/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGa) today announced it is extending the grace period on premium payments to help members directly impacted by Georgia tornados on April 27 and 28. Extensive property damage, injuries and death are attributed to these storms.
A Governor's State of Emergency remains in effect, and a Presidential Disaster Declaration has been made for Bartow, Catoosa, Coweta, Dade, Floyd, Greene, Lamar, Meriwether, Monroe, Morgan, Pickens, Polk, Rabun, Spalding, Troup and Walker Counties. Additionally, the damage caused by the tornados and storms have had a significant impact on transportation throughout the state, including disruptions in mail service.
Mail delivery disruptions may have caused delays in BCBSGa receiving premium payments, and as a result, BCBSGa has extended the grace period on premium payments for Georgia members for payments due in April and May. Members impacted by the tornados that may receive a delinquency notice or cancellation notice need to contact BCBSGa to have the delinquency notice waived. Policies will not be cancelled for this timeframe if premium payments were delayed due to disruptions in mail service.
"This is a very tragic time for many Georgians and it is of the utmost importance that our members not experience additional hardships," said Morgan Kendrick, President, BCBSGa. "We are taking every precaution possible, including extending grace periods and shifting staff roles to assist in the processing of any premium payment backlogs."
If members have questions about their premium payment status due to mail disruptions caused by recent inclement weather conditions, they should call the customer service number on the back of their Member ID card, and if they do not have their card, they should call 1-866-417-7107.
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Showing posts with label blue cross blue shield. Show all posts
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Thursday, May 05, 2011
Thursday, November 04, 2010
Our Nation's Veterans Have Options for Health Care Coverage
/PRNewswire/ -- As the nation pauses to honor its veterans on Nov. 11 for their patriotism, love of country, and willingness to serve and sacrifice for the common good, Blue Cross and Blue Shield of Georgia (BCBSGA) wants our veterans to be taken care of, especially when it comes to their health. Those who have served their country through the United States military have several options surrounding their health care coverage.
Qualifying veterans receive care at VA facilities. Additionally, those 65 years old and older – and those with certain disabilities – may qualify for Medicare. "Many veterans don't know about their Medicare rights," said Krista Bowers, president of senior business at BCBSGA's parent company. "Most have earned access to the Medicare system, just as they've earned their VA benefits. They shouldn't lose the opportunity, especially since some of these benefits may be offered at an affordable or no cost."
"VA and Medicare offer different, yet valuable, benefits to veterans," stated Morgan Kendrick, President of BCBSGA.
Through the VA, eligible veterans have access to a full range of preventive outpatient and inpatient services as long as they stay within the VA health care system, which includes hospitals, clinics, nursing homes, pharmacies and doctors nationwide. VA co-payments and deductibles, including the costs of prescription drugs, are generally less than Medicare. Eligibility for benefits is based on a priority system. According to the United States Department of Veterans Affairs website, there are more than eight million people covered by the VA Health Care System.
Medicare has four parts – A, B, C and D. Part A covers inpatient services, including hospital, skilled nursing facility, home health and hospice care. Part B covers outpatient medical services, such as doctor visits, preventive care and durable medical equipment. Part C, also known as Medicare Advantage (MA), combines Parts A and B into one plan that is run by a private insurance company, like Blue Cross and Blue Shield of Georgia, rather than the government. These plans may also include Part D, which is drug coverage.
Most people, including veterans, don't pay a premium for Part A. In most cases, these costs have been covered by payroll taxes. In contrast, Part B generally requires a monthly payment. Some companies offer Medicare Advantage plans (Part C) that cover everything included in Parts A and B, and more, including preventative services, at no additional cost. These are known as "zero premium plans." Some of these plans could also include dental, vision and hearing coverage. Other plans provide the same services, but require a monthly premium.
Enrollment processes and eligibility differ for VA and Medicare. Veterans can choose to participate in one program or the other or both. Enrollment in a Medicare plan does not affect an individual's VA eligibility.
On its website the VA recommends veterans not decline Medicare based solely on their VA coverage. The VA says there is no guarantee funds will continue to be appropriated for medical care for all enrollment priority groups. This could leave some veterans, especially those enrolled in one of the lower priority groups, with no access to care. For this reason, having a secondary source of coverage, like Medicare, may be in a veteran's best interest, the VA says.
Additionally, people who decline Medicare Part B when they are first eligible to receive it face substantial financial penalties if they decide to enroll later. The initial enrollment period typically occurs in the three months before the person's 65th birthday, their birthday month and the three subsequent months. There is no similar penalty for veterans who delay Part D enrollment because the VA's drug coverage is deemed equal to or better than Medicare.
Other benefits of Medicare for veterans include having access to doctors, hospitals and pharmacies outside the VA network and potentially having a larger list of covered drugs. Wider access could be important in case of an emergency or if a veteran needs a second opinion or specialized care.
There are additional benefits to having a Medicare Advantage plan. These advantages vary by insurer, but may include some or all of the following:
* Limits to total out-of-pocket costs
* Fitness programs, such as free gym memberships
* Preventive dental and vision care
* Programs that help people with chronic diseases, such as diabetes and asthma.
* Discounts on non-covered health-related products
* Chiropractic and podiatry services
It's important to remember that Medicare cannot generally pay for the same service paid for by the Department of Veterans Affairs (VA). Similarly, the VA generally cannot pay for the same service paid for by Medicare
"Obviously, this can get very complicated," said Kendrick. "There are many things for veterans to consider when selecting health care, including premiums, copayments and access. At Blue Cross and Blue Shield of Georgia we provide health benefits to many veterans and are happy to answer their questions to help them understand their options. After all, they deserve the absolute best health care coverage they can get."
