HealthBlogOne

According to a New York Times article, women are paying more for health insurance than men even though the coverage is identical. And we’re not talking about a small difference. The size and prevalence of these disparities are very surprising, because women are paying hundreds of dollars a year more than men. The reason this is an issue is because of a practice known as “gender rating.” This allows insurers to set different health insurance rates for men and women. Gender rating can happen because there are no federal guidelines governing specific amounts health insurance companies can charge in the individual market. Among states that gender rate, some insurers charge a 40-year-old woman up to 48% more than a man the same age for the same coverage.

Though the sector of women who are buying individual coverage is low because most women receive health insurance coverage from their employers, it is becoming more and more popular. Because of the declining economy, many people are losing their jobs and are being forced to buy individual health insurance on their own. Also, many employers are now ridding their companies of health coverage and instead giving employees a fixed sum to buy insurance in the individual market.

But why charge women more for health insurance than men? The one main reason is that women are more likely than men to access healthcare services, thus providing women under the age of 55 healthcare costs substantially more than men of the same age. Women are more likely to visit doctors, get regular checkups and take prescription medications. Some other factors that force health insurance companies to charge women more than men is maternity care and increased incidence of chronic conditions among women. Some women are even holding off on having children because their insurance policies do not cover maternity care.

Marcia D. Greenberger, co-president of the National Women’s Law Center, has it right: “The wide variation in premiums could not possibly be justified by actuarial principles. We should not tolerate women having to pay more for health insurance, just as we do not tolerate the practice of using race as a factor in setting rates.”

These disparities aren’t only evident in major insurance companies. Disparities have also been evident in state high risk pools, which offer coverage to people who cannot obtain private individual coverage. Most state insurance pools, for high-risk individuals, also use sex as a factor in setting rates. Some facts from the article state that “in Dallas or Houston, women ages 25 to 29 pay 39 percent more than men of the same age when they buy coverage from the Texas Health Insurance Risk Pool. In Nebraska, a 35-year-old woman pays 32 percent more than a man of the same age for coverage from the state insurance pool.”

“Representative Xavier Becerra, Democrat of California, said that “if men could have kids,” such disparities would probably not exist.” I do not think it matters whether men can bear children or not. We live in the 21^st century and it’s about time women are treated equally, especially when it comes to health insurance. Health care is a human right, every women in the country deserves it. And they deserve it at the same price as men.

HealthAmerica and HealthAmerica Advantra’s HMO, POS, and Medicare Advantage plans rank among America’s top 20 health plans. This ranking was made by U.S. News & World Report in conjunction with the National Committee for Quality Assurance (NCQA). HealthAmerica was ranked 12^th among 287 commercial plans and HealthAmerica’s Medicare Advantage plan, Advantra, was ranked 18^th among 216 plans nationally.

So why were they ranked among America’s top 20 health plans? For 13 consecutive years, HealthAmerica’s HMO product and HealthAssurance’s POS product were both awarded “Excellent” accreditation from the NCQA. They’re HMO and POS are number 1 in 8 of 15 key measures. They have received the highest scores in:

·         Well-child visits for members 3 to 6 years old

·         Well-child visits for members over 6 years old

·         Beta blocker after a heart attack

·         Prenatal care in the 1^st trimester

·         Cervical cancer screening

·         Screening and testing of adults with diabetes

·         Controlling hypertension (high blood pressure)

·         Cholesterol screening for patients with cardiovascular conditions

HealthAmerica provides its members with a greater combination of health benefits and services for their money suitable to their needs and wants. They offer more health benefits, like coverage for most preventive health services, including periodic checkups, coverage for hospital and surgical care, emergency care worldwide, and chiropractic services. They offer access to over 35,000 providers in Pennsylvania and Ohio and more than 350 hospitals.  As a member, you are also entitled to the WellBeing program. This program offers free wellness programs and discounts on a wide range of products and services such as:

·         QualSight LASIK Discount Program

·         Weight Watchers

·         GlobalFit fitness network

·         Healthy Living and Wellness

·         Health Education Reimbursement

·         Wellbeing fitness clubs, acupuncture, and massage discounts

·         Personalized Health Improvement

·         EyeMed Vision Care Vision One EyeCare Discount Program and LASIK Vision Correction

With your health plan you also get 24 hour assistance. You can call and talk to a Member Service Representative and get answers about any question you may have with convenient hours during the week and on the weekends. The website is always available for health information. My Online Services is a feature that allows you to manage your personal health care transactions anytime it’s convenient for you.

They have a wide variety of other products, employee health benefit plans, and value-added services. With the ability to customize benefit programs that meet your needs, you can choose from HealthAssurance Coordinated Care PPO (POS), HealthPass/HealthAssurance PPO, HealthAssurance FlexChoice, and HealthAmericaOne Individual plans.

