Overall, rates for health plans in California’s individual market will have an average weighted increase of 13.2% for 2017.
Blue Shield of California is having an overall increase of almost 20%! This is significant, but it amounts to a three-year average of 7 percent, which is less than it used to be (before the Affordable Care Act). According to Blue Shield, this year’s increase is expected to be a one-year adjustment due to the end of the government’s reinsurance program that had stabilized rates for the first years of the ACA. For 2017, Blue Shield will be the only PPO option available in every region of California.
Anthem Blue Cross will have less of a rate increase for 2017, but will have one significant change: Anthem will no longer have PPO plans available for the individual/family market in California. Their PPO plans will now be EPO plans, which means that if you visit an out-of-network provider, then you will not be covered. You can read more about this at Anthem’s PPO to EPO transition page.
Kaiser HMO plans will still be available in many regions in California. People’s opinions about Kaiser Permanente rarely fall somewhere in the middle; people seem to love it or hate it. But before you rule out Kaiser Permanente, please keep in mind that they consistently get higher ratings than other insurance carriers from Covered California. In fact, Kaiser has a 5-star rating in every region of California, where most other carriers consistently have two-star ratings.
We encourage everyone to shop around in the fall, as many can save money by switching to a different plan in the same metal tier. Covered California is estimating that nearly 80% of those who do shop around will find the same type of plan from another insurer at a lower cost. But please keep in mind that the doctor that you can see in your current plan, may not accept your new plan. Always check with your providers (doctors, specialists and hospitals), before enrolling in a new plan.
Starting November 1, 2016, you can shop for plans, and get enrolled. The Open enrollment Period will begin on November 1st, 2016 and ends on January 31, 2017. However, December 15th is the deadline to enroll, if you would like your new plan to start on January 1, 2017.