Health Insurance Blog

The five largest New Jersey health insurance companies and five physician groups have launched a pilot program to reduce administrative costs by allowing hospitals and physicians to communicate directly with health plans and address administrative tasks through a web portal.

The pilot is sponsored by AHIP and the Blue Cross Blue Shield Association.  If the pilot proves successful and can be rolled out nationally, representatives from AHIP believe hundreds of billions of dollars can be saved annually.

The participating health plans include:Aetna, Amerihealth, Horizon BCBS, CIGNA, and United Healthcare.
AHIP undertook a similar pilot with Ohio health plans in October.  That pilot program is still underway.

Akron Ohio based Summacare is going old-school by bringing back an old fashioned health care tradition and will be once again making house calls.

The Summacare House Call Program will be made available to select members of their traditional Medicare health plans in addition to members of their Medicare managed care products.

As part of the program, a geriatrician or nurse practitioner makes house calls to provide routine and preventive health care for frail patients who struggle to get to their doctor’s office.

In addition to being enrolled in one of SummaCare’s eligible products, patients also must have a diagnosis of hypertension, heart failure, chronic obstructive pulmonary disease, diabetes, bacterial pneumonia or other chronic illnesses to be eligible for the program.

More about: senior health insurance options, Ohio health insurance.

For many American families, COBRA coverage is still too expensive even with the current COBRA subsidy which is temporarily in place.  The COBRA subsidy program pays 65% of the monthly premiums for up to 15 months, but still can require a substantial monthly expense, as the average family of four still pays on average $389 per month even with the subsidy.

A recent report by eHealthinsurance.com found that in twenty states, families could save $600 per year ($50/mo) by purchasing a family health insurance plan as oppose to opting for the COBRA coverage.  Even with the subsidy!

The twenty states that were found to offer the affordable health insurance identified in the report include:  Alabama, Arizona, Arkansas, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Mississippi, Nebraska, New Mexico, North Carolina, Ohio, Oklahoma, South Dakota, Utah, Wisconsin, and Wyoming.

The US Census Bureau recently released a report that said the Cleveland area has a very high percentage of residents without health insurance coverage.

The report which was released Monday, Sept. 21, found that 22% of Cleveland residents under age 65 are uninsured.  Nationally 17% of the adult population go uninsured and in Ohio as a whole, 13.4% go without Ohio health insurance coverage.

Cleveland’s uninsured rate is the highest among large cities in Ohio.

If you live in Northeast Ohio and are uninsured because you think you can’t afford health insurance, you would be surprised as to the affordable health insurance options that you might be able to find if you shopped online and compared health plans side-by-side.

More information about Cleveland Health Insurance & Ohio Health Insurance.

Ohio has a vested interest in what occurs in Congress as health care reform is figured out.  According to Policy Matters Ohio, over 1 million Ohioans do not have Ohio health insurance.  This is about 11% of those under 65 in Ohio.  This is a huge percent and warrants concern. 

The article “In Congress, political scrapping has just begun” by Jessica Wehrman in the Dayton Daily News, discusses the challenges Sen. Sherrod Brown, D-Ohio faces as he sits on the Senate Health, Environment, Labor and Pensions Committee.  It’s been announced that committee Democrats have planned out a deal.  It would include both a public option as well as employer responsibility options.  Those provisions would require employers who could not offer health insurance to at least pay for a portion of the cost for employees to use the public plan.

Brown proposed that the measure would provide competition that would spur both the public and private insurance options to succeed.  He also said in many cases the public option would be available where a private option hasn’t been.

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

Tough times are resulting in many people being laid off from their jobs, and losing their health insurance as a result. They may be unable to afford COBRA, but still need health care. In the Columbus Dispatch, an article highlights several actions Ohio doctors are taking to help their patients without insurance. Despite their generosity, it is important to regain insurance as soon as possible: do so before insurers will no longer be required to cover any pre-existing conditions you may have. 

Some doctors are creating monthly payment plans that charge as little as $5 for those in dire straits and lacking Ohio health insurance. If they have some rate flexibility, they are charging the lowest amount possible to the uninsured. A lot of medical professionals give poorer patients free samples of prescription medication, although the economy is causing drug manufacturers to cut back on that practice as well. Meanwhile, prescriptions of generic drugs are more common, because they are far more affordable for uninsured patients. 

The article also states that medical practices are assisting patients in applying for government assistance programs, such as those for children’s health insurance. 

(Photo credit: Lauren Nelson under CC 2.0)

Ohio Governor Ted Strickland wants to enact a cap on individual health insurance premiums, according to an Associated Press article. In order to cover up to 52,000 uninsured individuals, Ohio health insurance companies will not be allowed to charge more than one and one-half times (150%) the lowest amount they would charge to someone of the same gender and age. Strickland believes that this measure will be especially helpful to those with pre-existing conditions; their premiums can often be prohibitively expensive.

While the cap would decrease premiums by up to 70%, the Ohio Insurance Department has calculated that it would result on a 5.5% increase in the cost of individual health insurance on average. However, less than 5% of Ohio’s population buys health insurance on the individual market.

Ohio is one of only two US states that are planning on expanding their publicly funded health insurance programs (such as Medicaid and Healthy Start Ohio).  The other state planning to do so is West Virginia.  19 Other states are making cuts to their programs, or are considering doing so.

Although the state hasn’t made a firm spending commitment, they have received approval to expand the children’s health insurance program in 2009.

As promised we will be breaking the US News and World Report health plan rankings down into the state level, to account for differences in health plan regulations, and mandated benefits in each state which can skew results.

According to the report:

The top 10 Ohio Health Plans are:

1. Summacare
2. Anthem Blue Cross Blue Shield of Ohio
3. Paramount Health Care
4. Medical Mutual of Ohio
5. CIGNA Healthcare of Ohio
6. The Health Plan of the Upper Ohio Valley
7. Aetna Health of Ohio
8. Kaiser Foundation Health Plan of Ohio
9. UnitedHealthcare of Ohio
10. Humana Health Plan of Ohio

We will be posting the top 10 health plans in each state over the next several weeks (3-5 states per day), so check back frequently if you don’t see your states health insurance rankings listed yet.