For more information about veterans and Medicare, visit the Department of Veterans Affairs Web site at http://www4.va.gov/healtheligibility/ and click on " Medicare Information for Veterans ."
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Qualifying veterans receive care at VA facilities. Additionally, those 65 years old and older – and those with certain disabilities – may qualify for Medicare. "Many veterans don't know about their Medicare rights," said Krista Bowers, president of senior business at BCBSGA's parent company. "Most have earned access to the Medicare system, just as they've earned their VA benefits. They shouldn't lose the opportunity, especially since some of these benefits may be offered at an affordable or no cost."
"VA and Medicare offer different, yet valuable, benefits to veterans," stated Morgan Kendrick, President of BCBSGA.
Through the VA, eligible veterans have access to a full range of preventive outpatient and inpatient services as long as they stay within the VA health care system, which includes hospitals, clinics, nursing homes, pharmacies and doctors nationwide. VA co-payments and deductibles, including the costs of prescription drugs, are generally less than Medicare. Eligibility for benefits is based on a priority system. According to the United States Department of Veterans Affairs website, there are more than eight million people covered by the VA Health Care System.
Medicare has four parts – A, B, C and D. Part A covers inpatient services, including hospital, skilled nursing facility, home health and hospice care. Part B covers outpatient medical services, such as doctor visits, preventive care and durable medical equipment. Part C, also known as Medicare Advantage (MA), combines Parts A and B into one plan that is run by a private insurance company, like Blue Cross and Blue Shield of Georgia, rather than the government. These plans may also include Part D, which is drug coverage.
Most people, including veterans, don't pay a premium for Part A. In most cases, these costs have been covered by payroll taxes. In contrast, Part B generally requires a monthly payment. Some companies offer Medicare Advantage plans (Part C) that cover everything included in Parts A and B, and more, including preventative services, at no additional cost. These are known as "zero premium plans." Some of these plans could also include dental, vision and hearing coverage. Other plans provide the same services, but require a monthly premium.
Enrollment processes and eligibility differ for VA and Medicare. Veterans can choose to participate in one program or the other or both. Enrollment in a Medicare plan does not affect an individual's VA eligibility.
On its website the VA recommends veterans not decline Medicare based solely on their VA coverage. The VA says there is no guarantee funds will continue to be appropriated for medical care for all enrollment priority groups. This could leave some veterans, especially those enrolled in one of the lower priority groups, with no access to care. For this reason, having a secondary source of coverage, like Medicare, may be in a veteran's best interest, the VA says.
Additionally, people who decline Medicare Part B when they are first eligible to receive it face substantial financial penalties if they decide to enroll later. The initial enrollment period typically occurs in the three months before the person's 65th birthday, their birthday month and the three subsequent months. There is no similar penalty for veterans who delay Part D enrollment because the VA's drug coverage is deemed equal to or better than Medicare.
Other benefits of Medicare for veterans include having access to doctors, hospitals and pharmacies outside the VA network and potentially having a larger list of covered drugs. Wider access could be important in case of an emergency or if a veteran needs a second opinion or specialized care.
There are additional benefits to having a Medicare Advantage plan. These advantages vary by insurer, but may include some or all of the following:
* Limits to total out-of-pocket costs
* Fitness programs, such as free gym memberships
* Preventive dental and vision care
* Programs that help people with chronic diseases, such as diabetes and asthma.
* Discounts on non-covered health-related products
* Chiropractic and podiatry services
It's important to remember that Medicare cannot generally pay for the same service paid for by the Department of Veterans Affairs (VA). Similarly, the VA generally cannot pay for the same service paid for by Medicare
"Obviously, this can get very complicated," said Kendrick. "There are many things for veterans to consider when selecting health care, including premiums, copayments and access. At Blue Cross and Blue Shield of Georgia we provide health benefits to many veterans and are happy to answer their questions to help them understand their options. After all, they deserve the absolute best health care coverage they can get."
For more information about veterans and Medicare, visit the Department of Veterans Affairs Web site at http://www4.va.gov/healtheligibility/ and click on " Medicare Information for Veterans ."
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Friday, October 29, 2010
Open Enrollment Goes Virtual: Blue Cross and Blue Shield of Georgia Launches Virtual Open Enrollment Center, Allowing Companies to More Easily Engage Employees
/PRNewswire/ -- For medium and large organizations, providing employees with complete, comprehensive and consistent information during open enrollment can be challenging. To help businesses reach and engage their employees more easily, Blue Cross and Blue Shield of Georgia (BCBSGA) has launched a Virtual Open Enrollment center, an easy to use, easy to understand interactive 3-D environment, which can be found at: http://tinyurl.com/23hkhqg.
"The virtual enrollment center is another way that Blue Cross and Blue Shield of Georgia is delivering the best value to our customers and the members we serve," said Morgan Kendrick, President, BCBSGA. "Many businesses tell us they want to improve their systems to more effectively and efficiently communicate important benefit information to their employees. The BCBSGA virtual open enrollment center, designed with input from businesses, was created to meet this need. Ultimately, we believe this will help individuals make the best benefit choices to fit their unique circumstances."
With the virtual enrollment center, employees can access benefits information at their convenience in a single intuitive and interactive location. Upon entering the site, a user will see a 3-D design with their company's logo and a video spokesperson delivering personalized messages. The center has scrolling marquees providing up to date messaging. The user can easily find enrollment information through simple key word searches. In addition, the virtual enrollment center has a content library, housing enrollment materials, documents that can be downloaded, and web links to additional information such as health plan details, provider lists, prescription information and other available health programs.
