New Ways to Get Insured: Unusual Group Health Plans And A Public/Private Partnership in Miami
The Wall Street Journal and The Miami Herald both have articles about innovative ways to find insurance.
The Journal reports that "people who have lost their employer-provided health insurance because of a layoff, early retirement or other reasons are turning to a little-known strategy to get coverage: forming a small business, or using an existing one, to buy a group policy." Group coverage "isn't always simple and cheap" and "may cost more than simply buying an individual policy," but it does guarantee coverage of all pre-existing conditions, which many insurers refuse to cover. Although the rules vary by state, "a person, a couple or a collection of individuals generally can qualify for group coverage if they can prove they have an actual business," including freelance and contract work. Insurance brokers say they are "seeing more people who lose their jobs form their own businesses doing consulting work for their former clients," sometimes hiring a spouse or secretary to form a group. The coverage can be costly. While group insurance is required to cover pre-existing conditions, insurers can still assess your health risks and raise your premiums accordingly. Small group coverage can also cost 30% more than what a larger group would pay (Greene, 5/27).
The Herald reports on the announcement of a new health insurance plan offered by a partnership between Miami-Dade County and Blue Cross. Creators of the plan, which aims to help the estimated 600,000 uninsured people in the county, believe it "could be a model for affordable health insurance nationwide." The plan "would cost a healthy 35-year-old male about $100 a month, but insurance brokers worry that "the benefits offered are less than in most popular plans, including a lack of coverage of branded prescription drugs."
Miami-Dade "helped shape the plan, which Blue Cross won in a competitive bid process, but it's not costing tax payers anything." The plan is available to "individuals up to age 65 and to small employers with up to 50 works," but "the insurer has the right to reject individuals who the plan thinks might be too costly." It has a $250 deductable and "pays 90 percent of in-network hospital costs and 100 percent of in-network lab tests. Generic drugs are available for a $10 co-payment." 1,500 doctors have agreed to be part of the network, and most of the primary care physicians "agreed to take about $50 for a basic office visit, which is the amount the plan will pay. Specialists will cost patients more." The creators say the plan is "not intended to compete with existing health coverage" (Dorschner, 5/27).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.