Health Insurance Blog

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)

RedOrbit recently reported that after many states have seen a significant increase in Medicaid enrollment since the beginning of the recession (Connecticut has seen a 6% increase this year), governors have asked Congress and President-Elect Barack Obama to help them pay for the publicly funded health insurance plan. The governors are petitioning for $40 billion to cover a shortfall in projected tax revenues, which would be a two-year long increase in the percentage Washington D.C. kicks in for medical funding. As of the 2007 fiscal year the federal goverment covers 57% of Medicaid costs while individual states cover the rest.

Medicaid is offered to children and the extremely poor; about 1 in 6 low income individuals in America are enrolled. Rising unemployment has resulted in more people being eligible for Medicaid, while at the same time state governments are suffering from lower tax revenues. Unlike the federal government, states aren’t allowed to run a budget deficit. If the states don’t recieve this funding, they will either have to cut programs or raise taxes in order to balance their budgets. While most unemployed individuals can buy into group health insurance plans, the majority cannot afford the premiums without an employer paying some part of them.

The National Business Coalition of Health just released a study based on data from its eValue8 comparison tool. The study’s findings include great news for individuals with chronic conditions and employer-based health insurance. The average health insurance plan is doing more to cover the medication and equipment needed, due to higher employee demand. The result is less expensive co-payments for consumers.

Visible Trends in 2008:

• Asthma. 32% of insurance plans reduce co-payments for treatment, and 19% eliminate them entirely.
• Diabetes. 33% of insurers reduce co-payments, and 27% waive them.
• Hypertension.  20% of insurers waive co-payments, and 28% reduce them.

Autism affects thousands of American families every day. In most cases, families must go into debt to pay for the comprehensive therapy they feel their children need; behavioral therapy is not covered by most insurance. Utah state senator Howard Stephenson and state representative Roger Barrus (both R) plan to change all that. In January, they will introduce a bill in the state legislature that would mandate providers of Utah health insurance to cover treatment for autism.

In the Salt Lake Tribune, Heather May outlined the provisions of this bill:

• The bill will only cover treatment for autistic children under 5 years of age, because that’s when therapy is said to have the greatest impact.
• The type of treatment covered by the bill is most likely to be ABA therapy (applied behavior analysis), which consists of up to 40 hours a week of one-on-one therapy that helps autistic children learn to communicate and teaches them appropriate social skills. ABA is widely considered to be effective, but it has been criticized by some for being an unproven method.
• Companies that are self-insured, as well as the federal government, will be excluded from the health care coverage mandate.
• The insurance will have a $30,000 annual cap, as well as a lifetime cap.
• The bill will also require families to contribute financially.

Women of child-bearing age (19 to 55 years old) pay more for health insurance than men, says Linda A. Firestone, Ph.D in the Sun-Sentinel. A typical woman’s policy includes maternity coverage, which accounts for the gender disparity in insurance rates. Since the majority of American adult women eventually have children, health insurance with maternity coverage makes sense for them–especially if there are pregnancy or birth complications.

Group health insurance plans (for example, those provided by employers) in Florida do not allow women to opt out of maternity coverage. If a woman does not plan to have children, she can choose to buy one of many individual health plans, which allow her to opt out of maternity coverage. In fact, many insurance providers (such as Humana), no longer offer maternity coverage in their plans. Insurance specialist Larry Wides says the cost savings from a group plan tend to cancel out the reduced premiums resulting from the elimination of maternity coverage.

Judith Graham from the Chicago Tribune’s Triage blog has mentioned that the state of Illinois is now suffering from an epidemic of 50 to 64 year-olds without health insurance. These individuals are caught between a rock and a hard place–they often suffer from pre-existing conditions that preclude buying individual health coverage on the open market, but aren’t yet old enough to qualify for Medicare.

An AARP/Disability Advocates of Chicago report found that over 287,000 (13.3%) adults in the 50-64 age group are uninsured. 44% of poor adults in this age range lack health insurance.

