Anthem Blue Cross And Blue Shield To Offer Limited-Benefit Plan To Employers In Five States

Main Category: Health Insurance / Medical Insurance
Article Date: 03 Dec 2007 - 10:00 PDT

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Anthem Blue Cross and Blue Shield on Wednesday announced plans to begin to offer a limited-benefit health plan to employers in Indiana, Kentucky, Missouri, Ohio and Wisconsin, the Indianapolis Star reports.

The plan, called the Blue Access Hospital Surgical PPO, provides "catastrophic" coverage for most hospitalizations and surgeries, as well as limited coverage for physician visits and other health care services. The plan does not cover urgent care center visits or durable medical equipment, such as wheelchairs.

According to Anthem, premiums for the plan, previously available only in the individual health insurance market, cost 70% less than those for a comprehensive PPO plan. Under the plan, employees have annual deductibles of between $1,000 and $5,000 for single coverage and between $3,000 and $15,000 for family coverage. After employees reach the deductible, they have to make a $20 copayment and pay 50% of the total cost for physician visits and make a $150 copay and pay 20% of the total cost for emergency department visits.

Anthem decided to offer the plan to help employers "struggling to offer benefits to their workers because of the rising cost of premiums," the Star reports. Robert Hillman, president of Anthem Blue Cross and Blue Shield in Indiana, in a statement said, "It's another option for employers who otherwise might be forced to cut back or eliminate health coverage altogether because of budgetary constraints."

However, some "medical experts worry that some patients covered by health plans with high out-of-pocket requirements could delay seeking needed medical treatment," according to the Star. Deanna Willis, assistant professor of family medicine at Indiana University School of Medicine, said, "The challenge for a product like this is the risk that people will delay their care" (Lee, Indianapolis Star, 11/29).

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