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Six United States insurance companies intentioned in ‘cleaning’ investigate
Six of the great health insurance companies in the U.S. have be given letters from U.S. Rep. Henry Waxman, D-Calif., looking for factors about their ways toward small businesses.
Louisville-based Humana Inc. is between six health insurers that have received letters. The other insurers that received letters were Aetna Inc., UnitedHealth Group Inc., WellPoint Inc., Medica and Wellmark Blue Cross Blue Shield.
Waxman is investigating an industry practice called “purging,” in which insurers drop coverage for sick individuals when they become too expensive to insure. “We are now looking into the practice of health insurance companies terminating the coverage of small businesses when their employees become ill and their health insurance claims increase,” Waxman said in a statement released by the House Committee on Energy and Commerce, which is chaired by Waxman.
“We need to better understand how widespread this harmful and destructive practice has become and how it is impacting small businesses and their employees across the country." Waxman suggested in the statement that health insurers will terminate coverage to small businesses by canceling their policies or raising premiums until they are unaffordable.
Officials with Humana could not immediately be reached for comment.
The Associated Press reported Monday that in response to the letters, America's Health Insurance Plans, a trade group that represents the companies, said Waxman's investigation was designed to smear private insurers and bolster support for a public insurance option.
The committee is asking for information and documents for small-group policies, consist of their renewal rates, factors applied to determine premium rates and the maximum premium rate boosts.
Health Insurers Walk Around Savings In Overseas Care
Elizabeth Kunz left her dentist’s office this spring with a mouth full of problems and no way to pay for them. The South Carolina resident went out of her way, factually, to discover an answer, which rolled out to be in Central America. Her tour to the tropics is a piece of a health insurance test for trimming medical fees: overseas care. As Washington explores for methods to tame the country’s increasing health care fees, more insurers are proposing networks of surgeons and dentists in nations like India and Costa Rica, where costs can be as much as 80 percent less than in America. Until recently, most Americans traveling abroad for cheaper non-emergency medical care were either uninsured or wealthy. But the profile of medical tourists is changing. Now, they are more likely to be people covered by private insurers, which are looking to keep costs from spiraling out of control. The four largest commercial U.S. health insurers — with enrollments totaling nearly 100 million people — have either launched pilot programs offering overseas travel or explored it. Several smaller insurers and brokers also have introduced travel options for hundreds of employers around the country. Growth has been slow in part because some patients and employers have concerns about care quality and legal responsibility if something goes wrong. Plus, patients who have traditional plans with low deductibles may have little incentive to take a trip. But a growing number of consumers with high-deductible plans, which make patients pay more out of pocket, could make these trips more inviting. In the meantime, the insurance industry’s embrace of overseas care has had a pleasant side effect at home: some U.S. care providers are offering price breaks to counter the foreign competition. This domestic competition and the slumping economy have led to slower growth for medical tourism over the past year, as patients put off elective procedures that involve big out of pocket costs, said Paul Keckley, executive director of the Deloitte Centre for Health Solutions. Last year, the centre estimated that 6 million Americans would make medical tourism trips in 2010. But Keckley has since shaved that projection to about 1.6 million people. Still, that more than doubles the roughly 750,000 Americans who traveled abroad in 2007, the last year for which Deloitte had actual numbers. Keckley expects the medical tourism industry to recover, as more health insurers offer the option and as more people wind up with high-deductible plans. Health care costs for employers who offer insurance to their workers were projected to rise 9.2 percent this year and another 9 percent in 2010, according to the consulting firm PricewaterhouseCoopers. That could mean double-digit percentage increases for employees through higher premiums, deductibles or co pays. Overseas care can lead to price breaks of more than $40,000, not counting travel costs, for procedures like knee replacement surgery or heart bypasses. Insurers, or employers who provide their own insurance, can save between 50 percent and 90 percent on major medical claims, said Jonathan Edelheit, president of the Florida-based Medical Tourism Association. A lower cost of living and lower prices for medical supplies and drugs help drive down care costs overseas compared to American providers. While employers or insurers reap much of the savings, these lower costs can be the difference between a manageable expense and a bank-breaker for patients with high-deductible plans. These increasingly popular plans can lead