This is also a valuable resource for human resource departments as they can easily maintain and publish content. The virtual enrollment center gives them the ability to efficiently reach all employees, increase visibility within the organization, track the number of visitors and monitor the usage.
"BCBSGA's virtual open enrollment center has been a great resource for our business and our employees," said Hazel Davis, manager, health and welfare plans for Albemarle Corporation. "We began using this new system last week and already our employee engagement has increased, and the employee feedback has been overwhelmingly positive. Our employees are able to access the center at their convenience, helping them to more effectively select the best benefits for themselves and their families. We have been looking for a way to increase employee engagement and Blue Cross and Blue Shield of Georgia's virtual open enrollment center has been a perfect solution."
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"The virtual enrollment center is another way that Blue Cross and Blue Shield of Georgia is delivering the best value to our customers and the members we serve," said Morgan Kendrick, President, BCBSGA. "Many businesses tell us they want to improve their systems to more effectively and efficiently communicate important benefit information to their employees. The BCBSGA virtual open enrollment center, designed with input from businesses, was created to meet this need. Ultimately, we believe this will help individuals make the best benefit choices to fit their unique circumstances."
With the virtual enrollment center, employees can access benefits information at their convenience in a single intuitive and interactive location. Upon entering the site, a user will see a 3-D design with their company's logo and a video spokesperson delivering personalized messages. The center has scrolling marquees providing up to date messaging. The user can easily find enrollment information through simple key word searches. In addition, the virtual enrollment center has a content library, housing enrollment materials, documents that can be downloaded, and web links to additional information such as health plan details, provider lists, prescription information and other available health programs.
This is also a valuable resource for human resource departments as they can easily maintain and publish content. The virtual enrollment center gives them the ability to efficiently reach all employees, increase visibility within the organization, track the number of visitors and monitor the usage.
"BCBSGA's virtual open enrollment center has been a great resource for our business and our employees," said Hazel Davis, manager, health and welfare plans for Albemarle Corporation. "We began using this new system last week and already our employee engagement has increased, and the employee feedback has been overwhelmingly positive. Our employees are able to access the center at their convenience, helping them to more effectively select the best benefits for themselves and their families. We have been looking for a way to increase employee engagement and Blue Cross and Blue Shield of Georgia's virtual open enrollment center has been a perfect solution."
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Wednesday, May 26, 2010
Blue Cross and Blue Shield of Georgia Announces It Will Unilaterally Implement Key Provisions of the 'Breast Cancer Patient Protection Act'
/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGA) announced today it will unilaterally implement key provisions of the Breast Cancer Patient Protection Act introduced by U.S. Representative Rosa DeLauro. These new provisions include more transparent benefit language including clear explanations of benefits to members with breast cancer, and the provisions standardize minimum recovery times in the hospital for women recovering from mastectomy.
The adoption of these provisions builds on BCBSGA's existing leadership in breast cancer treatment. While variability exists within clinical guidelines and state regulations, the vast majority of BCBSGA's members already receive the standard of care indicated in the legislation. However, BCBSGA believes that applying this universal minimum standard will both benefit our members, as well as encourage others in the industry to follow and adopt this standard. Beginning July 1, 2010, BCBSGA will standardize clinical guidelines for women recovering from mastectomy, and will continue to offer a voluntary 48-hour minimum in-hospital stay.
"Women recovering from breast cancer surgery, in consultation with their physicians, will decide whether hospitalization for 48 hours is required," said Robert McCormack, Medical Director, BCBSGA. "We are committed to making medical coverage decisions for women with breast cancer that are in accord with the latest scientific evidence and clinical research. It's important for us and our members that BCBSGA continues to lead in this area," he added.
"We continue to work with the American Cancer Society and academic thought leaders to gain real-world knowledge of breast cancer treatments that will shape improvements in care for women diagnosed and living with breast cancer, or who are in remission," said McCormack. "Our goal is to ensure that our members receive optimal care."
BCBSGA also champions effective member communication and transparency regarding breast cancer diagnosis and treatment options. More than 3,000 nurses and clinical associates work with members daily, to encourage detection of breast cancer at its earliest stages and to ensure that members are receiving the best breast cancer treatments available. Toward that end, BCBSGA is taking steps to provide more straight-forward explanations of benefits so that members more clearly understand their treatment options.
"BCBSGA works diligently to ensure that all of our members are getting best practice care," said Monye Connolly, President, BCBSGA. "We are especially proud of our record in improving care for women with breast cancer and believe these added measures will increase the quality of care that our members receive."
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The adoption of these provisions builds on BCBSGA's existing leadership in breast cancer treatment. While variability exists within clinical guidelines and state regulations, the vast majority of BCBSGA's members already receive the standard of care indicated in the legislation. However, BCBSGA believes that applying this universal minimum standard will both benefit our members, as well as encourage others in the industry to follow and adopt this standard. Beginning July 1, 2010, BCBSGA will standardize clinical guidelines for women recovering from mastectomy, and will continue to offer a voluntary 48-hour minimum in-hospital stay.
"Women recovering from breast cancer surgery, in consultation with their physicians, will decide whether hospitalization for 48 hours is required," said Robert McCormack, Medical Director, BCBSGA. "We are committed to making medical coverage decisions for women with breast cancer that are in accord with the latest scientific evidence and clinical research. It's important for us and our members that BCBSGA continues to lead in this area," he added.
"We continue to work with the American Cancer Society and academic thought leaders to gain real-world knowledge of breast cancer treatments that will shape improvements in care for women diagnosed and living with breast cancer, or who are in remission," said McCormack. "Our goal is to ensure that our members receive optimal care."
