Blue Cross, Blue Shield To Offer Limited-Benefit Plan To Employers

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Limited-Benefit Plan

Anthem Blue Cross and Blue Shield on Wednesday announced plans tobegin 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, aswell 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 theindividual health insurance market, cost 70% less than those for a comprehensivePPO plan. Under the plan, employees have annual deductibles of between $1,000and $5,000 for single coverage and between $3,000 and $15,000 for familycoverage. After employees reach the deductible, they have to make a $20copayment and pay 50% of the total cost for physician visits and make a $150copay and pay 20% of the total cost for emergency department visits.

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

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

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