Archive for the 'Health Insurance' Category

BCBSNC customers now in the drivers seat when it comes to cost information

A newly redesigned Member Services website has recently been launched by Blue Cross and Blue Shield of North Carolina. The website contains enhancements to the “Find a Doctor” search presenting customers with cost and quality information that includes out-of-pocket estimates for 9 non-emergency procedures. The search permits customers to comparison shop for their health care and enables them to make better decisions about costs without giving up quality.

This new website is yet another example of how BCBSNC is constantly searching for better solutions when it comes to lowering health care costs. Now their customers have the information they need so that they can save a substantial amount on their health care.

The following is a link to the news release that includes a short video about the search tool: http://mediacenter.bcbsnc.com/pr/bluecross/bcbsnc-puts-customers-in-the-driver-228024.aspx.

BCBSNC updates growth hormone therapy program with Omnitrope as preferred drug

 A new update has been made to the growth hormone therapy program.  Omnitrope, the preferred somatropin brand, is now the medication of preferred over others.  This drug was selected based on safety, efficacy, delivery device, and cost.

Key Points:

  • On November 18, 2011, Omnitrope moved from Tier 4 to Tier 3.
  • On January 1, 2012, all other growth hormones were moved to Tier 4.
  • By March 1, 2012, any BCBSNC member who is not on Omnitrope will be required to have their physician submit documentation demonstrating a medical explanation on why they should be prescribed a different drug.

 

BCBSNC no longer requires interviews with all parents of newborns

Since April 8, 2011, BCBSNC is no longer requiring telephone interviews with parents of newborns for every application. This change applies to all under-65 individual products. The requirement for telephone interviews with parents of newborns is now being determined on a case-by-case basis during the underwriting process.

Rates for Dental Blue for Individuals and Dental Blue Select Plan remain unchanged

Dental Blue for Individuals and Dental Blue Select Standard rates for complete and enhanced plans have been approved for 2012. There will be no changes to the rates for benefit year January 1, 2012 through December 31, 2012. Please see the attachment below for the rate charts and other important product reminders.

If you have questions about any of the Dental Blue products, please contact your BCBSNC representative.

2012_dental_rates.pdf

New Treatment Cost Estimator initiated by BCBSNC

On August 1, Blue Cross and Blue Shield of North Carolina began a new Treatment Cost Estimator that was created to assist members in their health care decisions by providing them with data on the costs of elective procedures. It will give consumers an estimated range of what a procedure might cost and provide them with information on how the cost will differ based on the physician or hospital they select. The new tool takes the place of the other cost estimation tool and provides cost information to the provider search tool. Blue Cross and Blue Shield of North Carolina joined other Blue plans throughout the U.S. to provide new cost range information for different types of treatments and procedures based on network claims data. The tool can be found on mybcbsnc.com.

This new cost estimator provides average costs for 59 common elective procedures. This information will help members get more informed and be more in control when they make choices about their health care. More information and medical procedures will be added to the tool later in the year. Unfortunately, the tool is not available to members on Medicare Advantage (Blue Medicare), Medicare Supplement, FEP and Dental-only.

BCBSNC decided to introduce the tool because health plans are progressively asking consumers to  make informed decisions about their health care, and consumers often don’t have the information they need to find out how much they will have to pay for a procedure and why. The goal of this new cost estimator tool is to help members as they work with their doctor to make decisions about where to select their health services.

BCBSNC members can use the tool after they log into Member Services online at www.mybcbsnc.com to find information about the cost of the treatment they need. Once they log in using their Member ID and secure password, members can use the doctor or facility search to see the cost ranges of specific practices or facilities.

The Treatment Cost Estimator in Member Services can also be used by members to find out the estimated cost range for many elective procedures, without even choosing a certain physician or hospital.

The tool will be updated every six months in April and October.

BCBSNC has launched a new medical cost campaign

In April, BCBSNC launched a new campaign in hopes of increasing public understanding of what fuels medical costs and to encourage leaders in the health care industry to work together to help bring down surging medical costs. One of their main goals is to reduce administrative costs by 20%.