BCBSGA also champions effective member communication and transparency regarding breast cancer diagnosis and treatment options. More than 3,000 nurses and clinical associates work with members daily, to encourage detection of breast cancer at its earliest stages and to ensure that members are receiving the best breast cancer treatments available. Toward that end, BCBSGA is taking steps to provide more straight-forward explanations of benefits so that members more clearly understand their treatment options.
"BCBSGA works diligently to ensure that all of our members are getting best practice care," said Monye Connolly, President, BCBSGA. "We are especially proud of our record in improving care for women with breast cancer and believe these added measures will increase the quality of care that our members receive."
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Blue Cross and Blue Shield of Georgia's New Medicare Supplement Plans Offer More Choice and Financial Flexibility to Georgia's Growing Medicare Population
/PRNewswire/ -- Today Blue Cross and Blue Shield of Georgia (BCBSGA) introduced new "modernized" Medicare Supplement plans that have been updated to consider the needs of today's Medicare beneficiaries.
BCBSGA's new Medicare Supplement plans will offer a portfolio of options ranging from comprehensive coverage that bridges Medicare gaps, to the availability of packages offering affordable monthly premiums and more predictable copayment structures that encourage wellness by making doctor's visits more affordable for beneficiaries. Consumers in Georgia can select from five plans: A, F, High deductible F, G and N with an effective date of June 1, 2010.
"The updates to the Medicare Supplement health benefit plans are welcome news for Medicare beneficiaries during these tough economic times because the plans align the benefits with the recent updates made to the Medicare program," said Krista Bowers, president of BCBSGA Senior Business. "The new 'modernized' Medicare Supplement plans offer peace of mind, practicality and affordability that is in tune with today's Medicare landscape."
The new Medicare Supplement plans are a result of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 that authorized a new set of Medicare Supplement insurance plans to reflect the needs of today's Medicare beneficiaries.
A Medicare Supplement policy (sometimes referred to as Medigap) is a supplemental health insurance plan sold by private insurance companies to fill the "gaps" in Original Medicare Plan coverage. Medicare Supplement policies help pay some of the health care costs that the Original Medicare Plan doesn't cover. If an individual is enrolled in the Original Medicare Plan and has a Medicare Supplement policy, then Medicare and Medicare Supplement will pay both their shares of covered health care costs. BCBSGA and its affiliated health plans are among the largest providers of Medicare Supplement health plans in the nation.
Although as of June 1, 2010 the current Medicare plans referred to as "standardized" plans will no longer be open for new sales or new membership, Medicare beneficiaries who are currently enrolled in a "standardized" or "pre-standardized" Medicare Supplement plan can retain their current plans as long as their premium payments are current.
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BCBSGA's new Medicare Supplement plans will offer a portfolio of options ranging from comprehensive coverage that bridges Medicare gaps, to the availability of packages offering affordable monthly premiums and more predictable copayment structures that encourage wellness by making doctor's visits more affordable for beneficiaries. Consumers in Georgia can select from five plans: A, F, High deductible F, G and N with an effective date of June 1, 2010.
"The updates to the Medicare Supplement health benefit plans are welcome news for Medicare beneficiaries during these tough economic times because the plans align the benefits with the recent updates made to the Medicare program," said Krista Bowers, president of BCBSGA Senior Business. "The new 'modernized' Medicare Supplement plans offer peace of mind, practicality and affordability that is in tune with today's Medicare landscape."
The new Medicare Supplement plans are a result of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 that authorized a new set of Medicare Supplement insurance plans to reflect the needs of today's Medicare beneficiaries.
A Medicare Supplement policy (sometimes referred to as Medigap) is a supplemental health insurance plan sold by private insurance companies to fill the "gaps" in Original Medicare Plan coverage. Medicare Supplement policies help pay some of the health care costs that the Original Medicare Plan doesn't cover. If an individual is enrolled in the Original Medicare Plan and has a Medicare Supplement policy, then Medicare and Medicare Supplement will pay both their shares of covered health care costs. BCBSGA and its affiliated health plans are among the largest providers of Medicare Supplement health plans in the nation.
Although as of June 1, 2010 the current Medicare plans referred to as "standardized" plans will no longer be open for new sales or new membership, Medicare beneficiaries who are currently enrolled in a "standardized" or "pre-standardized" Medicare Supplement plan can retain their current plans as long as their premium payments are current.
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Wednesday, April 21, 2010
HHS Secretary Kathleen Sebelius on Growing List of Insurers That Will Provide Coverage for Young Adults under Age 26
I welcome the Blue Cross Blue Shield plans, Kaiser Permanente, and Humana to the growing list of insurers who are offering to continue health insurance for young adults graduating from college or aging out of their parents’ plan. This initiative, complementing the permanent policy in the Affordable Care Act, will enable young people to retain insurance coverage at an important moment as they begin their adult lives and launch their careers.
Many young adults under the age of 26 have traditionally had a difficult time getting access to – and affording – health coverage. The Affordable Care Act, and the voluntary actions of insurers to eliminate the coverage gap for young adults on their parents plans, will give greater health security to millions of American families.
Insuring younger Americans is a top priority for the Administration and we will continue working to expand the opportunity for children and young adults to have access to quality, affordable care.
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Monday, December 21, 2009
Blue Cross and Blue Shield of Georgia Statement on For-Profit Health Insurance Tax Amendment
On December 19, Senator Reid released his Manager's amendment to the health care reform legislation currently being discussed in the U.S. Senate. One provision in the amendment involved the $6.7 billion annual tax that will be levied on the health insurance industry. As the Congressional Budget Office has stated, this tax will get passed on to consumers through higher premiums. In his amendment, Senator Reid put forth that non-profit health insurance companies will be exempt from this tax -- in essence leaving for-profit plans, and their members, to shoulder the entire tax burden.
