Posts Tagged ‘health insurance companies’

5 New Entrants to Indiana’s Health Insurance Exchange

Sunday, July 20th, 2014

Residents of Indiana are getting some new health insurance choices in the state’s health insurance exchange.  According to The Courier-Journal’s “Indiana health insurance market to see changes,” Maureen Groppe says that five additional companies will be selling plans in the state exchange this year.  There are currently four companies offering plan choices in Indiana.  Out of the 16 states that make their information public, Indiana has the most new entrants.  There will be some rate changes by the four companies who are already selling in Indiana’s exchange.  The highest change is a 96% increase and the lowest change is an 11% decrease in plan costs.  More choices mean that Indiana residents who already have health plans could get rates that are significantly lower than their current plan rates.

More than 130,000 Indiana residents purchase health insurance outside of an employer program or Medicare.  It’s possible that number could double next year as more uninsured Americans seek health insurance plans through the government exchanges and individual companies to comply with the individual mandate.  CareSource is one of the new companies to Indiana’s exchange and plans to offer very low, competitive rates.  Their rates are so low in fact, that the state regulators questioned the insurance company’s filing.  Premium prices will not be set in stone until just before the November 15 open enrollment period.  But the state filings help the market get a feel for what is going to happen in the fall.

Overall health care costs are increasing by 5.4%.  Insurance companies have to justify increases in premiums that are much more than the increasing cost for health care.  Some insurance companies face a greater amount of claims than others.  Indiana is changing the way that their disabled residents qualify for Medicaid, so close to 7,000 people with higher medical expenses will be entering the individual health insurance market next year.  Since these Affordable Care Act rules are fairly new, insurance companies are still trying to maneuver this health insurance market where they cannot deny coverage to people with preexisting conditions.  Companies are seeking rate increases and also lowering premium costs based on regions in the state and the tier level of different plans.  It will take a few years for health insurance companies to determine exactly what premium changes need to be made based on what happens each year with costs and new members.

Health Insurance Mistakes to Avoid

Thursday, June 19th, 2014

Whether you are looking for a new health insurance plan or already have one, there are some typical mistakes people make that you should try to avoid.  MSN Money just posted the article “Don’t make these 10 health insurance mistakes,” by Allison Martin of Money Talks News.  It’s wise to consider these ten things even if you are not shopping for individual health insurance coverage because you are likely contributing some of your health care costs even in an employer sponsored plan.  It’s rarely the best decision to simply choose the cheapest health insurance plan.  You should consider much more than just cost.  The first mistake that people make when it comes to health insurance is basing their policy decision solely on the premium and deductible costs.  Keep in mind that if your plan covers 80% of hospital or surgical procedures, the 20% that you owe could add up to a large chunk of money.

Also make sure that you read the fine print in any potential health insurance policy.  Some of the most important things to look for are in-network or out-of-network coverage, HMOs, PPOs, different coverage options and whether referrals are needed.  If there is coverage that you know you need or doctors that you don’t want to leave, check that before getting a new plan.  It’s a big mistake not to shop around for health insurance from different health insurance companies.  Read reviews from customers and others who have worked with the company.  Believe it or not, purchasing COBRA coverage is often a big mistake.  You pay more than 100% of the plan cost, when you paid around 25% with your employer sponsored coverage for the same plan.  It pays to shop for a less expensive health insurance option, even if it only ends up being temporary.

Some people make the mistake of purchasing too much insurance coverage.  If you don’t see the doctor often, a platinum level plan might be too much coverage for you.  In the health insurance exchanges, as well as with private health insurance plans, there are lower levels of coverage options from which to choose.  Health insurance plans are not one size fits all.  Many coworkers just choose what their friends in the company have chosen, even though their insurance needs might be very different.  Do not make the mistake of not getting health insurance because you are healthy.  You never know when you will need coverage and many hospitals no longer treat those without insurance.  Make sure to ask for discounts for things like quitting smoking or being in a wellness program.  It costs a lot of money to see a provider who is not in your network, so think carefully before seeing an out of network provider.  Some people opt for health insurance plans that do not have prescription drug coverage.  This is one of the most common items that people regret when choosing a health insurance policy.  Avoiding these ten health insurance mistakes could save you thousands of dollars in the long run, so do your homework.

