Anthem's bare-bones plan for employers
Anthem rolls out bare-bones health plan
By Daniel Lee
The Indianapolis Star
November 29, 2007
Anthem Blue Cross and Blue Shield on Wednesday unveiled a bare-bones health insurance plan designed for employers struggling to offer benefits to their workers because of the rising cost of premiums.
The new plan, called Blue Access Hospital Surgical PPO, provides “catastrophic” coverage for most hospitalizations and surgeries, as well as limited coverage for doctor visits and other services, according to Anthem, a subsidiary of Indianapolis health-insurance giant WellPoint.
“It’s another option for employers who otherwise might be forced to cut back or eliminate health coverage altogether because of budgetary constraints,” said Robert W. Hillman, president of Anthem Blue Cross and Blue Shield in Indiana, in a statement.
Deductibles — or out-of-pocket costs before any coverage starts — range from $1,000 to $5,000 for a single person and $3,000 to $15,000 for a family.
After the deductible is met, a patient would be responsible for a $20 co-pay, plus 50 percent of the total charge for an outpatient doctor visit, according to Anthem. An emergency-room visit requires a $150 co-pay plus 20 percent of the total charge.
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Comment:
By Don McCanne, MD
Although the numbers of uninsured continue to rise, the fastest growing problem in health care financing is underinsurance. In an effort to make health insurance premiums affordable, plans are shifting more of the costs to patients, making health care access unaffordable for many.
Catastrophic underinsurance plans have been much more common in the individual market where most individuals have faced directly the problem of paying in full the insurance premiums. They are faced with a choice of purchasing inadequate plans with premiums they can afford, or having no coverage at all since premiums for comprehensive plans are no longer affordable for average-income individuals.
Employers have been shifting to underinsurace much more gradually by nudging up the cost-sharing requirements for their employees. But that is about to change. Many employers have been struggling with the rising costs of their health benefit programs, and some have discontinued coverage. Now, Wellpoint’s Anthem, by offering Blue Access Hospital Surgical PPO, has provided employers with the opportunity to continue to offer their employees coverage, albeit bare-bones coverage.
As the private insurance industry continues to expand their offering of innovative insurance products, more and more people with health care needs will find that health care access will come with a heavy dose of financial hardship. But isn’t that what the private insurers are supposed to prevent?