Health Insurance Blog

Consumer Reports recently came out with a survey about consumers and their satisfaction with their current health insurance plan.  This is according to the article “Health Plans Get Only So-So Reviews” on the Washington Post’s website.

The survey’s findings were based on responses from 37,481 readers who reported their health insurance experience over a course of a year.  The numbers represent a good benchmark for HMO’s and PPO health insurance.  84% of the respondents have an employer based plan they will be able to keep under most proposals being discussed in Congress.

The Consumer Reports National Research Center found that only 64% of readers were very or completely satisfied with their current individual health insurance plan.  This shows a drop from the 2007 survey which revealed 67% was satisfied.  Based on other Consumer Reports surveys people are less satisfied with health insurance than other industries such as pharmacies and real estate agents.  Over 30% of readers are not completely satisfied with their health insurance and this leaves a lot of opportunity for health care reform.

BlueEdge is a high-deductible health plan offered by Blue Cross Blue Shield of Illinois (BCBSIL) that can be combined to form an HSA. There are also BlueEdge plan options for employer groups that work in conjunction with health reimbursement arrangements.

BlueEdge also includes coverage for both preventative & wellness benefits.

Health savings accounts are effective ways to keep monthly premiums down, especially for individuals or families that are relatively healthy.

Health insurance rates for BlueEdge can be as low as $75/mo or for BlueChoice PPO as low as $58/mo.

More information about Illinois health insurance.

Many people are confused by the difference between PPO health insurance and HMO health insurance.  A helpful article on insurance.com entitled “HMO vs PPO” in their FAQ section does a great job of explaining the differences.

With an HMO, which stands for health maintenance organization, members must choose a primary care doctor from a list of member doctors.  This doctor will foresee all of your general medical care and must refer you to specialists.  With PPO health insurance, which stands for preferred provider organization you can either choose a general practitioner or a specialist, without a referral which can save a lot of time.

HMO’s usually require you to see in-network doctors, whereas PPO’s do not.  But with PPO’s there often is incentive to stick with in-network doctors.  The main benefit of HMO’s compared to PPO’s is that there usually isn’t a deductible to meet and the co-payments are generally lower.  The best choice totally depends on your personal situation and your particular needs.  It’s important to take the time to evaluate each health insurance option before making a decision.

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.

According to the article “An affordable insurance quote requires careful research” on healthcare.com customers will benefit from doing their research when shopping for health insurance quotes.  You may find an affordable quote quickly, but read the fine print to prevent future issues with your policy. 

One potential issue is in and out-of-network stipulations.  PPO and HMO plans offer discounts to health providers that the insurance company has negotiated with to set reasonable rates.  Medical tests and various procedures are usually cheaper with in-network physicians.  Researching what is included in the in-network costs can save you a lot of time and money as you use the health care system.  There have been many scenarios where patients go to an in-network hospital but tests are sent to an out-of-network lab and the patient is left with the cost. 

To avoid such complications, compare options side by side and shop around for health insurance quotes.  Find out how benefits vary from providers to ensure you have the coverage best suited for your needs at reasonable costs. 

According to the article “New York, New Jersey UnitedHealth subsidiaries see ratings rise” by IFAwenews Staff, A.M. Best has upgraded its ratings on Oxford Health Plans in NY, NJ and CT and Oxford Health Insurance, Inc. 

This ratings service upgraded their financial strength from A- to an A.  Issuer credit ratings were increased from A- to A as well.  In addition to name benefits, A.M. Best also noted that the subsidiaries’ solid risk based capitalization and encouraging earnings, especially at Oxford Health Plans, in NY, and Oxford Health Insurance.

Oxford Health Plans and Oxford Health Insurance offer health care benefits to individuals as well as employers in NY, NJ and CT with commercial products, including HMOs, PPO health insurance, point of service plans and consumer driven plans.  UnitedHealth is one of the country’s largest publicly traded health care companies serving over 70 million Americans with many different services and products.

The State Health Plan - North Carolina’s health plan for state employees lost $137.6 Million in the fiscal year ending in June 2008.  The plan covers roughly 667,000 North Carolinians.  The primary driver of the financial implosion was the introduction of a more generous PPO health insurance option that prompted 76,000 existing enrollees to switch over to this plan, as well as prompting an additional 30,000 state employees to sign up for the state sponsored plan.

The members who were enrolled in the PPO plan specifically took advantage of routine eye and hearing exams and their increased utilization of services overwhelmed the discounts with network hospitals and doctors negotiated by Blue Cross Blue Shield of North Carolina (BCBSNC).

BCBSNC, The largest North Carolina health insurance company administers the PPO plan, and claims ended up costing nearly $164 million more than was projected.  In addition, administrative costs were extremely high ($66.6 Million), but they were allowed based on the contract that was signed.