Health Insurance Blog

Children’s Health Insurance Update for 2012

Posted on: January 27th, 2012 by SamTabes No Comments

Each state has their own structure for providing health insurance to children. There are many updates throughout the nation for 2012, and it’s important you know how you may be affected if your child needs health insurance protection. ”Child-only” plans are individual policies which are offered to children 18 and under with no guardian listed on the same policy.

Many health insurers have stopped offering these types of plans, partially due to the 2010 Patient Protection and Affordable Car Act which prevents the insurers from declining applications due to pre-existing conditions. Insurers are worried parents will wait until a child gets sick before they start applying for health insurance coverage. This could be disastrous financially for many insurers.

With this said, some states and health insurers have designated open enrollment periods for child-only plans as a possible solution according to the press release from eHealthInsurance found on Yahoo Finance. These specific enrollment periods give parents and guardians a window of opportunity to enroll their child in their own individual health insurance plans and they will not be turned down due to pre-existing conditions. Yahoo Finance offers a state by state summary which represents a brief overview of current rules and regulations by state.

As an example, Arkansas has availability of child-only plans and enrollment periods vary from insurer to insurer. This differs from Maine where child-only health insurance policies are available throughout the entire year. Some states, such as Iowa, have specific enrollment periods. Iowa residents can enroll their children from July 1 through August 14, 2012. Utah is an example of a state that requires a certificate of insurability which can be obtained by applying and being declined for the state’s high-risk pool. As you can see, each state has a slightly different system in place, so be sure to look up how your state is handling child-only health insurance plans.

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Health Care Reform Implementation in 2012

Posted on: January 23rd, 2012 by SamTabes No Comments

It’s been about two years since President Obama signed the Affordable Care Act and got America’s health care reform underway. A lot has taken place, despite a good amount of opposition and resistance. At this point, 47 states are part of the new premium rate review system where insurance companies need to justify the rationale for insurance premium increases that are in the double digits. About half of the country is working towards establishing their own Affordable Insurance Exchange which is an important part of the new law that needs to be structured.

In order for health care reform to truly be successful, cooperation is necessary. The Affordable Insurance Exchange aspect of reform is crucial. They are one-stop marketplaces where America’s consumers can choose a health insurer plan that meets their individual needs. Exchanges will choose health plans qualified to offer coverage, provide consumer help, include shopping and enrollment, as well as coordinate eligibility for the Exchange. The Act aims to give states more power by setting up their own Exchanges if they choose to do so. The WhiteHouse.gov website says the Department of Health and Human Services awarded $49 million to 48 states and the District of Columbia to start planning activities.

The site has done a great job of summarizing the actions states have taken towards establishing Exchanges and gives examples of some of the actions and planning meetings taking place throughout the nation. They offer a snapshot of ten states and their progress. They didn’t necessarily profile the states that are the furthest along, but rather they show some of the diverse approaches being taken towards progress. It’s an informative look at what’s really going on with health care reform at this point in time.

Written by Sam Tabes

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Tags: health care access, health care reform, health insurance companies
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Alaska Health Insurance: Large Spending for High Risk Pool

Posted on: January 19th, 2012 by ymedina No Comments

Alaska is looking to spend a surprising $200k per year for each high risk pool member based on Kaiser Health News article by Phil Galewitz. Alaska is one of the most expensive places to live in the United States and these increased costs apply to health care as well. High risk pools are being set up under the federal government to assist uninsured individuals who have pre-existing conditions. Alaska expects to spend $10 million this year to include about 50 members which equates to around $200,ooo per person.

Cecil Bykerk, executive director of the Alaska Comprehensive Insurance Association, which is running this pool, points out how expensive Alaska health care is, and although there’s a small number of people, the average cost of a claim is higher than expected. The high risk pool appeals all types of high risk patients including pregnant women, and children who need heart transplants. The costs far outweigh the original allocation of $13 million from the government under the pre-existing condition insurance plan.

Alaska is one of nine states to need additional funding and hopefully it will all work out since New Hampshire and California have already received more money. Alaska has already spent $4.5 million since the pool started in September of 2010. In December, Alaska asked for more money to avoid running out of funds before the plan ends in 2014. According to Bykerk, Alaska officials are still awaiting a decision on whether or not their needs will be fulfilled.

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Tags: alaska health insurance, health care access, high risk pools, pre-existing conditions
Posted in affordable health insurance, Alaska health insurance, health care access, health insurance trends, high risk pools, pre-existing conditions | No Comments »

Introducing Simple Blue PPO From Highmark

Posted on: January 16th, 2012 by ymedina No Comments

A new individual health insurance plan is available from Highmark called the Simple Blue PPO plan. This plan goes into effect on February 1, and the the article on IFAWEBNEWS.com by Bob Graham says the plan is geared towards being simple, affordable and predictable. The health insurance coverage aims to have lower premiums and lower deductibles with a more predictable copayment structure.

