Focus, Government, and Health Care

The Blues and Priority Health step into the health exchange fray

Lots of time and money is spent on promotion, but who really needs coverage?

October 4, 2013
| By Pete Daly |
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Blue Cross Blue Shield
Health care costs are affected by health care providers passing on the cost for caring for the uninsured to the insured. Courtesy Thinkstock

Blue Cross Blue Shield of Michigan wants everyone to know it is the only health insurance company offering coverage in all 83 Michigan counties on the federal Health Insurance Marketplace that opened Oct. 1 — and it also brags about its low prices.

Priority Health announces it has partnered with grocery giant Meijer to help consumers learn their options under the historic Affordable Care Act, which is intended to get practically everybody in America covered by health insurance they can afford.

The two are among 14 insurance carriers participating in Michigan’s Health Insurance Marketplace. The others are Alliance Health and Life Insurance, Consumers Mutual Insurance of Michigan, Health Alliance Plan, Humana Medical Plan of Michigan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Total Health Care USA and UnitedHealthCare.

With all of the information — and marketing, advertising and “branding” — flooding the public consciousness, how will consumers make a choice?

First, don’t panic.

“Americans have three months to explore the best health insurance coverage options for themselves, their families and small businesses,” said Lisa DeMoss, director of the Master’s of Law program in insurance at Cooley Law School and a former vice president and general counsel for BCBSM.

“It costs nothing to shop for coverage on the state and federally facilitated exchanges and, so long as you enroll in coverage by Dec. 15, 2013, you will be covered on Jan. 1, 2014. You may enroll after Dec. 15 and before March 15, and still avoid the penalty for failure to acquire minimum essential coverage in 2014. Individual plan coverage will go into effect on the first day of the month for any application processed before the 15th day of the preceding month.”

She said the best way for small group employers and consumers to determine how they and their families or employees will be impacted by these changes is to spend some time investigating the options online at healthcare.gov or on the applicable state exchanges.

BCBSM and its affiliated HMO, Blue Care Network of Michigan, claim to offer some of the lowest-priced plans across Michigan’s 16 rating regions. According to BCBSM, in the majority of counties in Michigan, BCBSM or BCN bronze and silver plan options are among the lowest priced premiums on the marketplace. The plans and prices are available on the government’s website.

Both Priority Health and Meijer are based in West Michigan, and Meijer has a lot of pharmacies in its supercenters scattered across Michigan, as well as several other Midwestern states. In an announcement last week, Meijer said that Priority Health, “Michigan's leading health plan,” has joined with it to unveil a “Health Reform and You!” website (www.meijer.com/aca). It is also providing informational brochures for customers at 203 Meijer pharmacy locations in Michigan, Ohio, Indiana, Illinois and Kentucky.

“We know patients will have questions about their health care, and we consider it important to be able to help them get the answers they need regarding the Affordable Care Act,” Meijer Drug Store Vice President Nat Love said. “Meijer is committed to providing options to help our customers lead healthier lives. We want to help them find the information they will need to make the best choices for the health care of their families while addressing any questions or confusion they may have.”

But does all of this posturing really matter for the majority of customers? Not really, according to Monica Navarro, a Cooley health law professor and a council member of the State Bar of Michigan Health Law Section.

“There are many misperceptions about who needs to do something when the health insurance exchanges roll out … in order to avoid the individual mandate penalty. Most people have to do nothing. The 80 percent of Americans who already have health insurance through work or who are enrolled in a government program like Medicare or Medicaid don't have to do a thing. For these people — the vast majority of the population — the individual mandate (is) a non-event.”

As of Oct. 1, anyone without access to an employer-sponsored insurance plan is able to purchase coverage online on the Health Insurance Marketplace. Consumers can compare plans and decide which medical coverage to purchase. The Marketplace also indicates if an individual is eligible for tax credits to help pay for the insurance or for subsidies to help reduce out-of-pocket costs like deductibles and co-pays.

“By partnering with Meijer, we are leveraging our joint commitment to provide consumers with the tools and information they need to navigate this new era of health care,” said Marti Lolli, director of health reform at Priority Health.

But the Blues also are jumping up to help consumers get the lowdown on what to do. Terry Burke, BCBSM vice president for individual business, said the Blues and Blue Care Network “have worked very hard to put affordable health insurance options in front of Michigan consumers as uninsured people and small employers” began open enrollment Oct. 1.

The Blues said they will offer a total of 18 options for coverage on the Health Insurance Marketplace through independent Blue-certified insurance agents and directly through BCBSM and BCN.

“The Affordable Care Act has significantly changed what health insurance covers, how it’s sold and what it costs. With the marketplace now open, consumers will be able to choose from 18 competitively priced Blues products, with options available to Michigan residents in every county,” Burke said.

The Blues said the ACA offers “more access to richer health benefits for more people.” Essential Health Benefits are required of all carriers, and more preventive services will be covered in every carrier’s offering. Carriers may not turn individuals away based on health status or pre-existing conditions.

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