August 1, 2017

Update on VUMC's participation in 2018 individual insurance plans

People who purchase individual health insurance plans in Tennessee are finding the marketplace for 2018 is even more restricted than 2017’s already limited offerings. 

After BlueCross BlueShield of Tennessee’s exit from the exchange last year, patients could not access Vanderbilt University Medical Center (VUMC) through an exchange-based product except for those living in a limited number of rural Tennessee areas.  VUMC has remained in the “off-exchange” individual market for both ACA-compliant and non-ACA compliant plans through Aetna and Farm Bureau.

However, in 2018, Aetna will no longer offer individual health insurance products in Tennessee. Also, BlueCross BlueShield of Tennessee continues to remain out of the exchange and the off-exchange plan markets for residents of major geographic portions of the state including Nashville and Memphis.

The limited availability of these plans creates challenges for patients who utilize individual insurance coverage options. The Medical Center’s Contracting Team is working hard to reach agreements with the limited number of carriers who remain willing to offer individual plans either through the exchange or as off-exchange products.

For 2018, VUMC remains available to patients in the individual market place through Cigna’s ACA-compliant Local Plus “Bronze” plan, and through Farm Bureau for non-ACA compliant individual plans.  Non-ACA compliant plans require screening for high-cost health conditions before coverage is sold, may not cover the same essential health benefits defined under the ACA, and do not qualify for a tax subsidy.  For 2018, Farm Bureau will no longer offer its ACA-compliant plans. Patients utilizing a Farm Bureau ACA-compliant plan will receive notification and may want to consider purchasing the alternative non-ACA compliant plan.

In addition to these options, one or more new carriers offering exchange plans are entering the Tennessee market for 2018, and beginning discussions with these carriers are already taking place.

Health insurers have until September 23, 2017, to confirm their plan participation status for 2018. The Annual Open Enrollment period for patients to purchase 2018 coverage will begin on November 1, 2017. Updates will be provided regarding progress on individual plan options for 2018.