What does this mean to the nearly 91 percent (5,285,472) of Georgians that have health insurance provided by for-profit companies?
It means Georgia's share of the $6.7 billion tax will increase. It will directly impact Georgia's insured population and will cause premium amounts to increase even more under this legislation. Because a greater percentage of Georgians are insured by for-profit companies (91 percent) than the national average (55 percent), Georgia taxpayers will subsidize states like Michigan, which has a very low enrollment in for-profit health insurers (23 percent).
Any proposal to tax only for-profit health plans will further exacerbate the un-level playing field for not-for-profit plans, without improving access to health benefits coverage or enhanced health services. While some plans are not-for-profit, that does not mean they are not "profitable." Insurers are required to generate a "net income" in order to help ensure they can pay future claims by members. Not-for-profit simply reflects a tax status under the Internal Revenue Service Code. In many states, the net income on a per-member, per-month (PMPM) basis for not-for-profit health plans is actually higher than that of the for-profit health plans.
Over time, un-equal taxation will lead to the erosion and potential insolvency of for-profit plans, as a progressively smaller share of the overall market would bear the burden of sustaining the entire amount of the tax. Ultimately the government would receive no revenue from the tax when there are no for-profit entities remaining subject to the tax.
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What does this mean to the nearly 91 percent (5,285,472) of Georgians that have health insurance provided by for-profit companies?
It means Georgia's share of the $6.7 billion tax will increase. It will directly impact Georgia's insured population and will cause premium amounts to increase even more under this legislation. Because a greater percentage of Georgians are insured by for-profit companies (91 percent) than the national average (55 percent), Georgia taxpayers will subsidize states like Michigan, which has a very low enrollment in for-profit health insurers (23 percent).
Any proposal to tax only for-profit health plans will further exacerbate the un-level playing field for not-for-profit plans, without improving access to health benefits coverage or enhanced health services. While some plans are not-for-profit, that does not mean they are not "profitable." Insurers are required to generate a "net income" in order to help ensure they can pay future claims by members. Not-for-profit simply reflects a tax status under the Internal Revenue Service Code. In many states, the net income on a per-member, per-month (PMPM) basis for not-for-profit health plans is actually higher than that of the for-profit health plans.
Over time, un-equal taxation will lead to the erosion and potential insolvency of for-profit plans, as a progressively smaller share of the overall market would bear the burden of sustaining the entire amount of the tax. Ultimately the government would receive no revenue from the tax when there are no for-profit entities remaining subject to the tax.
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Thursday, October 15, 2009
Blue Cross and Blue Shield of Georgia to Provide First Dollar Coverage of H1N1 Vaccine for All Members
/PRNewswire/ -- Each year, influenza causes illness, hospitalizations and deaths, and severely strains the health care delivery system. This year, seasonal flu is complicated by the emergence and rapid spread of the H1N1 virus. In an effort to ensure that individuals and their families can take the appropriate actions to help protect themselves against the H1N1 virus, Blue Cross and Blue Shield of Georgia (BCBSGA) will cover the administration of the H1N1 vaccine without co-pay or deductible for all of its members. BCBSGA is also are encouraging self-insured employers to cover the cost of the vaccination for their employees.
"At BCBSGA, our priority is to ensure that our actions and communications support public health," said Dr. Bob McCormack, BCBSGA medical director. "Our goal is to keep our members as healthy as possible. We are committed to working with the CDC and HHS on an information campaign to ensure that members and the public are vaccinated to prevent H1N1, and if they develop H1N1 flu, they are treated effectively and appropriately."
Since a significant proportion of the vaccine is likely to be administered through non-traditional providers such as pharmacies, retail clinics and public health clinics, BCBSGA is currently working to complete agreements with these providers to increase access to the H1N1 vaccine. In addition, the antiviral medications Tamiflu and Relenza will move to an economical tier in plan formularies.
The CDC has recommended that certain populations receive the 2009 H1N1 vaccine when it becomes available. Initial prioritization includes pregnant women, people who live with or care for children younger than six months of age, children and young adults from 6 months to 24 years old, and people from 25 through 64 years old if they have chronic medical conditions that increase their risk of complications from influenza infection.
The CDC also recommends people take common-sense steps like washing your hands frequently; covering your mouth with your arm when you cough and sneeze; and staying home when you are sick to help protect others from the flu.
"The U.S. health care system has a responsibility to achieve maximal vaccination and effective treatment of H1N1 flu and its emerging risks, and we are eager to do our part to be sure that populations at high risk are immunized against this virus," said Monye Connolly, president, BCBSGA.
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"At BCBSGA, our priority is to ensure that our actions and communications support public health," said Dr. Bob McCormack, BCBSGA medical director. "Our goal is to keep our members as healthy as possible. We are committed to working with the CDC and HHS on an information campaign to ensure that members and the public are vaccinated to prevent H1N1, and if they develop H1N1 flu, they are treated effectively and appropriately."
Since a significant proportion of the vaccine is likely to be administered through non-traditional providers such as pharmacies, retail clinics and public health clinics, BCBSGA is currently working to complete agreements with these providers to increase access to the H1N1 vaccine. In addition, the antiviral medications Tamiflu and Relenza will move to an economical tier in plan formularies.
The CDC has recommended that certain populations receive the 2009 H1N1 vaccine when it becomes available. Initial prioritization includes pregnant women, people who live with or care for children younger than six months of age, children and young adults from 6 months to 24 years old, and people from 25 through 64 years old if they have chronic medical conditions that increase their risk of complications from influenza infection.