RI Insurers Are Sharing Health Insurance Claims Data

Saturday, May 3rd, 2014

There is an interesting development when it comes to your health insurance and your privacy.  According to Rhode Island news station WPRI, health insurance companies in Rhode Island are preparing to send your personal health care information to the state.  This is happening in twelve other states as well in an effort to better understand health care trends and costs.  The goal of this information sharing is to make the entire health care system in Rhode Island, and the other states participating in this program, run more smoothly.  All sharing of information is said to be anonymous, so you shouldn’t have to worry about personal consequences related to your health insurance company sharing your health care information with state or federal agencies.

This program in Rhode Island is called the All-Payer Claims Database Project and is a collaboration between multiple agencies.  Rhode Island’s Department of Health, Office of the Health Insurance Commissioner, their health benefits exchange and their health and human services department will be sharing health care information and compiling data related to both medical and pharmacy claims.  The project assures residents that names, addresses and any other personal information will be removed before the health insurance data is shared.  Claims information will be used to help the Rhode Island health care system improve overall.  They also seek to improve the quality of health care.  Companies started gathering data at the beginning of this year.  Starting May 1, companies are now submitting their data to the project.

A representative from the ACLU fears that the information sharing will not be as anonymous as the program promises.  He thinks that people would be able to put a name to the indirect information given if they truly wanted to.  Sharing your personal health information could hurt you in a job hunt or in other areas as well.  But you truly should be safe because the agencies involved assure Rhode Island residents that their information is safe.  Keep in mind that you can opt out of having your health insurance claim information shared for this project.  You can opt out online through a special website, but there have been complaints that is wasn’t working.  Some people worry that those who opt out might actually be targeted though, so that’s something to think about.  If the anonymous sharing of your health, dental and pharmacy claims helps improve the overall health care system in your state, would you support it?

Hard to Find Health Insurance Anywhere After March 15 Deadline

Thursday, April 24th, 2014

The deadline to sign up for health insurance and meet the Affordable Care Act requirements has come and gone.  Health insurance exchanges will not start offering plans until later this year for the next enrollment period.  But most people were not expecting some private health insurance companies to stop selling health insurance plans after March 31 as well.  According to Health Day’s Karen Pallarito, “Suddenly Health Insurance Is Not For Sale“.  One Tennessee insurance broker said that many health insurance companies in her area are not selling insurance plans until the exchanges open again later this year.  One of the main reasons that some health insurers have made this decision is because they believe they will attract healthier, younger people when the government exchanges are open as well.  Insurance companies can no longer reject sick people or those recently diagnosed with a disease.  They are hoping that they will be able to attract the young, healthy individuals that will keep their costs lower.

For coverage that will start in 2015, the next open enrollment period starts on November 15.  Penalties for not obtaining insurance coverage yet won’t be issued until tax time next year, but those who waited might just be ready to purchase insurance come November.  Healthy and young individuals are most likely to plan in advance when shopping for health insurance.  That is why it makes sense economically for health insurance companies to only offer plans during open enrollment times.  Individuals who have recently become sick or need some type of care right away are the most likely to search for health insurance at any time of the year.  Open enrollment periods were designed to deter people from waiting until they are sick to shop for health insurance.  When that happens, insurance can become unaffordable all around.

Health insurance companies offering plans outside of the exchanges can choose whether or not to sell health insurance year round or not.  One survey of 180 health insurance companies found that one or more health insurers will be offering plans after March 15 in only 14 states.  Some of those plans will only be offered through the end of April.  You will be able to find health insurance in some places though.  Arizona’s non-profit insurer Meritus plans to continue offering health insurance plans year round.  They are currently working with the Arizona Department of Insurance.  In Nevada, their Health Coop will continue offering insurance plans to consumers around Las Vegas.  There may be some states where it is difficult to find health insurance before November 15.  If you are looking for a plan, you will probably have to work a little harder than before the deadline.

