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WSJ article on new health plans for early retirees
Old 08-21-2007, 06:39 AM   #1
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WSJ article on new health plans for early retirees

I found this article in the WSJ about new health insurance plans for young folks and early retirees to be worthwhile reading.

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More adults in the 50-to-64 age group also need individual medical-insurance policies these days because of early retirements and layoffs from jobs that included group benefits.
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Old 08-21-2007, 08:55 AM   #2
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Thanks for posting this. I found this factoid particularly relevant to many of us:
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It is also harder for older adults to qualify for coverage in the first place. On average, 11% of applicants who complete the medical underwriting process for individual plans in the 18- to 24-year-old age group are rejected; but 30% of 60- to 64-year-olds are rejected, according to America's Health Insurance Plans, a trade group.
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Old 08-21-2007, 09:58 AM   #3
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And these are only the people who apply. Many don't bother to apply because they know they will be rejected.
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Old 08-21-2007, 09:59 AM   #4
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"Though the new plans could meet some of the needs of a number of young and older people, they won't necessarily reach those among the roughly 45 million uninsured Americans most in need of health coverage. That's because the new plans currently are available mainly in states where looser regulations allow insurers greater leeway to cull prospective policyholders, and thus choose the healthiest people as customers."

While expanding choices is generally a good thing, it seems to me that the net effect of these "new" policies will be to exacerbate the already existing adverse selection problems.
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Old 08-21-2007, 04:14 PM   #5
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"the plans usually have high deductibles of as much as thousands of dollars a year and strip out some coverage that could be important, such as maternity care and brand-name prescription drugs."

The statement above was taken from the WSJ article. This statment kind of cracks me up, because it makes it sound like most other individual health plans (that aren't marketed to the young or Pre-Medicare markets) have this kind of coverage and that the insurance companies are only "stripping out" these benefits, because they know that that's all these groups really need....

..."says John Garamendi, California's lieutenant governor and former insurance commissioner. "It is designed to cover everything that a 19- to 34-year-old is not going to need. That happens to be the principal childbearing age, and it doesn't cover pregnancy," he says."

The above statement is 100% totally incorrect. Individual health insurance plans NEVER have maternity built in, not even on plans targeted to other markets. Maternity is an optional benefit, that you can add to your coverage if you want. To mandate maternity coverage on all individual healthplans would make the cost of individual insurance prohibitive, particularly for the "young and invincibles", who are the target market of these low-cost plans (such as Humana Monogram, Anthem Tonik, etc..). The whole purpose of offering the low cost plans with emphasis on preventive care is to attract more of the "young and invincibles" to buy coverage. They make up a HUGE number of the uninsured population, particularly because they don't see the value in "wasting" money on insurance when they never get sick. When these kids get sick or injured, it usually is a catastrophic claim...all of the other stuff, routine office visits and brand name Rx coverage, is stuff they can usually afford out of pocket.

Personally, I think these plans are a great way to attract 19-35 yr old uninsureds back to the marketplace. These kids don't want or need full coverage healthplans. Catastrophic plans with an emphasis on preventive care is EXACTLY what the need AND want. The Blue Cross Tonik plan even has 100% coverage after copay for ER visits AND preventive dental and vision coverage....John Garamendi from California has no idea what he's talking about. Blue Cross designed the Tonik plan to cover EXACTLY what young people need and want....A very low cost plan with coverage for all of the little things thing that young people need, plus a cap on catastrophic out of pocket.

IMO - John Garamendi's comments are an obvious push to try to get legislation passed that would mandate maternity coverage in the individual market, which would ultimately make individual coverage even more expensive, resulting in even MORE uninsured "young and invincibles".
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Old 08-21-2007, 08:50 PM   #6
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Originally Posted by tomz View Post
Thanks for posting this. I found this factoid particularly relevant to many of us:
Unless you live in Massachusetts where you cannot be denied coverage due to age or pre existing condition.
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Old 08-22-2007, 02:33 AM   #7
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Good article. It is about time that insurers target the market and develop creative solutions.
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Old 08-22-2007, 06:43 AM   #8
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IMO - John Garamendi's comments are an obvious push to try to get legislation passed that would mandate maternity coverage in the individual market, which would ultimately make individual coverage even more expensive
Especially for the men
TJ
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Old 08-22-2007, 08:39 AM   #9
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Especially for the men
TJ
But TJ - Insurance is all about spreading risk. As a man, don't you want to share in subsidizing the cost of teen pregnancy & the pregnancies of all those "young and invincibles" who don't know how to abstain outside of marriage or take the responsibility to use contraception?
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