The CDC also recommends people take common-sense steps like washing your hands frequently; covering your mouth with your arm when you cough and sneeze; and staying home when you are sick to help protect others from the flu.
"The U.S. health care system has a responsibility to achieve maximal vaccination and effective treatment of H1N1 flu and its emerging risks, and we are eager to do our part to be sure that populations at high risk are immunized against this virus," said Monye Connolly, president, BCBSGA.
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Wednesday, September 23, 2009
Blue Cross and Blue Shield of Georgia Launches Zagat Health Survey Tool
/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGA) today announced the launch of the Zagat Health Survey tool, an online survey tool that will allow its members to share their physician experiences with other members throughout the state.
"Zagat is widely known and trusted for its ability to help people share and learn from other consumer experiences. By working with them we are able to create a trusted resource for our members that will actively engage them in sharing and using that information," said Monye Connolly, president of BCBSGA. "We are committed to providing our members with useful information to better help them navigate the health care system. Making information available, such as the patient experience information contained in the Zagat Health Survey, along with other quality and cost transparency information, is part of that commitment."
The Zagat Survey enables BCBSGA to address an unmet need for peer-to-peer interaction among health care consumers. The Zagat Health Survey tool provides a vehicle for members to review physicians based on a set of distinct criteria, creating a trusted resource to support informed member decision-making. The criteria are solely designed to reflect a consumer's experience with a physician and not to reflect the quality of care received. This tool not only helps members, but is also designed to assist doctors in understanding members' experiences.
The online survey tool allows consumers to review their doctor visits based on:
-- Trust - Confidence in the physician's approach
-- Communication - Physician's bedside manner, responsiveness and rapport
-- Availability - Convenience for making appointments and physician's
punctuality
-- Environment - Condition of the office, staff helpfulness, atmosphere
and amenities
Members are also asked whether they would recommend their doctor to others. The survey also features a comments section, allowing members to explain their ratings.
The online entry will display physician contact information, ratings on a 30-point scale for each of the four categories, and the percentage of members who recommend that physician. The most recent comments will be displayed first, and members will have the option to rate the usefulness of comments and report suspicious comments. BCBSGA members can complete the Zagat Health Survey by logging on to the secure member portal on the BCBSGA Web site.
"For physicians the Zagat survey tool can provide valuable, objective feedback on how their patients feel about them and their practice, information that often remains unknown," said Dr. Robert McCormack, medical director for BCBSGA. "For consumers, the survey can provide information to help them select a physician who is most likely aligned with their personal style and who will meet their health care needs. All-in-all, it is a viable mechanism that could very well change the way health care is measured and delivered throughout Georgia."
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"Zagat is widely known and trusted for its ability to help people share and learn from other consumer experiences. By working with them we are able to create a trusted resource for our members that will actively engage them in sharing and using that information," said Monye Connolly, president of BCBSGA. "We are committed to providing our members with useful information to better help them navigate the health care system. Making information available, such as the patient experience information contained in the Zagat Health Survey, along with other quality and cost transparency information, is part of that commitment."
The Zagat Survey enables BCBSGA to address an unmet need for peer-to-peer interaction among health care consumers. The Zagat Health Survey tool provides a vehicle for members to review physicians based on a set of distinct criteria, creating a trusted resource to support informed member decision-making. The criteria are solely designed to reflect a consumer's experience with a physician and not to reflect the quality of care received. This tool not only helps members, but is also designed to assist doctors in understanding members' experiences.
The online survey tool allows consumers to review their doctor visits based on:
-- Trust - Confidence in the physician's approach
-- Communication - Physician's bedside manner, responsiveness and rapport
-- Availability - Convenience for making appointments and physician's
punctuality
-- Environment - Condition of the office, staff helpfulness, atmosphere
and amenities
Members are also asked whether they would recommend their doctor to others. The survey also features a comments section, allowing members to explain their ratings.
The online entry will display physician contact information, ratings on a 30-point scale for each of the four categories, and the percentage of members who recommend that physician. The most recent comments will be displayed first, and members will have the option to rate the usefulness of comments and report suspicious comments. BCBSGA members can complete the Zagat Health Survey by logging on to the secure member portal on the BCBSGA Web site.
"For physicians the Zagat survey tool can provide valuable, objective feedback on how their patients feel about them and their practice, information that often remains unknown," said Dr. Robert McCormack, medical director for BCBSGA. "For consumers, the survey can provide information to help them select a physician who is most likely aligned with their personal style and who will meet their health care needs. All-in-all, it is a viable mechanism that could very well change the way health care is measured and delivered throughout Georgia."
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Analysis Shows Narrow Age Rating Would Raise Premiums by Nearly 50 Percent, Causing Many Young and Healthy to Forgo Coverage
/PRNewswire/ -- Allowing age adjustments more restrictive than 5 to 1 would cause dramatic premium spikes for the young and healthy in the individual insurance market, making coverage unaffordable for many according to a new analysis.
The Blue Cross and Blue Shield Association (BCBSA) released today new data, prepared by Oliver Wyman's Actuarial and Health and Life Sciences practice, showing that a 2 to 1 age rating ratio would increase premiums for the youngest and healthiest Americans in the individual market in many states by nearly 50 percent in the first year, relative to a 5 to 1 age rating ratio.
Currently 42 states permit health plans to vary premiums based on age by 5 to 1 or more -- the primary benefit being that premiums are kept affordable for younger individuals to encourage broad participation. If more restrictive age ratings are implemented, younger people would opt out of purchasing coverage. Oliver Wyman estimates that, over a five year period, more than 1 million younger members would leave the market, resulting in a 10 percent premium increase overall for individuals in some parts of the country.
