Bedford County's ACA insurer for 2018 does not cover Roanoke doctors

WDBJ7 Many of our hometowns will now only have one option for health insurance through the Affordable Care Act market.

In Roanoke and the New River Valley, that provider will be Anthem, but that option does not extend to the neighboring county of Bedford.

Bedford is a part of the Central Virginia region that will be covered by Piedmont Community Health Plan. This will affect people in Bedford who may currently have health providers through Roanoke hospitals and doctors.

The Affordable Care Act has different insurance carriers that opt to offer individual insurance on the ACA exchange. In the past, those have included multiple options like Anthem, Optima Health, and Piedmont Community Health Plan. People could choose, but things are changing for 2018.

“In most of Virginia, what it has boiled down to is most localities will just have one carrier, one insurance company to choose from,” said Brad Weaver, Director of Sales with Innovative Insurance Group.

Health insurance carriers had to make a decision to enter the ACA market by September 27th. For the team at Piedmont, owned by Centra Health, the decision was easy. According to a Centra representative, it was a unanimous decision.

At that point in time Anthem and Optima Health were not going to provide coverage the Central Virginia region. If Piedmont pulled out as well it would have left 20,000 people without access to insurance.

Anthem decided to opt into the program at a later date and cover only the bare counties, which still leaves Piedmont as the sole provider in their coverage area.

Piedmont spans from Bedford County all the way down to the North Carolina line. Because Piedmont is now the only provider in Central Virginia on the ACA market, people in Bedford will have to find health care providers in the Lynchburg area region as opposed to Roanoke.

Weaver says Piedmont is actually one of the least expensive options on the market in Virginia. Next steps would be for families to get enrolled before the December 15th deadline and look to see if they are eligible for tax exemptions.

While Piedmont is not expensive compared to other options, Weaver says healthcare in general is at an all time high cost. He does anticipate that this high cost of individual plans and limited choice is going to result in employer plans growing in popularity.

About 5,000 people are currently enrolled in Piedmont through the ACA. Now, Piedmont is prepping for some bigger numbers.

The team with Piedmont was focused on making sure they would stay in the exchange that they were not able to expand their coverage at that point in time, however they are open to speaking with representatives of any health care provider (including Carilion and LewisGale). These changes go into effect January 1st, 2018.