Health Insurance Blog

According to the article “Overhaul of Health Care Bad for Seniors” by John Fanning on summitdaily.com, many senior citizens are losing their health insurance coverage in 2010 as many insurers have reduced medicare supplement plans or have increased premiums drastically. 

Many seniors are currently struggling to get by and paying for health insurance is just another worry on their plate.  If the current health care bill passes in Congress, advantage plans may be dismantled and seniors will need to find a prescription drug plan for MedicareD.  This can add an additional $25-$50 to the cost of their health care.  With many senior citizens living off of only social security this can be disastrous, especially since there is no SS increase for 2010. 

Over 12 million Medicare benficiaries are enrolled in Medicare Advantage Plans which represents 23% of the total Medicare population.  Many use Medicare supplement insurance as well.  Medicare pays about 11% more for a beneficiary to have a Medicare Advantage plan than for original Medicare on average. 

Approximately 1 million Americans have been infected with the H1N1 virus, more commonly known as the swine flu, according to the article “Individual Health Insurance Could Provide Assistance for Swine Flu Vaccines” by Maggie Guo found on the Ethiopian Review. 

People who are covered by certain individual health insurance companies may have the swine flu vaccine paid for.  Anthem Blue Cross is covering their customers who carry vaccine coverage and America’s Health Insurance Plans says it will offer similar protections according to a St. Louis Post-Dispatch report.

Once the Food and Drug Administration approves treatment there will be roughly 160 million doses of innoculations according to the Centers for Disease Control and Prevention.  Clinical trials are currently in progress.  Across the country, cities are establishing free clinics to give vaccines.  There will be 100 centers in NYC alone in addition to a center at each elementary school.  Chicago and LA are following similar plans.

Pfizer has announced that they will provide free prescription drugs to current customers who have lost their jobs and subsequently lost their health insurance coverage.  More than 70 medicines will be available through this temporary program.

To be eligible, a person must have lost their in 2009 and started taking an eligible Pfizer medicine at least three months before losing their job. In addition, to be eligible, customers must also be without prescription drug benefits and must be able to attest to financial hardship.

Pfizer stands to gain, by gaining favor among their customers as well as increasing the likelyhood that these financially strapped customers will continue to take the perscriptions once they get their feet back on the ground.

Eligible participants will receive 12 months of free refills of the eligible perscriptions or until they obtain a replacement health insurance plan.

After April 1, Medicare beneficiaries will be locked into their current plan through the remainder of 2009.  If you are enrolled in a Medicare health plan and unhappy with it, don’t procrastinate shopping for a new plan.

According to Paul Precht from the Medicare rights Center, below are the changes that can be made before April 1.

• A Senior who is enrolled in a Medicare private health plan with drug coverage (like an HMO or PPO) can switch to another Medicare plan that also offers drug coverage. They can also switch to “original Medicare” with a stand-alone drug plan.
• If someone has original Medicare with a stand-alone drug plan, they can switch to a Medicare private health plan with drug coverage. However, they cannot,  add or drop the Medicare drug benefit (Part D) and they cannot switch from one stand-alone prescription drug plan to another one. Most people with Medicare will not be able to change their health plan again until 2010.

More information about senior health insurance options

According to a recent article in the Orlando Sentinal, consumer advocate groups in Florida have warned that health insurance companies are misleading customers into believing that they are better off purchasing generic prescription drugs as opposed to their more expensive brand counterparts.

In many cases, brand name prescription drugs have an equivalent generic drug, which is perfectly safe and cost effective.  However in some cases, the Brand name drug that was prescribed by a patients doctor does not have an equivalent generic drug.  In those cases, the health insurer is recommending generics of different drugs that are in the same class.  This practice might not be a good plan for everyone, especially those prescribed anti-depressants, and blood pressure pills for example.   In any event, if the generic drug recommended is not an exact match of the brand name drug persribed, the doctor will have to approve the change anyway.

More information about Florida health insurance.

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.