Health Insurance Blog

SmartSense® health plans are a portfolio of affordable health plans for individuals offered by Anthem Blue Cross Blue Shield.

Monthly premiums for SmartSense can be less than $50 per month for an individual (single Male in Ohio, age 27)  if a high deductible ($10,000) is selected.  If a $2,500 deductible is chosen the monthly rate would be just over $60/mo.

Some of the highlights of SmartSense® include:

• A wide range of deductibles to choose from
• Access to a large network of doctors and hospitals
• No referrals or paper work needed
• Prescription drug benefits
• Online health support
• One of the most trusted names in health insurance

Just an example of high quality and affordable health insurance that can be found if you take a few minutes to shop around.  You can compare health insurance quotes right here at healthinsurancesort.com in less than 5 minutes.

Effective January 1, Blue Shield of California will be removed from the Major Risk Medical Insurance Program (MRMIP) because their premiums were substantially higher than the rates offered by the other two insurers that make up the Program.

The MRMIP currently covers almost 7,000 California residents who are unable to purchase private health insurance due to pre-existing conditions.

Health insurance companies that participate in the MRMIP Program are allowed to charge 25% higher premium than the market rate for a given health insurance policy, and if the insurer loses money they will be reimbursed by the state.  Despite the state subsidization, Blue Shield’s health insurance rates were much higher than both Kaiser Permananete’s or Anthem Blue Cross of California.

Current enrollees in the MRMIP Program via Blue Shield will be able to keep their existing coverage until January 1, and then must enroll with one of the other health plans that participate in the Program.

More information about California health insurance.

Blue Cross Blue Shield Association (BCBSA) has an awards program called Blueworks which is a collaboration between BCBSA and the Harvard Medical School Department of Health Care Policy according to the Blue Cross Blue Shield website in their Newsroom.

The Blueworks program is in its 5th year and last week they recognized 6 Blue Cross Blue Shield companies with a total of 7 Blueworks Awards for innovative approaches to improving the quality of health care for comsumers. 

Harvard researchers evaluate and choose BCBS companies’ health care programs for recognition based on their innovation, and potential for replication.  BCBSA president and CEO, Scott P. Serota says that the winning programs are great examples of the work Blue Cross Blue Shield companies are doing in the community to improve health care.  They are providing consumers with valuable information needed to help make educated health care decisions. 

On Blue Cross Blue Shield’s website there is a news article entitled “New Census Report Underscores Need for Health Care Reform”.  It has a statement from President and Chief Executive Officer of Blue Cross Blue Shield Scott P. Serota.  The statement follows after the release of the report from the US Census Bureau that shows the number of uninsured Americans increased from 45.7 million in 2007 to 46.4 million in 2008. 

Serota points out that no one should have to worry about having quality, affordable health insurance.  He believes that 46 million uninsured is unacceptable.  It’s an important reminder of the critical need for health care reform.  According to Serota, we should enact bipartisan health care reform this year that will give health insurance coverage to everyone. 

Blue Cross Blue Shield companies support initiatives working towards this goal.  They want to build on the employer based system currently in place.  He says the high number of uninsured is partly because of the recession, but something still needs to be done now to fix this problem. 

Approximately 1 million Americans have been infected with the H1N1 virus, more commonly known as the swine flu, according to the article “Individual Health Insurance Could Provide Assistance for Swine Flu Vaccines” by Maggie Guo found on the Ethiopian Review. 

People who are covered by certain individual health insurance companies may have the swine flu vaccine paid for.  Anthem Blue Cross is covering their customers who carry vaccine coverage and America’s Health Insurance Plans says it will offer similar protections according to a St. Louis Post-Dispatch report.

Once the Food and Drug Administration approves treatment there will be roughly 160 million doses of innoculations according to the Centers for Disease Control and Prevention.  Clinical trials are currently in progress.  Across the country, cities are establishing free clinics to give vaccines.  There will be 100 centers in NYC alone in addition to a center at each elementary school.  Chicago and LA are following similar plans.

Blue Cross Blue Shield health insurance companies’ anti fraud investigations caused savings and recoveries of about $350 million for 2008 according to the article “Blue Cross And Blue Shield Companies’ Anti-Fraud Efforts Recover $350 Million In 2008″ found on BCBS’s website. 

According to data released from Blue Cross Blue Shield National Anti-Fraud Department, this is a 43% increase from 2007.  The number of cases opened increased by about 34% and closed cases increased by 43% from 2007 to 2008. 

Approximately 3% of all health care spending is lost to fraud each year according to The National Health Care Anti-Fraud Association.  This totals to about $68 billion in losses.  The total savings for all BCBS companies’ anti fraud units and Special Investigative Units was around $7 for every $1 spent on anti fraud efforts.  BCBS is a leader in detecting and following up with fraud according to Scott P. Serota, BCBSA president and CEO.

The September issue of Consumer Reports ranks the top PPOs and HMOs in the country.  In all, 41 PPOs were rated as well as 35 HMOs.  The ratings were based on surveys of 37,000 respondents.

Some of the findings included in the report inlcude:

• Median health insurance premiums were $1,829 (up 38% from two years ago).  PPO members paid $2,003 on average, while HMO members paid $1,466.
• The highest rated PPO health insurance plan was Anthem Blue Cross Blue Shield of Connecticut
• The highest rated HMO was Group Health of Idaho & Washington
• 64% of respondents were very or completely satisfied with their health insurance carrier.  10% were dissatisfied.

In JD Power & associates 2009 rankings of the top health plans in Ohio, Medical Mutual took top honors.  Based on JD Power surveys, Medical Mutual of Ohio is among the best health plans in the country.

Humana is the 2nd best health plan in Ohio according to this study of well over 100 health plans nationally, and also among the best in the country.  Other Ohio health plans that were rated include:  Anthem Blue Cross Blue Shield & Aetna which were both rated as average, and CIGNA & UnitedHealthCare which were rated as below average.

More information about Ohio health insurance.

US News Top Ohio Health Plans

According to the article, “Blue Cross requiring psychiatrists to get prior authorization before treating patients” by Liz Freeman on naplesnews.com, Blue Cross Blue Shield health insurance of Florida implemented a new rule taking effect this fall which will require psychiatrists to get authorization before treating patients in their office or out patient locations.

Blue Cross sent letters to psychiatrists which outline the new rule that goes into effect on Oct 3.  A contract amendment must by signed by the mental-health providers by June 24 if they accept Blue Cross Insurance.  The pre-authorization will be required to treat patients for office based visits, inpatient admissions, and for partial psychiatric and substance abuse care.  Emergency visits are covered but the provider will need to request authorization.  This is all outlined in the notice from Blue Cross.

Blue Cross officials state the new authorization rule is partly because of the Mental Health Parity Act of 2008 which intends to end inequity between medical treatment and mental health care for plans with 50 or more employees.  The David Lawrence Center, a private nonprofit mental health center in Golden Gate, Florida, believes its expenses may rise with the new rule, but their patients will not face any fee increases and they will not turn anyone away because they have Blue Cross.

J.D. Power and Associates rating of the top health plans for the South East Central region lists two health plans tied for the top spot for 2009 - Anthem Blue Cross Blue shield of Kentucky and BlueCross BlueShield of Alabama.

CIGNA & Humana finished close behind while still receiving designation as being among the nations best.

Aetna & Blue Cross Blue Shield of Tennessee were rated as “about average” while  United HealthCare and Blue Cross Blue Shield of Mississippi were rated below average.