According to US News and World Report, Capital Health Plan, an affiliate of Blue Cross Blue Shield of Florida, is the top rated Medicare Health Plan in Florida.
Founded in 1982, Capital Health Plan serves the four county are surrounding Tallahassee. They currently provide coverage to more than 110,000 members.
More information about Florida health insurance & senior health insurance.
Blue Cross Blue Shield of Florida (BCBSF) has introduced a new Medicare Advantage plan to its portfolio of health plans for seniors.
BlueMedicare Regional PPO joins a senior health insurance portfolio which already included HMO, PPO, Fee-for-service, Medicare Part D, and traditional Medicare Supplement Plans.
BlueMedicare Regional PPO is available across Florida for a $45 monthly premium. Benefits include the ability for members to choose theit own doctors ans hospitals with no referrals required, as well as both in-network and out-of-network coverage.
More information about Florida health insurance and Medicare Advantage Plans.
Blue Cross Blue Shield of Florida (BCBSFL) offers a Medical Discount Card called FamilyBlue that provides discounts on health care. FamilyBlue is not health insurance, but it does provide discounts on heath care services which is negotiated with providers.
As mentioned above, FamilyBlue is not health insurance, and should be viewed as a last resort only if health insurance cannot be obtained. If you shop around and compare rates for individual health insurance plans in Florida you will find that there are many affordable health plans available. A true health insurance plan will offer superior benefits and protect you more comprehensively should you have an accident or become ill.
There are two different FamilyBlue Plans.
More information about Florida health insurance.
Blue Cross Blue Shield member plans initiatives to increase access to affordable health insurance by the uninsured.
Part IV
GoBlue is a product offered by Blue Cross Blue Shield of Florida which provides Florida residents access to doctor visits, basic and preventative dental care, prescription coverage, and lab tests all at affordable rates as low as $26 per month, for a 25 year old.
GoBlue is a guaranteed issue producty which means florida residents cannot be declined due to health conditions. In addtion, the product has no lifetime maximums so members can continue to be enrolled as long as they continue to pay their monthly premiums.
More information about Florida health insurance.
Blue Cross Blue Shield of Florida Plans to sell individual health insurance plans via storefront on a larger scale in the future. BCBSFL who has had an operational health insurance storefront in Pembroke Pines for more than a year plans to expand to five to eight stores across the state.
Individual health insurance have become much more popular health insurance alternatives as the recession has cost thousands their employer sponsored health coverage.
While some say that individual health plans are the least cost effective for the customer because of high administrative costs, they can be quite effective and inexpensive for the young and healthy in particular.
Other similar health insurance storefronts in Florida include an AvMed store in Hollywood aimed at Medicare Seniors, and about a dozen Humana stores across the state.
More about Florida health insurance.
Miami-Dade county in Florida has teamed up with Blue Cross Blue Shield health insurance of Florida for a very unique partnership according to the article “Dade, Blue Cross offer health plan” by John Dorschner on miamiherald.com. Currently there are around 600,000 uninsured in Miami-Dade county and leaders felt something needed to be done to fix this.
Janet Perkins with the Office of Countywide Healthcare Planning believes this is a cutting edge program for Florida health insurance and a national model. It’s called Miami-Dade Blue and it’s a revolutionary option to offer affordable health insurance to the uninsured. This special health insurance would cost a healthy 35 year old man around $100 which is extremely low. This concept was first a vision of Commissioner Joe Martinez from about 5 years ago. He said it’s been a long, hard road, but he’s truly excited and good things can come from this plan.
There are some concerns over the benefits of the program. Some insurance brokers believe the benefits may not be as good as most popular plans which may cause a problem as policyholders file claims. One of the major challenges was getting providers to take discounted prices. Approximately 1,500 doctors have agreed to be included in the Miami-Dade Blue network which is a great start in the right direction.
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.
The state of Florida was not included in the Southeast region when J.D. Powers ranked the top health plans in the Southeast, in their rating of the top health plans in 17 distinct regions, Florida is its own region. That being said, J.D. Power and Associates rated Blue Cross Blue Shield of Florida as the top rated health plan in Florida.
BCBSFL was rated as being among the best health plans in the country, as was Humana, coming in just behind the Florida Blue Cross Blue Shield plan.
Other Florida health plans that were rated as part of this study included UnitedHealthCare, CIGNA, and Aetna. UnitedHealthCare was given 4 stars out of 5 in overall experience (better than most) while CIGNA & Aetna were given 2 stars, a below average rating.
More about Florida health insurance.
John Dorchner reports in the Miami Herald that the state might consider a bill that would require gender equity in Florida health insurance premiums. Florida’s insurance consumer advocate Sean Shaw is looking to team up with a congressperson that would sponsor legislation that would ban the practice of gender rating. Women pay higher premiums than men, even when you exclude maternity coverage.
For example, a Blue Cross Blue Shield of Florida policy for a 30-year-old in Miami costs $246 for a man and $291 for a woman. Insurers claim that women use more health care services and are more likely to keep up with regular screenings; some believe that’s a perverse incentive to forgo preventative care.
However, due to that higher level of utilization, older women are in better health and have lower health insurance premiums than their male counterparts. Using the BCBSFL example above, a 60-year-old Miami woman pays a monthly premium of $593, while a man of the same age pays $644.
The Sun-Sentinel’s Bob LaMendola wrote about a shocking trend among Florida health insurance companies: they’re now trying to save money by forcing consumers to take completely different drugs that are less expensive than the medications actually prescribed. While it’s customary for insurers to only cover generic versions of prescription drugs (that are chemically equivalent to the brand names), this is a recent development. Blue Cross Blue Shield of Florida and AvMed Health are among the insurers going this route. Patients have been informed that they will face increased co-payments or the elimination of coverage altogether for certain brand name medications.
Doctors are being encouraged to prescribe similar drugs with a generic equivalent; for example, instead of prescribing a patient Lipitor (which has no generic), give them the generic of Zocor. The insurance companies claim that these practices will result in an 80% savings. However, doctors are worried that insurance companies are attempting to second-guess their judgement on what a patient actually needs. Patients could suffer if forced to take a less effective drug. Bob points out that they can appeal to the insurance company if only the brand name drug is effective, but appeals are time-consuming and costly.