Strong Support for Mandatory Birth Control Coverage

Tuesday, April 22nd, 2014

Back in 2010, the Affordable Care Act mandated that private health insurance companies cover birth control for their plan participants.  It is one of the so-called 10 essential benefits that must be covered by insurers.  Some of the other benefits include screenings for cancer and vaccines.  You don’t even have to pay co-pays for these 10 essential benefits and often don’t have to pay anything for the contraception either.  A recent study at the University of Michigan found that the majority of Americans strongly support the mandate for birth control coverage by insurance companies.  They surveyed more than 2,000 people for the study and found that 69% of them were in support of this mandatory contraception coverage.  Not surprisingly, women were among the strongest supporters of the mandate.  Black and Hispanic respondents also supported the mandate in higher percentages.

This information comes from NBC News’ Maggie Fox in the article “Most support birth control mandate, survey shows“.  While most Americans support the mandate for health insurance companies to cover birth control, there is strong opposition to this mandate as well.  Religious groups, employers with conservative beliefs, and outspoken conservatives don’t believe that companies should have to pay for contraception when it is against their personal beliefs.  Two employers filed a lawsuit against the mandate, saying that it is against their religious beliefs to support some kinds of birth control.  The Supreme Court will rule on that lawsuit in June of this year.  Health insurance companies had to revamp a lot of their health plans with this change in contraception coverage, as well as other mandates that have been coming into law since 2010.  The majority of Americans support the mandated birth control coverage, so you will continue to find this available when searching for health insurance plans.

New York Gets a New Health Insurance Company Based on Simplicity

Tuesday, September 24th, 2013

Well I must admit that I am intrigued by this new health insurance concept in New York.  According to ny1 news in New York, Erin Billups says that a “New health insurance company offers (a) unique approach to coverage for New Yorkers.”  Each state’s health insurance exchange will start offering health insurance plans October 1 and New York has a brand new insurer involved in their exchange.  Three men with tech industry backgrounds have started a new health insurance company called Oscar and their goal is to simplify the process of health insurance and make it more straightforward.  They were motivated to build Oscar after one of the entrepreneurs opened a health insurance bill and was utterly confused.  He said that the benefits and even who his doctors were had been unclear and the men involved in Oscar have vowed to change that confusing process.

There will be 17 health insurance companies in New York’s insurance exchange, one of which is Oscar.  Plans from this insurer range from $0 to $500 per month.  On the company’s website, your health history will be laid out for you in a similar fashion to Facebook’s timeline feature.  Your information can be accessed from your phone and goes back years into your health history.  The overall goal is to translate the health care system and make it easy to understand and very transparent.  Costs will be clear up front, from the cost of a prescription to any necessary services.  One feature that Oscar is particularly proud of is their “tele-doc” service.  You can make a phone call to a doctor at any time and receive a call back within an hour.  This helps eliminate unnecessary emergency room and other doctor visits when a simple question could have been quickly answered.

Oscar definitely has an uphill battle as a new insurer entering the market, but they are hopeful to reach their capacity of 50,000 customers quickly.  They will have to manage finding the right mix of customers and maintaining the simplicity that they are basing their company off of to become successful.  But if Oscar can make this simple concept work, they could change the face of health insurance in America at a time when everything is up in the air.  Contact us with any health insurance questions, including those regarding health insurance exchanges.

Health Insurance Marketing Getting Funny and Targeting Youth

Saturday, July 13th, 2013

Here’s a side of health insurance that most consumers haven’t considered.  Aside from the occasional hilarious or inappropriate commercial that you see, you probably don’t remember many of them.  But as Americans get closer to the date where health insurance coverage is federally mandated, look for insurance companies to amp up their advertising campaigns in some interesting ways.  Kaiser Health News’ Sarah Varney discusses how “Marketing health insurance may be funny business” in the days to come.  Kaiser spoke with a viral marketing agency in New York City to find out where the difficulties lie for health insurance marketers and what you can expect in the upcoming months.

