Health Insurance Blog

PacificSource Health Plans has acquired Clear One Health Plans for $46 Million.  Under the merger agreement, Clear One will become a wholly owned subsidiary of Eugene Oregon based PacificSource.

The merger will allow PacificSource to increase its presence in Central Oregon and expand into the Medicare and Medicaid markets through Clear One Health Plans  operation while continuing to devote energy towards PacificSource’s commercial health insurance business.

The deal still requires approval by the Oregon Insurance Division, the Centers for Medicare & Medicaid Services and the Oregon Division of Medical Assistance Programs, as well as final shareholder approval.

Bend Oregon based Clear One provides health insurance, including Medicare Advantage plans, commercial plans, individual health insurance plans as well as administrative services to individuals and businesses throughout the West.

After the merger, PacificSource Health Plans is expected to cover about 228,000 members and PacificSource TPA about 80,000. Employer clients are expected to total 5,676 and 303 respectively.

More information about Oregon Health Insurance.

Houston, Texas elected a new mayor earlier this month named Annise Parker.  According to the article “Houston Is The Largest City to Elect Openly Gay Mayor” by James C. McKinley on NYTimes.com, voters gave a solid victory to this openly gay woman.

There are some smaller cities that have elected openly gay mayors, but this is the largest city in history to do so.  Her success came in a conservative state which makes the victory that much more historic.  Many Houston residents believe this is a huge step forward for the city as diversity is embraced.

Ms. Parker has a challenging job ahead as she faces many important issues such as Houston health insurance.  With Texas suffering from a very high rate of uninsured residents, it’s important that elected officials of major cities such as Parker, make health insurance reform a top priority.  With health insurance weighing heavily on the government’s agenda, health insurance quotes may change noticeably in the coming months.

Nine out of ten seniors are satisfied with their medicare supplement insurance according to Blue Cross Blue Shield’s (BCBS) website.  Most Medigap policyholders feel they are getting good value for their money based upon a survey recently released by BCBS and America’s Health Insurance Plans.

The survey, which was conducted by American ViewPoint, INC, shows that approximately 88% of seniors carrying medicare supplement insurance were satisfied and 62% consider themselves very satisfied.  Even more impressive is that 87% said they would recommend their Medigap coverage to friends and family.  According to the survey, the main thing they liked about their coverage was the flexibility choosing any physician they wish and the peace of mind they find with their protection.  Medical bills and processing paperwork is simple as well for these consumers.

Shopping around for a Medigap policy can be overwhelming since there are so many companies offering these types of policies, including BCBS medicare supplements.  To ensure you are part of the majority who have positive experiences with their Medicare, it’s important to shop around to get the best rates as well as the most comprehensive benefits that suit your needs.

According to the BCBSA website, BCBSA has started a new Pediatric Obesity and Diabetes Prevention Pilot Program in Texas, New Mexico, Mississippi, North Carolina and Kansas.  Through this program Blue Cross Blue Shield plans on reducing the epidemic of childhood obesity and stop further cases of young people getting Type 2 Diabetes.

The plan consists informational toolkits for doctors to use as reference guides when addressing obesity.  The kit was designed with the American Diabetes Association and the American Academy of Pediatrics to encourage healthy choices and was passed out in mid-November.  BCBS collectively protects over 100 million Americans through individual health insurance and other health insurance policies, so this large effort by them should have a great impact.

The toolkit offers healthy lifestyle suggestions such as eating 5 servings of fruits and vegetables a day, limiting TV time to 2 hours a day, getting an hour of physical activity every day, and stop drinking sweetened drinks.  According to the US Department of Health and Human Services, an overweight teen has a 70% chance of becoming an obese adult which is one of the leading causes of health issues in our country.  This type of action is proving very necessary.

Clark County Nevada commissioners are discussing making the only public hospital in Las Vegas private according to the article “County Talks of Privatizing Vegas Public Hospital” by The Associated Press on Mercury News’s website.

Commissioners say that the University Medical Center (UMC) is southern Nevada’s safety net hospital and treats many with no Las Vegas health insurance.  They are considering making this hospital private to save money, and if they do they may still treat those uninsured.  An audit that was performed recently shows that UMC lost $83 million last year.  Commissioners believe the county system needs to be overhauled to save money.

County manager Virginia Valentine says they are trying to figure out if they can make the switch to a private hospital and continue to be known as the top trauma and burn center.  Treating the uninsured is another valuable part of the hospital.  Even those uninsured who think they cannot afford Las Vegas health insurance should get health insurance quotes to see if there is anything affordable and help keep more hospitals in business.

