Let’s hope it’s not contagious

The Indianapolis Star has a disturbing story about a new Anthem Blue Cross/Blue Shield plan available to businesses who want to further trim their health care costs. The “Blue Access Hospital Surgical PPO” is being rolled out in Indiana, Ohio, Kentucky, Missouri and Wisconsin.

What’s new here isn’t the fact that Wellpoint-Anthem-Blue Cross is selling these yucky plans. It’s easy to find stripped-down plans like this if you have to buy coverage on your own, without the benefit of an employer negotiating a lower group rate. The difference is the fact that they’re offering it to businesses as an “alternative” that costs as much as 70% less than comprehensive plans.

Stats on the “Blue Access” plan include:

  • DEDUCTIBLES $1,000 to $5,000 (for an individual) and $3,000 to $15,000 (for a family).
  • COPAYS (doctor’s office) $20, plus half of the total charge. (This, of course, is after you’ve paid full price for every doctor’s visit until the deductible is met).
  • COPAYS (hospital) $150 co-pay, plus 20% of the total charge (after the deductible is met).
  • COPAYS (generic drugs) $10 in-store, $20 mail order
  • OUT-of-POCKET MAXIMUMS $5,000 (individual), $10,000 (family) — it’s unclear from the story if the out-of-pocket maximums would be on top of the deductible, or include the deductible.

Sooooo…… this development makes it even more important that health reform efforts establish a solid “minimum benefit package,” which includes doctors and hospital care, preventive care, maintenance of chronic diseases, prescription drugs, and other benefits, that would be credited as coverage. It’s only a matter of time before more of these types of plans seep into business’ open enrollment packets and head westward.

Health Access California promotes quality, affordable health care for all Californians.

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