Health Insurance Blog

According to the BCBSA website, BCBSA has started a new Pediatric Obesity and Diabetes Prevention Pilot Program in Texas, New Mexico, Mississippi, North Carolina and Kansas.  Through this program Blue Cross Blue Shield plans on reducing the epidemic of childhood obesity and stop further cases of young people getting Type 2 Diabetes.

The plan consists informational toolkits for doctors to use as reference guides when addressing obesity.  The kit was designed with the American Diabetes Association and the American Academy of Pediatrics to encourage healthy choices and was passed out in mid-November.  BCBS collectively protects over 100 million Americans through individual health insurance and other health insurance policies, so this large effort by them should have a great impact.

The toolkit offers healthy lifestyle suggestions such as eating 5 servings of fruits and vegetables a day, limiting TV time to 2 hours a day, getting an hour of physical activity every day, and stop drinking sweetened drinks.  According to the US Department of Health and Human Services, an overweight teen has a 70% chance of becoming an obese adult which is one of the leading causes of health issues in our country.  This type of action is proving very necessary.

Texas insurance consumer advocate is looking to get rid of the blanket authority of health insurance companies to decide what their policies will cover according to the article “Texas Consumer Advocate Wants Ban on Health Insurers’ Blanket Clauses” by Terrence Stutz on DallasNews.com.  This would cause a big impact on individual health insurance in Texas.

Deeia Beck, the Public Insurance Counsel, asked the state’s insurance commissioner to stop provisions present in many health insurance policies, called discretionary clauses.  This gives health insurance companies the freedom to decide what benefits will get paid.  The health insurance industry strongly opposes this type of change being made.

There are currently 22 states who have banned this clause, and Texas may be next.  Insurance Commissioner, Mike Geesline, has held a hearing to consider whether or not to move forward with this proposal.  The National Association of Insurance Commissioners has urged its members to stop this practice.

According to the article “Advantage Plan Cancellation: What To Do” found on TucsonCitizen.com, you have two options in the case that your Medicare Advantage Plan is cancelled.  It’s important to understand those options to the best of your ability so you aren’t left without coverage for any period of time.

The first option is to change to another Advantage Plan as quickly as possible.  The other option is to return to a Medicare Plan and get a Medicare Supplement along with it.  This is called “guaranteed issue” and it’s a great option for many.  Finding individual health insurance can be challenging for anyone, but when your Medicare Advantage Plan is cancelled, you don’t want to be left scrambling.

In order to take advantage of “guaranteed issue” a few requirements must be met.  A copy of the cancellation letter from the company canceling the Medicare Advantage Plan must be submitted along with the Medicare Supplement application.  It’s important to ensure the appropriate boxes on the application are checked to show that one would be eligible for “guaranteed issue”.

On AARP’s website they have what is called a “Doughnut Hole Calculator” which has been designed for the 2010 Plan to avoid falling into a gap for Medicare Part D coverage.  It’s a four step tool that is very useful for saving you money on your health insurance quotes.

The Doughnut Hole Calculator is easy to use.  First, gather your medications and drug plan cards and go onto AARP’s website.  Enter the name of each drug, dosage, and how often you take it.  Then you can view a chart to determine if you are going to hit the “doughnut hole” for Medicare Part D.  The calculator will give you a list of alternative drugs that are similar to the prescribed drugs but they can dramatically reduce expenses and stretch your AARP Medicare supplements coverage.  They supply a form letter you can print out and show your doctor to ensure the drugs will suit your needs.

You can learn more about avoiding a gap in your Medicare coverage on AARP’s website.  You can also read and share experiences with the Doughnut Hole Calculator to see what other people are dealing with.  There is an online community available to members which many find extremely valuable.

According to a recent research report written by Debra A. Donahue of Mark Farrah and Associates, the individual health insurance marketplace is growing.  As of the end of Q2 2009, national individual health insurance enrollment totaled about 9.7 Million, up from about 9.6 Million from the previous year.  This enrollment does not include those individuals enrolled in Medicare Health Plans, or other state sponsored Programs.  Part of this growth is being fueled by high unemployment rates and less people having access to group sponsored plans.

