Health Insurance Blog

Jerry Lynott in the Times-Leader reports that Geisinger Health Plan has filed requests to increase its rates with the Pennsylvania Department of Insurance.

Geisinger wants to raise its rates by 5.5% for employers with less than 51 health care subscribers, and 7.1% for groups with more than 51 members. The rate increases will impact about 49,000 members with employer-sponsored health plans.

If the state doesn’t take some action by February 12, the rate increases will go into effect in April 1. (While that is April Fool’s Day, the Geisinger health insurance premium increases are, unfortunately, real.)

Geisinger is one of the largest providers of Pennsylvania health insurance.

(Photo credit: Nikki Spickard under CC 2.0)

Keith L. Martin of the Insurance and Financial Advisor just reported on a new proposal by Governor David Paterson regarding New York health insurance. He wants to expand health care coverage by mandating that health insurance companies cover policy dependents up to age 29, at the policyholder’s own expense. Currently, parents’ health insurance plans in New York state cover their children until they are either 18 if they aren’t enrolled in college, or 22 years old if they are.

This age group is at increased risk for being without health insurance: many 19-to-29 year olds are either unemployed and struggling to find jobs, laid off, or working in positions that don’t offer health insurance. Individual health plans are usually far more expensive than group coverage.

Paterson’s legislation will address those issues, in addition to possible provisions for any grandchildren of the policyholder. Keith says that this proposal is a step towards universal health care reform by controlling medical costs and including a large group of generally healthy people in the pool to spread risk. This demographic is a low-risk pool for insurers, but could have a negative effect on smaller employers.

(Photo credit: jimbowen0306 under CC 2.0)

According to the Baltimore Business Journal, the Maryland Health Insurance Plan (MHIP) will offer health coverage for reduced premiums for individuals and families with limited household income.

MHIP offers health insurance to Maryland residents who aren’t eligible for Medicaid, can’t afford health insurance from a private health insurance carrier or simply can’t qualify for individual health insurance due to health conditions.

Under the MHIP’s current health insurance rates, premiums range from $90 per month to over $500 per month.  The reduced rates which take effect February of this year will represent savings of $18 -$99 per month and apply to nearly 25% of currently enrolled members.

More Information about Maryland health insurance.

The baby boomer generation (ages 45 to 64) is worried about losing their health insurance, and the current economy is even more cause for concern. Many baby boomers have been either laid off or forced to retire early, and with that comes the loss of their employer sponsored health insurance plan. Meanwhile, they’re not yet old enough to enroll in Medicare.

There are still several options available to people in this age group, says Emily Brandon of U.S. News and World Report. They include:

1. Continuing your former employer’s coverage through COBRA, which they are required to offer unless they go out of business. However, you will have to cover the entire cost of the plan, plus a 2% administrative fee, yourself.
2. Getting on your spouse’s health insurance, if they have continued to work and their employer allows it.
3. Finding another job and continuing to work until you turn 65. Some companies even offer health insurance benefits to part-time employees working as little as 20 hours per week.
4. If you’re lucky to have worked for a firm that offers health insurance coverage to retirees (a steadily declining percentage), take advantage of it. Don’t rest easy, though; many companies are failing to keep their promises and are shifting a higher portion of health care costs onto retired workers.
5. Buy yourself individual insurance. Individual health insurance policies can be expensive, with premiums of over $300 per month according to the Commonwealth Fund. It also may not cover you if you have a chronic, pre-existing condition (and will be even more costly if it does), but if you are relatively healthy it may be your only option. A high-deductible plan could save you money on premiums, although you run the risk of catastrophic out-of-pocket costs. If you go down this route, make sure to research the most affordable health insurance quotes.

There is also the option of forgoing health insurance, but it’s not recommended. You’d either have to cover all of your medical expenses out-of-pocket, or go without some needed medical care.

The LA Times reports that Blue Shield of California has agreed to reinstate the health insurance policies of roughly 700 California residents whose health plans were canceled after they got sick.  Blue Shield also agreed to the way they handle their individual health insurance plans. In exchange for the agreement, the state of California dropped its lawsuit against Blue Shield and will not pursue $12.6million in fines.

In September the state reached a similar settlement with Health Net, who agreed to reinstate nearly 1,000 policy holders whose health coverage was canceled when they got sick.  In addition, Anthem Blue Cross, Kaiser Permanente and other California health insurance companies reached similar agreements with the state last year.

The health insurance companies have maintained no wrong doing and maintain that the state allows them to review old medical records after the policy holder becomes ill, and determine if the policy holder left vital information off of their enrollment application.

Reuters is reporting that Healthbase Online, a medical tourism facilitator, is engaged in a pilot program with Wellpoint to provide global health care coverage to Wellpoints members in Wisconsin.  Healthbase’s involvement in the pilot involves setting up all the medical & travel logistics.

Under the Wellpoint program, members who choose to have non-emergency elective procedures performed overseas, such as joint replacement, will have access to Joint Commission International accredited HealthCare providers in India.

The program would save members thousands of dollars in out-of-pocket costs.

As previosuly reported here in this blog, studies conducted by UCLA medical school have shown that patients who have procedures down overseas have a much greeater chance of experiencing complications or post-op infections.  Nonetheless there continues to be interest in the program in the name of saving money.  We will see if similar programs proliferate among other health insurance carriers, subsequent to this pilot program.

TradingMarkets.com reports that Aetna health insurance has made improvements to NYC Community Plan, its slate of health care offerings for small business owners and their employees. The plan, launched one year ago, is intended to make New York health insurance more accessible for groups that are traditionally underserved. It’s currently available in the New York City boroughs of Brooklyn, Manhattan, Staten Island, the Bronx, and Queens. Hopefully, Aetna will soon introduce similar products in other markets.

Changes to the plan include:

• unlimited generic pharmacy benefits in a calendar year
• discounts on branded medications
• lower co-payments for hospital visits

With cooperation from doctors, hospitals, and other providers, Aetna has actually managed to lower premiums of small business health insurance to as little as $243 per month!

(Photo credit: fergusonphotography under CC 2.0)

Barack Obama and the Dems are considering major expansions to the existing government assisted health care programs.  One of the changes being discussed would subsidize employers’ expenses for temporary continuing health insurance coverage to laid-off and retired workers and their dependents, as mandated by COBRA, and allow workers who lose jobs that did not come with health insurance benefits to be eligible for health coverage via Medicaid.

According to Emily Coleman of The Missourian, a state legislator is planning to introduce a bill that would require Missouri health insurance companies to cover diagnosis and treatment of infertility. Steve Hodges (D) is trying again, after failing to get a hearing for a similar bill last year. 

It is unclear whether the bill would make the insurers’ infertility coverage also apply to men. Emily says that the inspiration for this bill is a recent study finding that males from Columbia, Mo. had lower sperm counts than those from major American cities, possibly due to pesticides used in the farming town. (However, all of the men in the study were still fertile.) Men could go to a fertility clinic for an inexpensive, fast analysis and have the non-invasive procedure covered by insurance if the bill is passed with such a provision. 

(Photo credit: ksr8s under CC 2.0)

Several new Georgia state laws become law as we ring in the new year today.  Among these new laws is one which will eliminate both state and local taxes for Georgia health insurers who offer high-deductible health insurance plans.  The tax break will save insurance companies an estimated $146 Million over 5 years.  The idea behind the law is that it will ultimately save the Georgia Government money as a proliferation of high-deductible health plans will provide coverage for the estimated 1.7million Georgia residents who lack health insurance and end up costing the state money, however critics of the plan question whether this law will do anything to reduce the number of uninsured.

More information about Georgia health insurance.