Sansum Clinic still has no contract with Blue Shield for Covered California patients as open enrollment for the health insurance exchange opens Wednesday.
Santa Barbara County has only one insurer, Blue Shield of California, offering Covered California plans for 2018, after Anthem Blue Cross pulled out of the local market and many others.
People who currently have Anthem Blue Cross Covered California plans will have to choose new plans for 2018.
Sansum Clinic has 23 primary, specialty and urgent care clinics on the South Coast, and Anthem is currently the only Covered California plan that is in-network for Sansum providers, and has been since the exchange started in 2014.
It’s a worrying situation for the South Coast patients who use Anthem Blue Cross Covered California plans at Sansum Clinic, since costs for out-of-network care are much higher.
Sansum Clinic spokeswoman Jill Fonte said the organization is still working on a contract with Blue Shield, but doesn’t have one yet.
“We know people are frustrated with the uncertainty – and we share that frustration,” she said in an email.
“We know how important it is to our community and our patients to resolve this, and we are doing everything we can to secure a contract to cover individual patients who will have Blue Shield through Covered California.”
Sansum still has contracts with Blue Shield to cover patients insured as part of a group policy, she noted.
Blue Shield has an “established network of providers in Santa Barbara,”said Clinton McGue, a spokesman for Blue Shield of California.
We are open to having discussions with Sansum, as we are with other health care providers throughout the state, who share our goal to help ensure Californians have access to high-quality care at an affordable price,” he said in an email.
“Health care is local, and costs are an important consideration in contracting with providers,” he said.
McGue confirmed that Blue Shield has contracts with Santa Barbara Neighborhood Clinics, Planned Parenthood California Central Coast, Community Health Centers, Dignity Health Family Medicine Center and Marian Community Clinics.
Open enrollment
The Patient Protection and Affordable Care Act, also known as Obamacare, created health insurance exchanges with open enrollment periods each year for people to sign up for plans.
The 2018 Covered California open enrollment period runs Nov. 1 to Jan. 31, 2018.
Anthem’s withdrawal from the exchange will not impact people with Anthem employer-based insurance, Medicare Advantage, Medicare Supplement, Medi-Cal, or individuals and families whose plans are “grandfathered,” meaning they were purchased prior to March 23, 2010, according to the company.
Consumers in the Central Coast region — Santa Barbara, San Luis Obispo and Ventura counties — who buy health insurance through the Covered California exchange will have the option of Blue Shield PPOs and for part of the region, Blue Shield HMO or Kaiser Permanente HMO plans in 2018.
The Blue Shield PPOs are the only plans offered for Santa Barbara County consumers.
The Santa Barbara County Public Health Department has certified application counselors to help people sign up for Covered California or Medi-Cal (Medicaid in California), which has year-round enrollment.
Appointments at county health care centers are available Mondays through Fridays, and community members need to bring documentation related to residency and income, Public Health said.
All assistance is free, and available in English and Spanish.
Applicants are encouraged to contact Santa Barbara County Public Health Care Centers for more information:
» Lompoc Health Care Center: 805.737.6400, 301 N. “R” Street, Lompoc
» Carpinteria Health Care Center: 805.560.1050, 931 Walnut Avenue, Carpinteria
» Santa Maria Health Care Center: 805.346.7230, 2115 S. Centerpointe Pkwy, Santa Maria
» Franklin Health Care Center: 805.568.2099, 1136 E. Montecito Street, Santa Barbara
» Santa Barbara Health Care Center: 805.681.5488, 345 Camino Del Remedio, Santa Barbara
Medi-Cal enrollment is year-round, and CenCal Health, which administers Medi-Cal in San Luis Obispo and Santa Barbara counties, has more information about eligibility here.
CenCal Health CEO Bob Freeman said there are no changes for Medi-Cal in 2018, and there was no impact from Anthem Blue Cross withdrawing from the local Covered California market.
— Noozhawk managing editor Giana Magnoli can be reached at gmagnoli@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.