction of nothing but nightmares –
and unfortunately it has been proving true.
Covered California introduces a new feature for PPO members
On August 16, 2016, Covered California sent a notification to
members introducing a new addition to PPO plans. Starting in 2017, Blue Shield
of California will match a Primary Care Physician (PCP) for all of our
on-exchange and off-exchange IFP PPO members enrolled in non-grandfathered
plans.
Although this update offers our members the ability to build a relationship with a PCP, this does not change the way our members access care. Members of non-grandfathered PPO plans will continue to have the freedom to choose specialists and other providers – without referrals inside or outside the network – as they do now.
This new feature gives our PPO members a central point of contact in the health system for receiving long-term, comprehensive, coordinated care for most health needs. PPO members are able to switch PCPs at any time. There is no action for members to take. Blue Shield will provide additional details on this new feature in the coming weeks
Although this update offers our members the ability to build a relationship with a PCP, this does not change the way our members access care. Members of non-grandfathered PPO plans will continue to have the freedom to choose specialists and other providers – without referrals inside or outside the network – as they do now.
This new feature gives our PPO members a central point of contact in the health system for receiving long-term, comprehensive, coordinated care for most health needs. PPO members are able to switch PCPs at any time. There is no action for members to take. Blue Shield will provide additional details on this new feature in the coming weeks
