Health Insurance Blog

Geisinger Health Plan recently released an update on the 2009 Influenza flu season.  This is found in the article “Influenza Update From Geisinger Health System: 900 Cases” by Dr. Lisa Esolen who is the director for Geisinger Health System Infection Control on Poconorecord.com.

They continue to see a steady increase in the number of flu cases with about 900 cases in the last 3 weeks at both of their Pennsylvania hospitals.  There have also been about 30 hospitalization cases.  Nationally, 46 states have reported widespread influenza cases.  Shipments of the H1N1 vaccine continue to be shipped but there are lower quantities than expected.  These are first being given to health care providers, schools, and hospitals throughout the state.  Currently, there are no public vaccination sites for the H1N1 vaccination since the vaccinations are not plentiful as of now.

Geisinger Health Insurance continues to receive shipments of the H1N1 vaccine, but in small amounts.  Most of the vaccines have been used for pregnant people as well as children.  Many organizations encourage pregnant women to get vaccinated since they are more likely to get severely sick from the flu virus.  It’s important to wash your hands regularly to help limit the spread of the flu. 

October is Breast Cancer Awareness month and people in Houston, Texas are gathering together to support the cause.  According to the article “Community Breast Health Event at Cy-Fair Hospital” found on the cypresstimes.com, the Women’s Imaging Center at Cy-Fair Hospital is hosting a Breast Health Event on October 29th.

The Cypress Fairbanks Women’s Imaging Center has an experienced and caring staff who understand the importance of supporting breast health.  This event will not only raise awareness, but they will be offering education on self exams, general breast health information as well as offering giveaways and bone density testing. 

The article points out that breast cancer affects 1 in every 8 women in the US.  Early detection is very important in treating breast cancer.  The American Cancer Society recommends that women over 40 years of age should get a mammogram once a year and many Houston health insurance companies should cover this screening.

You may not know that State Farm, in addition to insuring more cars and homes than any other insurance company in the US, offers health insurance.  This is made possible through the national alliance that allows Assurant Health’s individual medical products available through State Farm health insurance across the country, according to the press release “State Farm, Assurant Health Renew National Distribution Alliance” found on Assurant Health’s website.

The alliance was renewed last year and included a 10 year term with the option for either company to leave after 5 years.  It also highlighted a marketing program that will allow for expansion of various sales opportunities for State Farm and licensed agents. 

Assurant Health President and CEO Don Hamm said that the alliance with State Farm is beneficial to everyone involved and they are very pleased to be continuing the relationship.  State Farm is one of their largest business alliances. 

According to the article “Blue Cross Says It Will Cover Swine Flu Vaccine” by Shelia M. Poole on The Atlanta Journal-Constitution’s website, Blue Cross and Blue Shield of Georgia announced this week that it will include the H1N1 virus, also known as the Swine Flu, in its flu vaccine coverages.

Blue Cross and Blue Shield of Georgia has 3 million members so this is a huge benefit to the state.  They will be covering clinician’s fees and doctor visits for those receiving the H1N1 vaccination.  October is the expected date for the vaccine to be available according to health officials. 

Health care workers, emergency staff, pregnant women, healthy patients between 6 mos and 24 years, those living with children under 6 mos, and people ages 25-64 who are at high risk for illness due to health disorders are the first groups recommended to get the vaccine according to The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. 

Spokeswoman for Blue Cross and Blue Shield of Georgia, Cheryl Monkhouse, states that the majority of their policyholders have vaccine coverage so this offer will be beneficial to many of their customers.

The health insurance industry agreed yesterday to halt the practice of charging more for health insurance for women.  Currently when women purchase individual health insurance are charged higher health insurance rates for the same coverages,especially during the child bearing years.

The move was viewed as a concession to Congress by health insurers in order to head off the democrats desire to form a government health plan that would compete with private health insurance companies across the country.

In a previous concession, health insurers agreed to stop charging higher health insurance rates or declining coverage to sick people if the government would make carrying health insurance coverage mandatory for all Americans.

At the end of the day, even if women are charged less for health insurance coverage, they will likely spread that additional health insurance claim equally across men and women, which will proportionately raise the cost of health insurance for men.  Thus, the only women that will save money in that scenario would be single women, which is absolutely fair if they are indeed paying mor than they need to for similar health insurance benefits.