Texas insurance consumer advocate is looking to get rid of the blanket authority of health insurance companies to decide what their policies will cover according to the article “Texas Consumer Advocate Wants Ban on Health Insurers’ Blanket Clauses” by Terrence Stutz on DallasNews.com.  This would cause a big impact on individual health insurance in Texas.

Deeia Beck, the Public Insurance Counsel, asked the state’s insurance commissioner to stop provisions present in many health insurance policies, called discretionary clauses.  This gives health insurance companies the freedom to decide what benefits will get paid.  The health insurance industry strongly opposes this type of change being made.

There are currently 22 states who have banned this clause, and Texas may be next.  Insurance Commissioner, Mike Geesline, has held a hearing to consider whether or not to move forward with this proposal.  The National Association of Insurance Commissioners has urged its members to stop this practice.

According to the article “Advantage Plan Cancellation: What To Do” found on TucsonCitizen.com, you have two options in the case that your Medicare Advantage Plan is cancelled.  It’s important to understand those options to the best of your ability so you aren’t left without coverage for any period of time.

The first option is to change to another Advantage Plan as quickly as possible.  The other option is to return to a Medicare Plan and get a Medicare Supplement along with it.  This is called “guaranteed issue” and it’s a great option for many.  Finding individual health insurance can be challenging for anyone, but when your Medicare Advantage Plan is cancelled, you don’t want to be left scrambling.

In order to take advantage of “guaranteed issue” a few requirements must be met.  A copy of the cancellation letter from the company canceling the Medicare Advantage Plan must be submitted along with the Medicare Supplement application.  It’s important to ensure the appropriate boxes on the application are checked to show that one would be eligible for “guaranteed issue”.

On AARP’s website they have what is called a “Doughnut Hole Calculator” which has been designed for the 2010 Plan to avoid falling into a gap for Medicare Part D coverage.  It’s a four step tool that is very useful for saving you money on your health insurance quotes.

The Doughnut Hole Calculator is easy to use.  First, gather your medications and drug plan cards and go onto AARP’s website.  Enter the name of each drug, dosage, and how often you take it.  Then you can view a chart to determine if you are going to hit the “doughnut hole” for Medicare Part D.  The calculator will give you a list of alternative drugs that are similar to the prescribed drugs but they can dramatically reduce expenses and stretch your AARP Medicare supplements coverage.  They supply a form letter you can print out and show your doctor to ensure the drugs will suit your needs.

You can learn more about avoiding a gap in your Medicare coverage on AARP’s website.  You can also read and share experiences with the Doughnut Hole Calculator to see what other people are dealing with.  There is an online community available to members which many find extremely valuable.

Humana One has valuable information on their website about special discounts that they currently offer and in today’s economy we’ll take all the discounts we can get.

Some examples of useful Humana One discount programs that will save you money are eye care and vision services, which can save you up to 35% off retail on glasses and over the counter and prescription medications which can save you up to 25%.

Humana One also offers special discounts on chiropractic, acupuncture, and massage therapy saving members up to 30%.  Discounts on health-related products and services, which also includes skin care, nutrtional supplements and vitamins, can save members about 20%.

All of these discounts add up and can mean huge savings on PPO health insurance.

According to a recent research report written by Debra A. Donahue of Mark Farrah and Associates, the individual health insurance marketplace is growing.  As of the end of Q2 2009, national individual health insurance enrollment totaled about 9.7 Million, up from about 9.6 Million from the previous year.  This enrollment does not include those individuals enrolled in Medicare Health Plans, or other state sponsored Programs.  Part of this growth is being fueled by high unemployment rates and less people having access to group sponsored plans.

The report makes it crystal clear that Wellpoint is the largest and most dominant player in the individual health insurance marketplace, albeit partly due to their large geographic footprint, covering 15 states.

The top 5 health plans ranked by enrollment in individual health plans include:

1. Wellpoint - with enrollment of over 2.25 Million (23% market share)
2. HCSC (Health Care Services Corporation) - 670,000 (7%)
3. Blue Cross Blue Shield of Florida - 370,000 (4%)
4. Kaiser Foundation Health Plans - 344,000 (4%), down 12% from previous year
5. Humana - 336,000 (4%), up 28% from previous year

Humana increased the number of states it offered it HumanaOne individual health insurance plan from 15 states to 24 states in March 2008, which accounted for their large increase in enrollment.

Wellpoint and HCSC are both health insurance companies that offer Blue Cross Blue Shield Health Plans in multiple states.  Wellpoint includes 15 BCBS licensees, and HCSC 4.