"An affordable, sustainable insurance market requires broad participation across all age groups to maintain more affordable premiums. As this analysis shows, overly restrictive age rating regulations would hurt a large portion of those with individual coverage -- making coverage less affordable and undermining the key goals of healthcare reform," said Scott P. Serota, president and CEO of BCBSA. "To ensure the long-term sustainability of healthcare reform, we must strike the right balance on age rating to avoid disproportionately burdening one segment of the population over another. For this reason, we support a 5 to 1 age rating similar to what the vast majority of states permit today."
The Oliver Wyman analysis also finds that restricting age rating ratios to 3 to 1 would increase premiums in many states by as much as 30 percent for younger people, relative to a 5 to 1 ratio.
"Younger individuals are much more sensitive to the costs of health insurance compared to older individuals. The bottom line is that if premiums are too high, young and healthy individuals simply will not purchase insurance and their needed cross-subsidies for older, sicker people will be lost, increasing the cost of healthcare for everyone," Serota said.
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The Blue Cross and Blue Shield Association (BCBSA) released today new data, prepared by Oliver Wyman's Actuarial and Health and Life Sciences practice, showing that a 2 to 1 age rating ratio would increase premiums for the youngest and healthiest Americans in the individual market in many states by nearly 50 percent in the first year, relative to a 5 to 1 age rating ratio.
Currently 42 states permit health plans to vary premiums based on age by 5 to 1 or more -- the primary benefit being that premiums are kept affordable for younger individuals to encourage broad participation. If more restrictive age ratings are implemented, younger people would opt out of purchasing coverage. Oliver Wyman estimates that, over a five year period, more than 1 million younger members would leave the market, resulting in a 10 percent premium increase overall for individuals in some parts of the country.
"An affordable, sustainable insurance market requires broad participation across all age groups to maintain more affordable premiums. As this analysis shows, overly restrictive age rating regulations would hurt a large portion of those with individual coverage -- making coverage less affordable and undermining the key goals of healthcare reform," said Scott P. Serota, president and CEO of BCBSA. "To ensure the long-term sustainability of healthcare reform, we must strike the right balance on age rating to avoid disproportionately burdening one segment of the population over another. For this reason, we support a 5 to 1 age rating similar to what the vast majority of states permit today."
The Oliver Wyman analysis also finds that restricting age rating ratios to 3 to 1 would increase premiums in many states by as much as 30 percent for younger people, relative to a 5 to 1 ratio.
"Younger individuals are much more sensitive to the costs of health insurance compared to older individuals. The bottom line is that if premiums are too high, young and healthy individuals simply will not purchase insurance and their needed cross-subsidies for older, sicker people will be lost, increasing the cost of healthcare for everyone," Serota said.
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Thursday, September 17, 2009
Senate Finance Committee Plan Goes Far To Achieve Reform But New Taxes Raise Affordability Concerns
/PRNewswire/ -- Scott P. Serota, president and chief executive officer of the Blue Cross and Blue Shield Association (BCBSA), issued the following statement regarding the chairman's mark released yesterday by Chairman Max Baucus (D-MT) and members of the Senate Finance Committee:
"We strongly support healthcare reforms that expand coverage to everyone, improve quality, and rein in costs. This chairman's mark achieves many of these goals.
"The mark addresses many necessary insurance reforms, the foundation of which is a proposal advocated by BCBSA to guarantee coverage to everyone, regardless of pre-existing conditions. We commend Chairman Baucus for including in his mark a personal responsibility requirement to obtain and maintain coverage -- the linchpin to making insurance reforms work.
"We also support the mark's age rating provision which allows discounts to young people to encourage them to purchase coverage. Age rating provisions in other bills would preclude these discounts and would result in major premium increases to young people causing many to forgo coverage. Making insurance affordable for young people, who account for as much as 40 percent of those without insurance, is critical to reducing the number of uninsured and will help to lower the cost of health insurance for everyone, including older Americans.
"We strongly support the goal of making coverage affordable. However, we are greatly concerned that burdensome new taxes and fees aimed at insurers and other healthcare industry stakeholders would severely undermine the reforms that the chairman's mark aims to achieve. These unprecedented new taxes would make coverage much less affordable for individuals, their families, and employers.
"We look forward to continuing a vigorous and productive discussion with the Senate Finance Committee. This is a once-in-a-generation opportunity to achieve meaningful and sustainable change in our healthcare system, and BCBSA will continue to advocate for reforms that expand access to everyone, improve quality, and rein in costs."
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"We strongly support healthcare reforms that expand coverage to everyone, improve quality, and rein in costs. This chairman's mark achieves many of these goals.
"The mark addresses many necessary insurance reforms, the foundation of which is a proposal advocated by BCBSA to guarantee coverage to everyone, regardless of pre-existing conditions. We commend Chairman Baucus for including in his mark a personal responsibility requirement to obtain and maintain coverage -- the linchpin to making insurance reforms work.
"We also support the mark's age rating provision which allows discounts to young people to encourage them to purchase coverage. Age rating provisions in other bills would preclude these discounts and would result in major premium increases to young people causing many to forgo coverage. Making insurance affordable for young people, who account for as much as 40 percent of those without insurance, is critical to reducing the number of uninsured and will help to lower the cost of health insurance for everyone, including older Americans.
"We strongly support the goal of making coverage affordable. However, we are greatly concerned that burdensome new taxes and fees aimed at insurers and other healthcare industry stakeholders would severely undermine the reforms that the chairman's mark aims to achieve. These unprecedented new taxes would make coverage much less affordable for individuals, their families, and employers.