Many customers will start shopping for their health insurance coverage in the online insurance exchanges.  Others will take more traditional routes, but the overall landscape will be different.  Before the Affordable Care Act, people were turned down for insurance coverage because of pre-existing conditions and they are still angry about that.  Some customers saw premium increases up to quadruple what they had originally paid for their health insurance.  Regardless of what they have done in the past, good or bad, many consumers have negative opinions about insurance companies and how they treat their customers.  It’s a perfect time for insurers to catch the eye of consumers in a good way and get a positive perception out there.

It can be difficult to tell one insurance company from another sometimes.  Whether it is Care First, Anthem, or PacifiCare doesn’t necessarily matter to most consumers.  What matters first is that insurance companies get their name out there and then take good care of their customers.  In order to get their name to the general public, health insurers may start following in the footsteps of car insurance companies by using humor.  Everyone knows Geico’s gecko and Progressive’s Flo, but who can name a health insurance company “mascot?”   The marketing expert believes that we will see a lot more of the humorous and comical when it comes to our health insurance ads.

He also points out that ads are going to be targeted a lot more to young and healthy people.  They have been the least likely to buy individual health insurance plans partly because some think they are unlikely to get sick and partly because they make less money and are not willing to spend it on insurance.  The benefit isn’t as obvious as it may be with older consumers.  But with the government requirement impending, insurers might start marketing their names and logos in places where the youngest, healthiest people will see it.  Perhaps you’ll see an Angry Birds character or a Jersey Shore-like show advertisement related to drinking.  In addition to being inundated with a new type of advertising, we will probably see insurers offering more reward programs for staying with their company.  You might get an i-tunes or Starbucks gift card for maintaining good health and sticking with your insurer for five years.  It costs a lot of money to find a customer to replace you.

As customers become even more valuable to health insurance companies, consumers will be a little more in control over their plans.  Expect insurance companies to fight to get you and fight to keep you.

Emergency Contraception Prescribed Preventively to Teens

Tuesday, November 27th, 2012

Okay I have to admit, I’m a little bit torn with this story.  While I understand the reasoning behind it, I’m not sure that this is the best idea for young girls.  The American Academy of Pediatrics has just recommended that pediatricians not only talk to their adolescent patients about emergency contraceptives like Plan B, but that they also offer them prescriptions to have on hand just in case they need it.  Lylah M. Alphonse of Parenting talks about this controversial issue in “Should Pediatricians Give Kids Access to the Morning After Pill in Advance?”

The United States has a much higher rate of teen pregnancy than other industrialized countries, even though the teen pregnancy numbers have been going down for nearly two decades.  With the rates still so high, the AAP believes that putting something like the morning-after pill in the hands of the teens who need it will help lessen that rate even more.  Studies have found that the chances are much better for adolescents to use emergency contraception if they already had a prescription before the time they need it.  I wonder if girls under the age of 17 can really comprehend what they are getting into without significant discussion about Plan B and sex in general.

While I believe that it is the parents’ responsibility to make sure that their children have education about sex and contraception, I do realize that this doesn’t always happen.  But my initial concern about teens having easy access to Plan B is that it will either make their decision to have sex at a young age easier or make them less careful when they do.  Seven studies showed, however, that having such a prescription does not increase the chances that a teen will have sex or lessen the chance that they will use protection against pregnancy.  Plan B works best if it is used within a day of unprotected sex, although it can be taken up to 120 hours later.  So it makes sense to have such a prescription available to those who may need it.

Offering Plan B prescriptions for girls under the age of 17 without telling their parents doesn’t sit right with me.  I get it though.  In an ideal world, girls would talk to their parents and ask for help if they had unprotected sex.  Or better yet they would use protection because of their excellent sex education or even abstain altogether.  It’s not an ideal world and girls make mistakes.  Some even get taken advantage of against their will.  These girls should have access to emergency help if they need it.  I don’t know if a secret prescription for Plan B is the best bet, but it is something to help lower the teen pregnancy rate.  There’s another question that arises with pediatricians prescribing Plan B.  Will health insurance companies pay the cost of this prescription?  And if not, it will most likely have to be the girls’ parents covering the cost.

