INScompanies Blog

Employers with workers outside area can benefit from Blue Precision 

OWINGS MILLS, MD (November 13, 2006) – CareFirst BlueCross BlueShield (CareFirst), in conjunction with Blues plans across the country, has developed a new health plan that will provide a lower-cost option for national accounts – employers with multiple business locations or employees around the United States.  Blue Precision will give national account members access to custom networks of health care providers assembled by local Blues plans and result in lower costs for employers and reduced out-of-pocket costs for members.

National account members currently have access to care through the national BlueCard network of providers.  Beginning in January 2007, Blue Precision will offer custom local networks in 26 states and the District of Columbia.  Blue Precision members using the local network will have the least out-of pocket costs, with most benefits subject to a copay only.  Members will be responsible for a greater share of costs if they choose to use BlueCard or out-of-network providers.  By making available local networks of high-quality, cost-effective health care providers, employers and members will be better able to control health care costs.

“Blue Precision allows our national account members to take advantage of perhaps the biggest benefit of the Blue Cross Blue Shield family – unmatched local and regional health care networks around the country,” said Gregory A. Devou, CareFirst Executive Vice President and Chief Marketing Officer. “Employers and the employees and families they cover are looking for ways to control health care costs, and Blue Precision will give national accounts and their members a new and effective way to do just that.”

In the CareFirst service area (Maryland, Washington, D.C. and Northern Virginia), Blue Precision members will have access to the company’s CareFirst BlueChoice health maintenance organization (HMO) network along with the broad networks already available to national accounts through BlueCard.  BlueCard allows Blue Cross Blue Shield members to seek treatment from health care providers in Blues plans’ networks around the country.

Blue Precision has an open access format, so members do not have to obtain referrals to get coverage from specialists. Members do not have to choose a primary care physician, but are encouraged to use providers in the custom network, or first tier, to keep out-of-pocket costs to a minimum.

National accounts with 200 or more enrolled members must have a physical location in at least one other Blues plan’s service area, and at least 20 enrolled employees living in another plan’s service area are eligible to opt for Blue Precision.

In its 71st year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to nearly 3 million individuals and groups in Northern Virginia, the District of Columbia and Maryland. Through its CareFirst Commitment initiative and other public mission activities, CareFirst supports efforts to increase the accessibility, affordability, safety and quality of health care throughout its market areas.

Coverage of Generics During “Doughnut Hole” Period Now Offered 

OWINGS MILLS, MD (October 16, 2006) – Medi-CareFirst BlueCross BlueShield (Medi-CareFirst), a CareFirst BlueCross BlueShield affiliate, will now offer an option to cover the so-called “doughnut hole” in the Medicare Part D plan for beneficiaries. The Centers for Medicare and Medicaid Services (CMS) has approved Medi-CareFirst’s contract for 2007, enabling the insurer to offer Medicare Part D prescription drug products to beneficiaries in Maryland, Delaware, and the District of Columbia.

Legislation enacted by Congress establishing a new voluntary Medicare prescription drug benefit provides for coverage up to the first $2,400 in total drug purchases in 2007, after which the beneficiary is totally responsible for any drug purchases up to $3,850 in out-of-pocket spending  — a period known as the “doughnut hole.”  Above that amount, 95 percent of drug expenses are covered for the rest of the year.

Medicare beneficiaries will be able to enroll in a Medi-CareFirst plan between November 15 and December 31 this year. Two products are available this year - Blue Rx Standard and Blue Rx Enhanced.  The first, Blue Rx Standard, is a standard product carrying a $34.20 monthly premium.  The new product offering for 2007, Blue Rx Enhanced, provides seniors and disabled individuals covered by Medicare with doughnut hole coverage for a $42.20 monthly premium that covers all generic drugs throughout the coverage gap.

“We realize how important it is for seniors to feel secure in their health care benefits, and providing them coverage in the doughnut hole is a high priority,” said Gregory A. Devou, CareFirst Executive Vice President and Chief Marketing Officer. “As always, Medi-CareFirst BlueCross BlueShield is available to help seniors navigate what can be a confusing process.”

In another program change, the little-used prescription drug mail order option has been eliminated.  Enrolled seniors will now have the option of getting a three-month supply of their medications at their local pharmacy.  As an added benefit, three-month supplies will be available for the cost of two monthly copays – providing additional savings over the course of the year.

Medi-CareFirst is offering informational seminars at various locations throughout the Maryland, the District of Columbia and Delaware during October, November and December. In addition, outreach and sales staff will be available at numerous state and county-sponsored events throughout the region.

Newly eligible Medicare beneficiaries may still enroll after the December 31 deadline for the Annual Election period.  However, current Medicare beneficiaries who do not enroll by December 31 will have to wait for the next Annual Election enrollment period, November 15 through December 31 of 2007.  Those beneficiaries who wait to enroll past their initial eligibility period will have to pay a 1 percent penalty for life for every month they did not have coverage that was equally as good as Medicare prescription drug coverage. Newly eligible Medicare beneficiaries who first became entitled to Medicare October 1, 2006 and later can still enroll after December 31 without a penalty as long as they enroll within their 7-month initial eligibility window (three months prior to eligibility, the month of eligibility and three months after eligibility).