to out-of-pocket expenses surpassing $5,000 for individual coverage and $10,000 for family plans. High out of pocket costs also are common with dental coverage, which is one reason dental care trips have proven popular. Kunz, 47, initially doubted the potential savings she might see from visiting a Costa Rican dentist though a program offered by her insurer, BlueCross BlueShield of South Carolina. But a little comparison shopping — with help from the insurer — persuaded her to get on a plane. She had eight crowns replaced, a tooth filled and root canal. The work would have cost her $10,000 out of pocket back home, but she paid just $2,800 after insurance. Ben Schreiner of Camden, S.C., would have paid the entire $10,000 deductible on his insurance policy if he had his hernia surgery done last year near home. For that reason, Schreiner, 63, had planned to wait until he turned 65 and qualified for Medicare before fixing it. After reading about medical tourism in his insurer’s annual report, the retired bank executive flew to Costa Rica and paid about $4,400, including travel expenses. Frequent flier miles covered his flight. Schreiner said he was initially skeptical about the quality of care he might receive but reading about the doctors who could perform the surgery put him at ease. “When you read the bios and the backgrounds of the doctors, you kind of lose your skepticism,” he said. However, apprehension about medical travel remains a high hurdle. “People still do not understand that there could be a hospital in Thailand that can be as good as any hospital anywhere in the world or in the United States,” said John Ferguson, chief marketing officer for Georgia-based BasicPlus Insurance Services. BasicPlus, which guarantees and supplies group health insurance plans to employers, begin offering health tourism as part of a advantages package last year. About 200 employers it contracts with around the country now present that choice, but no patients have applied
Youtube.com Video:Why Health Insurance Cost So Much! Wake Up America # 7
Smart Tips To Getting The Best Homeowner's Insurance
According to the editors of Consumer Reports National Research Center “no” is might be the most people answer of the question of “Will your insurance company be there for you in the aftermath of a disaster, when you most need it?” When Consumer Reports National Research Center surveyed readers about their homeowners insurance claims in the last few years, half of those who had filed claims speak about to Hurricane Katrina reported troubles. That's twice the rate of problems reported by other readers. Even if you're nowhere near a hurricane zone, you could face catastrophe in the form of fire, wind damage or a lawsuit. It's in those dire situations that you truly need coverage that lives up to its promises. Yet CR's evaluation of home insurers found that doesn't always happen. Here are the highlights of CR's findings: • Excellent coverage can be costly or hard to get. • There are claims problems with some large insurers. In CR's survey, 35 percent of Allstate Insurance Group clients reported such problems with that carrier, the nation's second-largest. • Delayed payments are common. Twenty-one percent of respondents said they faced delays having claims paid. • Insurers are scaling back coverage. They are imposing high deductibles for windstorms in many places and cutting coverage for mold and dog bites. Tighter underwriting If you haven't shopped for homeowners coverage lately, be prepared: The landscape has changed. Insurers are getting pickier about whom they will take and whom they will keep. And they're using new tools to determine who will get the best price. An increasingly important pricing factor is your credit-based insurance score, which includes some of the elements that make up your credit score. The industry maintains that there's a correlation between credit history and the likelihood you will make a claim. To get the best price from a new carrier, you will need a stellar record. Dos and Dont's To get the best value and protection from your homeowners policy, CR recommends following these rules: • Compare prices. Every five years or so, shop for the same level of coverage, including deductibles, policy limits and riders. Check sites such as www.netquote.com or www.insweb.com. • Bundle your coverage. Buy several policies -- home, auto, boat -- from the same insurer to save up to 15 percent on all policies. • Raise your deductible. Going from $500 to $1,000 can save you up to 25 percent on the overall premium. • Clean up your credit report. An insurer viewing a mistake on your report could deny coverage or place you in a more costly price tier. • Maintain and upgrade your home. Fire and smoke detectors, burglar alarms and dead-bolt locks can cut as much as 20 percent off the premium. • Stay with your current company. If your insurer's rates are competitive, you might save by staying. Companies often give discounts for loyalty. • Do a home inventory now. Experts say one of the most difficult parts of the claims process is recalling lost or stolen items and papers. • Don't file small claims. Insurers can raise your premium or even drop you for making, say, two claims in two years. • Don't call to discuss whether to file. Even if you decide not to make a claim, your inquiry could end up in your claims record as an incident, making you vulnerable to a premium increase. • Don't smoke. You'll incur higher premiums.