Insurance Coverage Lacking for Eating Disorders

Sunday, October 21st, 2012

If you or a family member have ever suffered from an eating disorder, you probably know how difficult it can be to get your health insurance company to pay for treatment.  Kaiser Health News discusses this in an article by Shefail S. Kulkarni entitled “Patients Often Find Getting Coverage for Eating Disorders is Tough.”  They talk about a 44-year old woman who has been fighting binge eating disorder for two decades.  Since eating disorders like this, anorexia, and bulimia are mental health conditions; coverage is very individualized and hard to classify.

Unfortunately, many people don’t get consistent treatment because their health insurance either doesn’t cover eating disorder treatment or only covers partial or short-term treatment.  As with most mental health disorders, treatment can take a long time, sometimes the rest of one’s life.  It takes comprehensive care from a primary doctor, nutritionist, therapist, and psychiatrist to treat most eating disorders.  Patients say that insurance companies are less than generous with their coverage in these areas compared to insurance coverage for physical ailments.  The Eating Disorder Coalition fought hard to get eating disorders classified as “essential health benefits” that must be covered per the Affordable Care Act.  They were not successful.

Fourteen million people are suffering from eating disorders right now.  But because health insurance companies are suffering with soaring health care costs, eating disorder coverage is often one of the first things to get dropped from insurance.  While insurers don’t think this coverage is essential, almost 100% of eating disorder specialists say that denial of coverage for people battling anorexia puts them in a life-threatening situation.  Insurance companies argue that since there is not a clear cut treatment program for eating disorders, it is more difficult to provide blanket coverage.  Parents of autistic children have run into the same kinds of problems when it comes to coverage of their children’s treatment.  After fighting insurers, coverage for autism treatment is now mandated in 31 states.

Eating disorder treatment ranges from nutritionist appointments, group therapy, and antidepressants to hospitalization and admittance to mental health facilities.  Once such facility’s worker said that insurance companies are much more likely to pay for treatment for mood disorders than they are for eating disorders.  Insurers also are quicker to authorize longer stays when it comes to mood disorder treatment.  Patients believe a lot of the problem is with the stigma attached to eating disorders.  It seems to many outsiders that someone should just eat something or stop eating, but the mental health issue is far beyond allowing patients to do that.  There is definitely spotty coverage when it comes to eating disorders, so check with your personal insurer to see what services you can receive if you need eating disorder treatment.

Compare Health Insurance if BREVAGen Risk is High

Monday, September 24th, 2012

BREVAGen is a new predictive risk test that could not only make a huge difference for health insurance, but also for the lives of women all over the world.  Primary Care Associates’ Dr. Lisa Steffensen is using this test to help her patients determine their risk of developing breast cancer that is not related to a familial tie.  This type of cancer is sometimes referred to as sporadic breast cancer.  The press release, “Primary Care Associates of Bellevue Pioneers Breast Cancer Risk Assessment,” is in Yahoo!’s Finance section today.  Dr. Steffensen says that by using this test, it allows her practice to treat patients in a way that will minimize their risk and hopefully save many more lives than without the use of BREVAGen.

This predictive risk test has been clinically validated to help predict sporadic, estrogen-positive breast cancer risk.  Some of the factors used in determining patients’ risk are their lifetime exposure to estrogen along with scientific markers to predict both a five-year and lifetime risk of developing this type of breast cancer.  BREVAGen uses an oral swab, which is sent to a CLIA-certified laboratory.  They study seven genetic markers and determine your risk factor based on those markers and other medical history.  Some of the medical history studied includes race, ethnicity, the age you first gave birth, your current age, your reproductive history and more.

Health insurance companies could garner some valuable information if BREVAGen becomes a widely used risk assessment measure.  They could lower health insurance rates for those with lower risk factors and offer additional health screenings and preventative care for those with higher risk factors.  The law ensures that Americans will not be denied health insurance coverage for pre-existing conditions, but a high risk factor may force people to compare health insurance rates if some companies use BREVAGen results to charge higher rates.  Primary Care Associates says that BREVAGen has been proven better at determining breast cancer risk than only using the Gail score.  They also say that it follows the guidelines for prevention and early detection given by the American Cancer Society and other non-profit cancer groups.