Health Insurance Blog

Health Care Lane is a new and interactive website where experts explain health insurance topics offered by UnitedHealthcare health insurance according to their Newsroom on uhc.com.  Health Care Lane enables an online community to get common health insurance questions answered quickly.

Health Care Lane was launched in time for open enrollment and offers help with selecting the right health insurance plan and understanding health insurance quotes.  The straightforward conversations are designed to be user friendly and easy to understand. 

Not only is Health Care Lane available to UnitedHealthcare members, but it’s also offered to anyone interested in learning more about health care topics.  Visitors can learn about simple topics such as the definition of a premium or more complex topics such as the benefits of a Health Savings Account.  This site is a great opportunity for consumers to educate themselves on the many facets of health insurance, now more than ever as the health care system is up for debate. 

Following up on a story reported a couple of days ago, UnitedHealth Group has agreed to pay $350 Million to settle a billing dispute related to out of network claims.  In addition, UnitedHealth pledged $50 Million and Aetna $20 Million to create a new database to determine our of network claims payment.  The previous database that was used was operated by Ingenix, a UnitedHealth subsidiary which was at the center of the dispute.

The Ingenix database, contained claims payment data that is contributed by health insurance companies.  The data is then used to set “usual and customary” charges for certain procedures, when members receive care outside of their network.

The lawsuit alleged that health insurance companies lowered the payment data when adding to the database, which allowed them to lower payments for future claims.  The patient would then be billed the difference.

An investigation by the New York Attorney General’s Office found that health insurers had underpaid by 10-28% as a result of the inaccurate data in the database.

Julie Appleby of USA Today reports that New York Attorney General Andrew Cuomo has reached an agreement with UnitedHealth Group that will protect policyholders against paying more than they should to see out-of-network doctors. While this immediately affects New York health insurance, the settlement could have far-reaching impact across the country.

UnitedHealth insurance used a subsidiary’s database (Ingenix)–as do many other health insurance providers nationwide–to determine how much doctors should be paid, through the insurers’ own reports of regional charges. Cuomo calls this a conflict of interest, and will establish a non-profit agency that will publicly post typical medical costs on a Website. UnitedHealth has agreed to donate $50 million to that agency.

On average, UnitedHealth underpaid out-of-network doctors by over 25%. Consumers suffer when doctors do not consider those incomplete reimbursements as full payment, since they have to cover the difference. The rules surrounding reimbursement of non-network care are often murky and confusing. According to Julie, Cuomo claims that many insurance plans don’t even tell consumers how much they’ll end up having to pay! 

Get UnitedHealth quotes for the second-largest health insurer in America.

This is very interesting: Vita Reed in the Orange County Business Journal says that a subsidiary of UnitedHealthCare called Prescription Solutions, which manages pharmacy benefits, is planning on introducing an e-prescription service. They are partnering with SureScripts-RXHub to do so. UnitedHealth got the California-based company as part of its acquisition of PacifiCare in 2005.

I predict this service will become very popular over the next several years. Imagine not having to drop off your prescription, because your pharmacy already recieved it online before you even left your doctor’s office! (Not to mention avoiding the issue of handwriting quality.) This deal will make this benefit available to more consumers. Currently, just 2% of doctors have adopted the system, according to the Washington Post. If it’s provided by a health insurance company, they might be more likely to use the technology.

(Photo credit: d70focus under CC 2.0)

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)

UnitedHealth Group announced that Ovations, their health and well-being company for seniors, is launching a new portfolio of Medicare Health Plans for 2009.

Ovations’ Medicare portfolio includes Medicare Advantage plans, Medicare Part D prescription drug plans, Medicare Supplement insurance programs, and innovative special needs plans.

to find more information about the new medicare plans being offered by UnitedHealth Group, visit www.uhcmedicaresolutions.com

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