HealthAmerica’s health insurance plans can help you get the coverage you need. They are known nationwide for their service and quality and in result they have achieved the recognition of top rank in health plans. HealthAmerica’s commercial plans were rated higher than the national average in all 15 key measures of medical services and member satisfaction. The plans were also ranked higher than the Pennsylvania state average in 12 of the 15 key measures.

Aetna Health Insurance has teamed up with the AARP to present the AARP Essential Premier Health Insurance. This product is custom-designed with employer-like benefits for AARP members that are aged 50-64 to bridge the gap between employer coverage and Medicare. What makes this plan unique is the dependent coverage it offers. This is available to children, grandchildren, and dependent relatives.

The reason for the foundation of this type of insurance was to ensure that retirees, sole proprietors, and individuals not eligible for Medicare are insured. Since fewer employees are offering benefits to retirees there is the need for this option of health insurance.

A study done by Aetna, received from a U.S. Census report, shows that 14% of people ages 45-64 are uninsured. These unique products help target the many people who have difficulty getting health insurance. The biggest problem has been found in Georgia, where 17% of the population is uninsured.

You can select from a variety of plans including their quality Premier plans or Preventive and Hospital care plans. High deductible plans are compatible with tax advantaged HSAs (Health Savings Accounts). There are a total of 7 plan options to choose from within the three above plans. The Premier plans combine affordable medical coverage with prescription drug and hospitalization coverage. Members may choose in or out of network doctors and can choose from annual deductibles of $1,500, $2,500, and $5,000. The Preventive and Hospital plans include a physical exam, an annual ob-gyn exam and well child care. The plans also provide inpatient hospital coverage. Coverage for the above plans is nationwide so consumers do not have to worry when they are travelling.

AARP Essential Premier Health Insurance plans have special programs in addition to the standard health insurance coverage offered. Members can receive the Aetna Rx Home Delivery which allows them to order their medications through a mail order pharmacy. Other features include weight management programs, an informed health line with 24/7 access to health care answers, and the Aetna Natural products and services programs which allows eligible members to access complementary health care products at reduced rates. These products and services include massage therapy, dietetic counseling, acupuncture and chiropractic care. Some of the insurance plans also provide AARP Vision Discounts at no additional cost as well as pharmacy savings.

The AARP Essential Premier Health Insurance products are currently available in 31 states and Washington, D.C. They are sold in Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Maryland, Michigan, Mississippi, Missouri, Nebraska, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wyoming and Washington, D.C

This is a great insurance option for AARP members. In this state of the economy, many “baby boomers” are being laid off because of the younger, college graduates who aren’t requesting as much money. It is getting harder and harder for retirees to maintain the health coverage they received when they were working so I’m sure the AARP Essential Premier Health Insurance is going to be a huge hit with the baby boomers.

Health Net, one of the largest health insurance carriers in the country, based in Woodland Hills California, recently settled an agreement with the State of California to pay $25 million as compensation for recently dropping the health coverage of close to 1,000 customers who tried to make use of their healthcare policies. In addition, the company will now offer coverage to 926 customers who were dropped between 2004 and the present year.

The company has pledged to repay up to $14.2 million in outstanding medical expenses as well as waive up to $7.2 million in insurance premiums. The remaining $7.2 million will be paid as a fine to the California Department of Insurance.

Health Net is not the only insurance carrier who has been accused of practices such as these. Critics of several large insurance companies argue that the insurers use insignificant application errors as justification for later dropping policy members as soon as costly bills come in. This process is known as rescission and it is the larger health insurance companies that have been accused of practicing it inappropriately. The state Department of Managed Health Care has already reached similar agreements with Anthem Blue Cross and Blue Shield as well as PacificCare and Kaiser.

Although Health Net is not the only company that has been exposed for rescission, it does seem to have set a precedent for the others. In February, Health Net was ordered to pay more than $9 million for dropping a breast cancer patient in the middle of chemotherapy; this ruling was the first of its kind. At this time, Cindy Ehnes, the director of the state Department of Managed Health Care was quoted in the Los Angeles Times as “pleased the courts are joining us, along with the public, the media, other regulators and elected officials in demanding the industry clean up its act.”  In February, Health Net pledged to change their coverage applications and retrain their sales force. Apparently this did not solve the problem, but Health Net has once again made promises to improve the quality of its consumer relations.    

In fact, Health Net did not admit to any wrongdoing, but instead settled the agreement as an attempt to move forward, despite the recission allegations, and once again focus on giving their customers reliable, affordable health insurance. Additionally, the company gave their assurances that in the future they will notify customers if their application information is being investigated. For future rescission decisions, the company will consult a third party.