“We recommend that people enroll online at www.medi-carefirst.com or over the phone at 1-888-784-0790,” said Devou.

Medi-CareFirst is the only Blue Cross Blue Shield-licensed Medicare Part D plan offered in Maryland, Washington, D.C. and Delaware. More than 32,000 individuals are enrolled in a Medi-CareFirst plan, and they will automatically be re-enrolled in the Blue Rx Standard plan, with the option of enrolling in the new Blue Rx Enhanced plan.

Medi-CareFirst BlueCross BlueShield is the trade name of First Care, Inc., which like its affiliate CareFirst BlueCross BlueShield (CareFirst), is an independent licensee of the Blue Cross and Blue Shield Association.  CareFirst is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to nearly 3 million individuals and groups in Northern Virginia, the District of Columbia and Maryland. Through its CareFirst Commitment initiative and other public mission activities, CareFirst supports efforts to increase the accessibility, affordability, safety and quality of health care throughout its market areas.

High deductible HMO to be paired with funding arrangements 

OWINGS MILLS, MD (October 3, 2006) – Area consumers seeking to combine the traditional benefits of Health Maintenance Organizations (HMOs) with the added control and tax advantages of consumer directed health plans (CDH) will soon have a new option.  Starting October 1, CareFirst BlueCross BlueShield, along with CareFirst BlueChoice, Inc., is rounding out its CDH portfolio, known as BlueFund Plans, with a high-deductible HMO paired with savings options.  The product will be available in Maryland, District of Columbia and Northern Virginia.

The plans will be CareFirst’s first Health Savings Account compatible HMOs offered in the individual market. CareFirst launched HMO BlueFund plans for groups earlier this year.

The lower-premium, high deductible HMO-based plans, called BlueChoice HSA, encompass tax-friendly medical funding arrangements to be used to help cover health care expenses, along with the interactive tools members need to manage their money and to receive health and wellness education. Out-of-pocket expenses associated with each member’s prescription drug benefits are also applied against the high deductible HMOs.

Health Savings Accounts (HSAs) are funded by the member. Any year-end balances from either of the accounts roll over from year to year, and HSAs are portable. . Contributions to the HSAs can be made with pre-tax dollars, post-tax contributions are tax deductible, and contributed dollars can earn interest tax-free. HSAs are offered through CareFirst’s preferred bank, The Bancorp Bank.

Members can manage and track their HSA online at the www.myhsabankaccount.com  member portal, which also offers interactive tools members can use to educate themselves on various aspects of health and wellness. With these tools, and understanding that they are now accountable for more of their health care expenses, members will have a better grasp of the true cost of health care and therefore greater motivation to ensure that their health care dollars are spent responsibly. Tools include the new internet hospital comparison tool, provided by WebMD Quality Services, which enables CareFirst members to compare treatment outcomes for 165 specific diagnoses and procedures for up to 10 hospitals at a time.

Individuals may choose an HSA with CareFirst’s preferred bank, The Bancorp Bank, or set up an account with their own bank. BlueChoice HSA members who enroll with The Bancorp Bank will also receive a new CareFirst BlueCross BlueShield debit card, enabling them to quickly and easily withdraw money directly from their HSA account. Members can visit www.carefirst.com, which provides interactive online tools to learn about various aspects of health and wellness, and The Bancorp Bank allows members to manage and track their account through www.myhsabankaccount.com. These tools enable individuals to get a better grasp of the elements contributing to health care costs.

“By adding an HMO-based plan, CareFirst has given consumers another affordable option with BlueFund’s one-stop shop appeal,” said Gregory A. Devou, CareFirst Executive Vice President and Chief Marketing Officer. “We are providing consumers the tools they need to make informed decisions about their health care, and ensuring they get the best care possible.”

Both medical and prescription drug coverage are combined under one deductible for members who have purchased a high deductible HMO with both medical and prescription drug coverage. Most preventive care is 100 percent covered, although a copay may apply in certain instances. Group members may get their care from any doctor in the CareFirst BlueChoice provider network.

Guidelines on what qualifies as acceptable medical spending of the HSA funds are listed in Section 213 of the federal tax code.  More information on HSAs is available at http://www.treas.gov/offices/public-affairs/hsa/. Once established, any money from the HSA that is withdrawn for purposes other than qualified medical expenses is taxed as ordinary income plus a 10 percent penalty.  The additional penalty is not assessed in similar situations for individuals after the age of 65.

In its 71st year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to nearly 3 million individuals and groups in Northern Virginia, the District of Columbia and Maryland. CareFirst BlueChoice is a for-profit affiliate under the control of CareFirst, Inc.  Through its CareFirst Commitment initiative and other public mission activities, CareFirst supports efforts to increase the accessibility, affordability, safety and quality of health care throughout its market areas.