Highmark is based in Pittsburgh and serves western and central Pennsylvania. Their new Simply Blue PPO plan is medically underwritten and targets individuals without group coverage and covers all preventative care services. Steven Nelson, senior vice president of health services strategy, product, and marketing at Highmark, says they listened to members’ feedback to come up with a more affordable plan without a large upfront deductible. They are trying to meet the needs of their customers and future customers.

At this point, the plan does not offer maternity health insurance, so if this is a valuable benefit to you, the plan might not work out. The program uses Highmark’s Progressive Formulary which is a new generic prescription drug plan that works with members to seek lower cost drug options but still continuing access to brand name prescriptions. Premiums for the plan start as low as $90 per month with a $500 deductible for males between the ages of 25-29. Simply Blue will be offered in 29 counties in Western Pennsylvania and should prove to meet the needs of many customers.

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Tags: bcbs, Highmark blue cross blue shield, pennsylvania health insurance, PPO health insurance
Posted in affordable health insurance, Blue Cross Blue Shield Quote, finding health insurance, health care access, Highmark blue cross blue shield, highmark blue shield, Highmark Blueshield | No Comments »

Will Medicare Eligibility Be Raised to Age 67?

Posted on: January 12th, 2012 by ymedina No Comments

There has been a lot of talk in Congress about raising the eligibility age on Medicare to age 67 to save costs. This has been talked about for years, but it faces a lot of opposition in Congress. According to the article “Raising Medicare Age Would Save $148 Billion, CBO Says” by Meghan McCarthy and Katy O’Donnell on National Journal, the Congressional Budget Office recently lowered how much the government would actually save.

Previously, the CBO stated there would be a savings of $162 billion, but this did not factor in the premiums lost from seniors paying into the program. A CBO official stated that a senator requested the new analysis of increasing the Medicare and Social Security eligibility ages to clarify savings. Many think that these savings are not significant enough to warrant changing the age. The savings may not affect the deficit, but it could create funds to create the “doc fix”, which is a permanent solution for a temporary pay raise Congress would legislate for Medicare doctors on a yearly basis.

The CBO estimates that raising the Medicare age could drop federal Medicare outlays, net of premiums, and other offsetting expenses by $148 billion from 2012 through 2021. The agency put out a very detailed report outlining how this will be accomplished. President Obama supports increasing the age, but faces a lot of opposition from other Congressional members. It’s definitely not all bad news for seniors who may miss out on some Medicare benefits. People from 65-67 who have to find private health insurance could find that they have better access to doctors than they may under Medicare. Time will tell as usual.

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Tags: health insurance news, medicare, medicare eligibility age, medicare news
Posted in health care reform, health care regulations, health insurance news, medicare, medicare supplements | No Comments »

BCBSSC Focuses on Quality for 2012

Posted on: January 11th, 2012 by ymedina No Comments

Quality health insurance for individuals in South Carolina can be challenging to find, but Blue Cross Blue Shield of South Carolina is putting an invigorated effort towards quality and wellness for residents. According to the news release on the BCBSSC website, many South Carolina residents find that the rising costs of medical care threaten their access to high-quality care. They recognize that these tough times need a company to focus on creativity, collaboration and community involvements.

US health care costs currently exceed about 17% of GDP based on reviews done by Harvard economist Michael Porter. This large number hurts our country on many levels. Inability to pay for health care is often cited as one of the biggest reasons individuals file for bankruptcy. As health care reform strives to fix the system’s problems, insurance companies need to work with the health care system to make costs more affordable now. BlueCross is engaged in multiple efforts to make health care more affordable for all Americans.

BlueCross is proud of their efforts to help today’s health care recipients. They are linking provider payments to coordinated high-quality health care delivery. They hope this plan will shift the health care system’s focus on wellness, instead of illness. Early intervention to disease is very important and in addition to this, the model aims to integrate improved health care services, with an extra focus on those with chronic conditions. It links provider reimbursement with patient outcomes that are positive and rewarding. Hospitals and physicians across the state are working towards these goals, hoping they will have a major impact on health care costs.

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Tags: blue cross blue shield of south carolina, health care reform, south carolina health insurance
Posted in affordable health insurance, blue cross blue shield of south carolina, finding health insurance, health care, health care access, health care reform, health insurance news | No Comments »

Aetna Health Insurance & Best Buy: An Unlikely Pair

Posted on: January 9th, 2012 by ymedina No Comments

Aetna Health Insurance and Best Buy retail may seem like an unlikely team, but they have partnered up to offer a product line which includes online modules focused on fitness, weight control, smoking cessation and stress management techniques according to the press release found on EON.BusinessWire.com.

This partnership is unique but could be a great opportunity for both companies to reach new customers. The “My Resources for Living Well” product line is now available within the Best Buy “health technology” department in three of their stores in Chicago. The department is 1200 square feet and is serving as a pilot for Best Buy to potentially expand to other areas. The product line brings together the latest technologies and tools to help customers achieve their fitness goals along with overall health improvement. They offer sleep and nutritional advice and the latest innovations for beauty, skin, face and hair care.

