In this era of health insurance woes, everyone wants a
Dependable insurer that will also continue to underwrite policies for the
Foreseeable future to avoid finding a new one.
There are 12 companies that comprise 50% of the market that generate roughly $550 Billion in premiums. Depending upon whether they insure in your state is important factor for what is available. So according to one summary, Anthem.com ranks #3 with a market share of 6.3%. So on that basis, they have the resources to deliver. However, in the context of the Health Insurance Swamp, my experience has been somewhat murky when it comes to speaking to their Claims and Benefits Customer Service which is your lifeline regarding your policy with them.
Like all industries, depending upon who you speak with, it's a coin toss as to whether you're getting correct info. It's just as daunting to get Anthem to be accountable if they advise you incorrectly and you make a decision that ends up costing you more than you bargained for. You might want to get that procedure done that's in your best interest and they tell you it's just a small co-pay only for it to mushroom into a $1000 chunk of your deductible. So, you have to be hyper-vigilant, read some of the boring coverage details and either get things in writing or get a reference number. Beware, though, that if they want to go into denial, things have a tendency to get lost. It's all about their bottom line and if you don't cover your butt, you might feel all jammed up.
So a few pointers, if you have to escalate things or appeal anything, use your cell phone where you will have a record of making a phone call. Anthem is not above lying about whether you actually called them.
Don't depend entirely on your state Insurance Commission to bail you out. They have all they can do to make sure that residents have insurance companies with deep enough pockets to sustain the trauma of dealing with most people that have pre-existing conditions that is the centerpiece of the ACA.
In my opinion, the ACA is positive and helps society. It just needs to be tinkered with and things will get better. While some people might disagree, the Individual Mandate is important in lowering overall costs as they get spread over a higher base of people.
Should you have a sudden unexpected illness, you will be supremely grateful that you're properly insured.
So, keep detailed notes on conversations, who you spoke with, a reference number and anything to back up your version of what was said should you find Anthem crossing the line.
As far as pharmacy benefits, most of that very well defined so Anthem will generally follow through. There are plenty of sites that rank health insurance companies so get reviews about insurance companies, their reviewers, etc.