Unfortunately, the current corruption scandal involving Ill. Governor Rod Blagojevich is distracting the state from its governing duties, including dealing with health care. Get the best Illinois health insurance quotes, regardless of your age.

(Photo credit: Cuksis under CC 2.0)

Earlier this week, 6 health insurance companies in Florida signed contracts with the state to offer affordable health insurance to the uninsured in Florida.  The health insurance offerings vary, but in general are less than $100 per month.

The program championed by Florida Governor Charlie Christ is called Cover Florida, and will launch on January 5, 2009.  The plan was unanimously approved by the Florida Legislature and require no tax dollars to make it happen.

The six participating health insurers will offer 25 health plans options between them, and each with 2 different benefit levels (one focusing on catastrophic coverage & hospital coverage, and the other on preventive care).

Of the six health insurance companies only offerings by Blue Cross Blue Shield of Florida and United HealthCare are available in all 67 Florida counties.

The UnitedHealth Group is now offering UnitedHealth Continuity, a policy for those that already have health insurance but are worried that they may lose it in the future. These people may be considering early retirement, or may fear unemployment and the resulting loss of health care coverage. Reed Abelson says in the New York Times that applicants must pass a medical review before being accepted. However, many individuals who have been unable to get insurance on their own are those with pre-existing conditions. The Continuity plan doesn’t seem to be helpful for them.

The UnitedHealth Continuity policy charges members 20% of the current health insurance premium to reserve the right to future coverage, and varies due to age, gender, location, and level of coverage selected. The monthly fee is also subject to increase in the future. There is also the danger of the plan becoming a costly high-risk pool that attracts people more likely to develop serious conditions.

Reed also speculates that proposed health care reforms from the incoming Obama administration include a requirement that private insurers offer individual health coverage to everyone, no matter the state of their health. That type of law would make the new UnitedHealth guarantee unnecessary. The president of UnitedHealth’s individual insurance unit, Richard A. Collins, claims that political wrangling and legislative delays make the Continuity plan viable, at least in the short term.

UnitedHealth Continuity is currently available in 25 states in which UnitedHealth already sells individual insurance. It believes that it will soon be able to offer the Continuity plan in 15 more states.

(Photo credit: Shahram Sharif under CC 2.0)

Kevin Freking from the Associated Press has just reported the reaction to President-Elect Barack Obama’s health care plan from America’s Health Insurance Plans (AHIP). AHIP is the leading health insurance industry trade group.

At the National Press Club, AHIP announced that it generally supports the Obama administration’s ideas for health care reform. However, they strongly oppose a proposed requirement that large- and medium-size employers must either contribute to their employees’ health insurance or pay a percentage of payroll to a national insurance plan. President and CEO Karen Ignagni claims that given the current state of the economy, any sort of employer mandate is a bad idea.

AHIP also doesn’t support comprehensive coverage mandates imposed by the states, preferring a national plan for small businesses that covers essential services such as emergency and primary care. This plan would exclude services that significantly increase monthly insurance premiums and those that insurers consider unproven. Consumer advocate groups believe that this will reduce the effectiveness of individual health coverage.

Politicians and industry representatives agree that they would like changes in health care policy to happen soon, before the new administration gets distracted by other issues.

In yesterday’s Miami Herald, John Dorschner reported that Blue Cross and Blue Shield of Florida is now offering a discount card statewide for those without health insurance. For $20 per month, the new FamilyBlue card administered by Coverdell gives individuals discounts on routine medical expenses such as:

• prescription drugs and vitamins
• doctor visits
• dental, vision, and hearing care
• diabetes supplies

However, unlike individual health plans the card doesn’t cover hospital stays, which are most likely to lead to medical bankruptcy. Dorschner also wrote of problems surrounding doctor awareness about the program. Out of 10 approved providers for the FamilyBlue card, only one doctor accepted it when asked. Experts say these discount cards may be more suitable for young and healthy individuals less likely to need hospitalization.