Health Insurance Blog

Aetna Health Insurance and BayCare Health Systems have resolved a contract dispute that would have reduced health care access for over 300,000 patients in the Tampa, Florida area. Stephen Nohlgren of the St. Petersburg Times says that if BayCare and Aetna didn’t settle their issues, Aetna insurance would no longer be accepted by BayCare hospitals after the current contract expires on December 31st. Patients would then have had to deal with the scary prospect of scrambling for new hospitals and doctors.

As of this Wednesday both parties have reached a 3-year agreement that will keep the BayCare hospitals in Aetna’s network, Stephen reports. BayCare owns most of the major hospitals in the Tampa/St. Petersburg region; most notably the Morton Plant, St. Joseph’s, Mease and St. Anthony’s hospitals. Details about the deal haven’t been released, but this agreement will surely lessen the year-end worries of some Tampa health insurance consumers.

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.

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.

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.

Nine health insurance companies, including Blue Cross Blue Shield of Florida (BCBSF), have agreed to participate in a plan to provide affordable health insurance coverage to the 3.6 million Florida residents that are currently uninsured.

The plan proposed by Governer Charlie Crist is called Cover Florida.

The Florida health plans offered by carriers as part of Cover Florida will be on a guaranteed issue basis (meaning that applicants cannot be refused coverage).  BCBSF will offer two health plans, catastrophic coverage for $150 per month, and a non-catastrophic plan for $50 per month on average.

Health insurers participating in the program can offer health plans with lower premiums because they are exempt from the requirement to inlcude more than 50 state mandated beenefits in the health plan

In addition to BCBSF, some of the other insurers who are participating in the program include: UnitedHealthCare, Total Health Choice Inc., Universal Healthcare, JMH Health Plan, Medica Health Plan of Florida, American Management Advisors and Celtic Insurance Co.

A number of national health insurance companies including Aetna, Humana, and CIGNA choose not to participate in the program.

According to the Kaiser Daily Health Report, a proposed rule that would standardize the application and medical questions that are used for small businesses (2 to 50 employees) is being challenged by two United Health Care Group companies (UHC).

The objective of the proposed rule is to close the Florida health insurance price gap between small businesses that can submit group applications and other smaller companies with fewer employees that are required to submit the medical histories of their employees.

The UHC companies are challenging the new rule on the grounds that the Florida Office of Insurance Regulation does not have the authority to require such a change.  In the absence of the rule, Florida health plans would be able to charge small businesses up to 15% more than rates that are filed with the state based on the medical histories that are submitted for each employee

Harry Wessel of the Orlando Sentinel recently reported Gov. Charlie Crist’s “Cover Florida” health plan is likely to fail. Passed by Legislature, this new Florida health insurance plan was designed to help reduce the number of uninsured Floridians. It is estimated that 3.7 million Florida residents do not have health insurance.

Wessel cites a report from the Washington, D.C. based policy-research group Center on Budget and Policy Priorities. The low cost health insurance plans offered at around $150 a month typically leave out important benefits, are still too high for low income individuals to afford, and have high deductibles those with low incomes cannot afford should they receive care. Without subsidies, “bare bones” plans like Cover Florida don’t offer a realistic solution.

Wessel’s article can be found in it’s entirety online here http://www.orlandosentinel.com/business/orl-health2108jul21,0,294263.story.