According to a recent eHealthinsurance study, comprehensive maternity coverage was only available in 12% of the 3,500 individual health insurance plans surveyed.  Non-comprehensive maternity coverage was offered by an additional 9% of health plans surveyed.

The 3,500 health insurance plans were geograghically diverse, and represented 47 US states.

Women who are shopping for an individual health insurance plan should ask the insurer or agent the following questions to make sure they will be covered properly

• Is there an out-of-pocket maximum for maternity coverage?
• Are there waiting periods before maternity coverage kicks in?
• Am I covered out-of-network ?
• Is my obstetrician or hospital in-network?
• Is there a deductible or co-pay for prenatal, delivery and postpartum services?
• Does the policy pay for a home birth or birth center delivery?

John Dorchner reports in the Miami Herald that the state might consider a bill that would require gender equity in Florida health insurance premiums. Florida’s insurance consumer advocate Sean Shaw is looking to team up with a congressperson that would sponsor legislation that would ban the practice of gender rating. Women pay higher premiums than men, even when you exclude maternity coverage.

For example, a Blue Cross Blue Shield of Florida policy for a 30-year-old in Miami costs $246 for a man and $291 for a woman. Insurers claim that women use more health care services and are more likely to keep up with regular screenings; some believe that’s a perverse incentive to forgo preventative care.

However, due to that higher level of utilization, older women are in better health and have lower health insurance premiums than their male counterparts. Using the BCBSFL example above, a 60-year-old Miami woman pays a monthly premium of $593, while a man of the same age pays $644.

The city of San Francisco has filed suit against California insurance regulators alleging that they have approved a health insurance rating system that allows California health insurance companies to charge women more than men for health insurance coverage.

In the state of California, gender rating is permitted in setting health insurance rates, which allows a customers gender to be used as a rating factor in determining their health insurance premium.  A practice that has resulted in women paying on average 39% more than men for identical coverage.

Currently 10 states outlaw the practice of gender rating with regard to individual health insurance rates, however California is not one of them.

Blue Shield of California representatives have claimed that their actuaries crunched the numbers based on healthcare data and indeed found that women are more injury prone than men and more likely to break bones or become sick, thus justifying the relevance of using gender as a rating factor.

Erin Allday from the San Francisco Chronicle recently reported on a proposal from the S.F. Attorney General that would eliminate bias in health insurance rates. Health insurance companies claim that they should be allowed to charge women under 55 more for health insurance than men, since they are more likely to suffer from some chronic illnesses and visit doctors for preventative care more often.

While 12 states ban or restrict the practice of gender rating, California does not. Women who buy individual health plans in California pay up to 39% higher premiums than men, according to Erin. The city of San Francisco is getting involved because women end up going to city clinics or emergency rooms because they can’t afford health insurance, costing the government money. 

A spokesman from America’s Health Insurance Plans, an industry group, states that gender rating is not discriminatory since women use more services. In addition, older men pay more for health insurance than older women. However, the Equal Employment Opportunity Commission prevents women from being charged more for their premiums based solely on their gender.

The National Women’s Law Center report found that women nationwide pay up to 48% more for health insurance than men, excluding maternity coverage. Maternity coverage is the most obvious factor that could drive up the cost of women’s health insurance.

It has been proven that preventative health care (check-ups and screenings) ends up costing insurance companies and society less in the long run. Should younger women be punished for taking responsibility for their well-being?

(Photo credit: Adria Richards under CC 2.0)

Women of child-bearing age (19 to 55 years old) pay more for health insurance than men, says Linda A. Firestone, Ph.D in the Sun-Sentinel. A typical woman’s policy includes maternity coverage, which accounts for the gender disparity in insurance rates. Since the majority of American adult women eventually have children, health insurance with maternity coverage makes sense for them–especially if there are pregnancy or birth complications.

Group health insurance plans (for example, those provided by employers) in Florida do not allow women to opt out of maternity coverage. If a woman does not plan to have children, she can choose to buy one of many individual health plans, which allow her to opt out of maternity coverage. In fact, many insurance providers (such as Humana), no longer offer maternity coverage in their plans. Insurance specialist Larry Wides says the cost savings from a group plan tend to cancel out the reduced premiums resulting from the elimination of maternity coverage.