"We look forward to continuing a vigorous and productive discussion with the Senate Finance Committee. This is a once-in-a-generation opportunity to achieve meaningful and sustainable change in our healthcare system, and BCBSA will continue to advocate for reforms that expand access to everyone, improve quality, and rein in costs."
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Monday, August 03, 2009
BCBSGA Announces Decision to Cover H1N1 Vaccine Administration
/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGA) announced today that it will offer coverage for the administration of the H1N1 (swine flu) vaccine when it becomes commercially available to the general public. The vaccine administration will be covered for members whose benefit plans provide coverage for vaccines.
BCBSGA will also continue coverage of seasonal flu vaccine administration for those whose health plans offer vaccine coverage. The U.S. Centers for Disease Control and Prevention has stated that the H1N1 vaccine is not intended to replace the seasonal flu vaccine. Seasonal flu and H1N1 vaccines may be administered on the same day, according to the CDC.
The decision to cover the H1N1 vaccine administration is based on formal recommendations announced this week by the CDC's Advisory Committee on Immunization Practices. ACIP recommended initial prioritization for those administering the vaccine for five key populations, including:
-- pregnant women,
-- people who live with or care for children younger than six months of
age,
-- health care and emergency services personnel,
-- children and young adults from 6 months old to 24 years old, and
-- people from 25 through 64 years old if they have chronic medical
conditions that increase their risk of complications from influenza
infection.
ACIP also provided guidance regarding high risk groups to be targeted in the event of a significant shortage of vaccine as well as recommendations for the rest of the general population if the supply of vaccine exceeds the needs of the target groups.
BCBSGA's immunization policy decisions are based on recommendations issued by ACIP and other nationally recognized organizations. ACIP is composed of 15 experts in fields associated with immunization who provide advice and guidance to the U.S. Department of Health and Human Services and CDC on the most effective means to prevent vaccine-preventable diseases.
Vaccine administration is covered for members whose benefit plans provide coverage for vaccines. Policyholders should confirm their specific benefits by calling the toll-free telephone number listed on their insurance card.
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BCBSGA will also continue coverage of seasonal flu vaccine administration for those whose health plans offer vaccine coverage. The U.S. Centers for Disease Control and Prevention has stated that the H1N1 vaccine is not intended to replace the seasonal flu vaccine. Seasonal flu and H1N1 vaccines may be administered on the same day, according to the CDC.
The decision to cover the H1N1 vaccine administration is based on formal recommendations announced this week by the CDC's Advisory Committee on Immunization Practices. ACIP recommended initial prioritization for those administering the vaccine for five key populations, including:
-- pregnant women,
-- people who live with or care for children younger than six months of
age,
-- health care and emergency services personnel,
-- children and young adults from 6 months old to 24 years old, and
-- people from 25 through 64 years old if they have chronic medical
conditions that increase their risk of complications from influenza
infection.
ACIP also provided guidance regarding high risk groups to be targeted in the event of a significant shortage of vaccine as well as recommendations for the rest of the general population if the supply of vaccine exceeds the needs of the target groups.
BCBSGA's immunization policy decisions are based on recommendations issued by ACIP and other nationally recognized organizations. ACIP is composed of 15 experts in fields associated with immunization who provide advice and guidance to the U.S. Department of Health and Human Services and CDC on the most effective means to prevent vaccine-preventable diseases.
Vaccine administration is covered for members whose benefit plans provide coverage for vaccines. Policyholders should confirm their specific benefits by calling the toll-free telephone number listed on their insurance card.
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Thursday, May 21, 2009
Blue Cross and Blue Shield of Georgia and Piedmont Healthcare Announce Contract Renewal
/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGA) and Piedmont Healthcare announced today that they have reached agreement on a three-year contract, effective August 1, 2009.
Under the agreement, BCBSGA HMO/POS and PPO members can continue to access Piedmont Healthcare as an in-network provider, including services from Piedmont Clinic physicians, Piedmont Hospital in Atlanta, Piedmont Fayette Hospital in Fayetteville, Piedmont Mountainside Hospital in Jasper, and Piedmont Newnan Hospital in Newnan.
"We are pleased to continue our relationship with Piedmont Healthcare," said Amy Cheslock, vice president of health services, BCBSGA. "As the state's largest health benefits provider, this new contract allows us to continue offering our members a wide range of choices and continued access to affordable, quality health care."
"We are pleased to renew our participation in the BCBSGA provider network that serves so many of our patients," said Gregory A. Hurst, executive vice president and chief operating officer for Piedmont Healthcare. "Piedmont has a long-standing commitment to the residents of Georgia and the communities we serve. This agreement ensures that BCBSGA members will continue to have access to the highest quality healthcare and the physicians and hospitals they have come to trust."
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Under the agreement, BCBSGA HMO/POS and PPO members can continue to access Piedmont Healthcare as an in-network provider, including services from Piedmont Clinic physicians, Piedmont Hospital in Atlanta, Piedmont Fayette Hospital in Fayetteville, Piedmont Mountainside Hospital in Jasper, and Piedmont Newnan Hospital in Newnan.
"We are pleased to continue our relationship with Piedmont Healthcare," said Amy Cheslock, vice president of health services, BCBSGA. "As the state's largest health benefits provider, this new contract allows us to continue offering our members a wide range of choices and continued access to affordable, quality health care."
"We are pleased to renew our participation in the BCBSGA provider network that serves so many of our patients," said Gregory A. Hurst, executive vice president and chief operating officer for Piedmont Healthcare. "Piedmont has a long-standing commitment to the residents of Georgia and the communities we serve. This agreement ensures that BCBSGA members will continue to have access to the highest quality healthcare and the physicians and hospitals they have come to trust."
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