The head of Aetna’s behavioral health and employee assistance program, Louise Murphy, says Best Buy was a natural choice for trying out some of the well-being products for the general public. A customer may be in Best Buy shopping for an electronic device to help their health such as a blood pressure cuff or a pedometer and while they are there they can get the information to help them achieve their wellness goals.

These products have been available to Aetna members through the employee assistance and WorkLife Programs for years, and now consumers can access these valuable programs through Best Buy. It will be interesting to see if this program takes off considering there’s a price tag associated with each plan around $20. Consumers can gain this kind of information online for free, but many might opt for the convenience structure of Aetna’s programs.

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Tags: aetna health insurance, aetna insurance, best buy wellness program, health care access, health insurance news, wellness programs
Posted in Aetna, health care, health care access, health insurance carriers, health insurance news, health insurance trends | No Comments »

Breakdown of How Health Insurance Premiums Are Used

Posted on: January 4th, 2012 by ymedina No Comments

Have you ever wondered why your health insurance premiums are so high and continue to rise? It may feel like the health insurance industry is taking advantage of consumers by rising premium costs across the board, but this isn’t necessarily true. A very interesting article on WashingtonPost.com shows a breakdown of exactly how much goes towards things such as doctors and hospitals. You may be surprised to learn that the insurance companies are taking a very small profit when it’s all said and done.

According to “How $1 in Health Insurance Gets Spent” by Sarah Kliff on WashingtonPost.com, health insurance companies only take about 2% of their revenue as profit. Here is a breakdown as provided by Blue Shield of California:

Hospital costs – 40%
Physicans – 28%
Pharmaceutical coverage – 12%
Other medical expenses – 5%
Admin costs – 13%
Income for Blue Cross – 2%

As you can see, most of your premium dollars goes towards medical care by a significant margin. Blue Cross of California pledged last year to cap its profits at 2% and this can be seen in many insurers across the nation. Based on a recent ranking from Fortune’s 2009 ranking of industry profits, on average, the health insurance industry takes 2.2% of revenue as profit. When you compare this to the pharmaceutical industry the difference is staggering. They make about 19.4% profit. This is a good set up since health care reform intends to require large employer plans to spend at least 85 cents on every dollar on medical costs, which is seems Blue Cross of California is already doing.

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Tags: blue cross of california, health care access, health care reform, health insurance, health insurance news
Posted in Blue Cross Blue Shield Quote, california health insurance, employer sponsored health plan, health care access, health care reform | No Comments »

Geisinger Health Plan System Not Hiring Smokers?

Posted on: January 2nd, 2012 by ymedina No Comments

Pennsylvania-based hospital through the Geisinger Health Plan System is expected to start screening job applicants for signs of nicotine for 2012. A hospital spokesperson, Marcy Marshall, said they plan on not hiring smokers to work at the facility starting February 1, 2012.

People who apply to a job position at Geisinger Health System can be tested for nicotine and will be offered help to quit and encouraged to re-apply after six months. Smoking is not allowed on the facility grounds since 2007 and they are striving to make the entire staff smoke-free.

This type of screening comes with a lot of criticism. Pennsylvania is one of 19 states that allow employers to screen job applicants for smoking signs according to the Bureau of Labor and Statistics. A similar program was started at the Cleveland Clinic in Ohio which aims to improve the wellness of employees.

Geisinger’s plan will be costing around $47,000 per year and doesn’t apply to existing employees, although they are encouraged to quit smoking. Applicants who test positive are allowed to reapply after 90 days. This comes across a little surprising given how many Americans smoke, but it has proven to cut costs and offer a healthier environment.

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Tags: geisinger health insurance, Geisinger Health Plan, health care access, health insurance news
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Businesses Choosing Private Health Insurance Over Government Option

Posted on: December 30th, 2011 by ymedina No Comments

The government option for health insurance has its pros and cons, but businesses are noticing that private health insurance could be the better choice. The article by Jamie L. Brockway, “Business Owners See Value of Private Health Plans Over Government Option” on ifawebnews.com talks about what challenges business owners face as they make this decision.

Most independent business owners are not planning on purchasing health insurance from the government and a big part of this is because of their disagreement over health care reform in general. About 88% of business owners do not think it’s right for the government to require health insurance coverage under the Patient Protection and Affordable Care Act (PPACA), based on a survey by the Small Business Authority. The survey concluded that 91% of business owners have no plan to buy health insurance from the government, but rather remain in the private sector.

Barry Sloane, chairman, president and CEO of the Small Business Authority, a national business service company, believes this may be in part due to their belief that the government will not eliminate the private sector and there will be sufficient health insurance options for small businesses. Sloane points out that 9% of business owners plan on buying the government insurance because they believe it will take over the private sector. The survey, which was based on a poll of 1000 independent business owners, also shows that about 53% of participants believe the cost of major medical insurance quotes is to increase over the next two years.

Written by Sam Tabes

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