The report makes it crystal clear that Wellpoint is the largest and most dominant player in the individual health insurance marketplace, albeit partly due to their large geographic footprint, covering 15 states.

The top 5 health plans ranked by enrollment in individual health plans include:

1. Wellpoint - with enrollment of over 2.25 Million (23% market share)
2. HCSC (Health Care Services Corporation) - 670,000 (7%)
3. Blue Cross Blue Shield of Florida - 370,000 (4%)
4. Kaiser Foundation Health Plans - 344,000 (4%), down 12% from previous year
5. Humana - 336,000 (4%), up 28% from previous year

Humana increased the number of states it offered it HumanaOne individual health insurance plan from 15 states to 24 states in March 2008, which accounted for their large increase in enrollment.

Wellpoint and HCSC are both health insurance companies that offer Blue Cross Blue Shield Health Plans in multiple states.  Wellpoint includes 15 BCBS licensees, and HCSC 4.

A recent report released by eHealthinsurance.com illustrates the relative affordability of individual health insurance plans across numerous dimensions, as well as a breakdown of what types of individual health insurance policies have been purchased most frequently.

Some of the findings in the report include:

• The average monthly premium for an individual health insurance policy was $161 ($383 when insuring a family)
• Half of individual health insurance policyholders paid $132 per month or less, when purchasing coverage just for themselves.
• Iowa laid claim to the most affordable health insurance in the country with avg. monthly premiums of $103 for insuring an individual,  New York was the most expensive at $339 per month.
• 16% of individual health plans purchased were HSA eligible plans with high deductibles.
• nearly 90% of individual health plans purchased included prescription drug coverage.
• about a quarter of policies had maternity benefits.

Blue Cross Blue Shield of Rhode Island (BCBSRI) has asked the Rhode Island Health Insurance Commissioner to approve a 10.2% rate increase for its direct-pay plans (available to individuals and families who are not eligible for group health insurance plans or government sponsored programs).

Direct Pay is the only health insurance plan in Rhode Island that is guaranteed issue for those not eligible for group plans or Medicare or Medicaid.

BSBCRI offers several programs that make individual health insurance more affordable including AccessBlue Subsidy plan, The Wellness Reward Plan and the Preferred Rate System.

More information about Rhode Island health insurance

Finding health insurance in Florida does not have to be a difficult challenge.  According to the article “Florida Health Insurance Buyers Guide” from TransWorldNews, there are certain Florida health insurance regulations that should be understood when shopping around.

Florida health insurance, like most states, are permitted to deny an application for pre-existing conditions.  This can potentially be avoided by applying for health insurance as a member of a group plan.  There are often restrictions with this option to watch out for though.  The group generally must have had coverage for 12 mos previously with no lapse. 

According to the article, Maryland, Massachusetts, Vermont, New York, and New Jersey are the only states who do not allow an application to be turned down because of pre-existing conditions.  Florida currently underwrites policies based on previous medical history.  In Florida you are able to purchase a conversion policy if you happen to lose coverage if you had 3 months of coverage through a group before it was lost.  And there is a limit on the cost.  It cannot be more than 200% of the price of a standard rate for an individual health insurance policy. 

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.

Residents living in Chicago suburbs pay on average 14.6% less on their health insurance rates according to the article “Health-care Insurance Cheaper in the Suburbs” by Sandra Guy on suntimes.com.  This may surprise many carrying Chicago health insurance.

Those living 15 to 25 miles from downtown Chicago pay 12-15% less on their health insurance premium and those living 25-40 miles outside the city pay 20-30% less.  This is according to data gathered by Norvax Inc.  They also found that people who live in the southern and western suburbs, which are generally considered blue collar, pay 24.5% less for Chicago health insurance.  Those who live in the northern areas pay 14.6% less.  The findings highlight the cost of health care in these various regions.

Health insurance quotes are definitely being affected by location, but the question is, is this fair?  Health insurance companies claim it’s a matter of risk-based pricing.  Astonishingly, 26.5% of Chiacgo residents do not carry health insurance according to the latest US Census Bureau report.  This may be a direct result of the insurance companies and the way they price their customers as well as regulations created by the state.