The material and quality of this unique campaign are different from anything that they have ever worked on before. This campaign recognizes that insurers share in the responsibility to confront soaring medical costs as well as doctors, hospitals, pharmaceutical companies, individuals and attorneys. The campaign emphasizes that all of these groups are capable and absolutely must work together to bring down medical costs.

There are also ways that the general public can help control medical costs. For one, they can ask their doctor to prescribe less expensive generic medications. They can also be vigilant about keeping up with medication schedules and treatment plans that their doctor prescribes. Everyone can and should certainly take advantage of preventive care services. And of course getting and staying active and living a healthier lifestyle are extremely important in helping keep costs down.

You can find more information and discuss your progress at their new website www.Let’sTalkCost.com.

Consumer advocates claim insurance bill is ‘anti-consumer’

 

The new insurance bill will allow people who don’t have insurance coverage to get health insurance. The bill was approved by a panel of North Carolina lawmakers, but consumer supporters believe that the bill is “anti-consumer”. The tension is really escalating concerning the health reform in North Carolina.

The bill will make it so that individuals and small businesses with limited funds, will be able to get affordable insurance.

Democrat Verla Insko says the re-write of the bill performed by the House Health Committee doesn’t do much to help the uninsured. She said, “the bill, as written, is really written for the benefit of the industry and not for the benefit of the people who will be using it.” She drafted an alternative bill that has numerous compromises worked out by a task force that the state convened. She also says that her bill will not get a hearing, claiming that Republicans want to run their own bill with a substantial input from the insurance industry that helped draft it. According to them, insurers have a voting seat on the governing board of the benefits exchange. Consumer advocates, as well as the North Carolina Insurance Commissioner, proclaim that that is a conflict of interest, because insurers will also be competing for business in the exchange.

This said, Lew Borman of Blue Cross Blue Shield of North Carolina doesn’t agree. He said, “whoever is appointed by whatever authority would have to fall under the ethics guidelines that had been passed a couple years ago. And again we believe that insurers add important expertise to the discussion.”

A non-voting seat on the board has been recommended for insurers by the Insurance Commissioner Wayne Goodwin. However, insurers, doctors, hospitals and the business community currently have most of the votes on the exchange board.

While consumer advocates suggest that the bill doesn’t do much to guarantee that the coverage that is offered in the marketplace will really be affordable, Borman, of Blue Cross Blue Shield, says that that is not the point of the legislation. He said, “it meets the federal guidelines and mandates to put together a web-based marketplace. The exchange doesn’t manage costs. This really advertises those costs and those plans across the board from Blue Cross and other insurers.”

Consumer groups are asking that the governing board of the marketplace be able to put a limit on premiums and demand uniform benefit plans so it will be easier for people to be able to comparison shop. The current bill that was approved by the House Health Committee does not do these things. The new measure will be considered by the House Insurance Committee.

Locate an authorized agent in your area

Blue Cross and Blue Shield of North Carolina offers affordable health insurance for individuals and families in North Carolina. Their health plans include Blue Options HSA, Blue Advantage PPO, and Medicare.

Whether you just have some questions or are ready to purchase a plan, click on www.bcbsnc.com/apps/AgentGuidedSelling/ to locate an authorized agent in your area.

BCBSNC to change their prior requirements for specific prescriptions

BCBSNC has made changes to their prior review/certification requirements for certain prescription drugs. The change will take effect on April 1, 2011.

Members who have filled prescriptions for oxymetholone (Anadrol-50), oxandrolone (Oxandrin) or doxepin (Silenor) within the past three months will be receiving letters from BCBSNC this week beginning March 14, 2011.

BCBSNC Bariatric surgery policy for morbid obesity

Bariatric surgery, also called “weight-loss” surgery, is performed to help extremely overweight people to lose weight, attain better health and heighten their quality of life. In the United States alone, morbid obesity has almost risen to epidemic proportions, causing around 11 million to suffer from its crippling effects.

Morbid obesity is defined by a body mass index (BMI) of more than 40 kg/m2 or 35 kg/m2 with related complications such as diabetes, hypertension or obstructive sleep apnea. Those who suffer from morbid obesity are at a substantially  higher risk for different types of cancers and even a shortened life span.

For the Corporate Medical Policy on morbid obesity with Blue Cross Blue Shield of North Carolina, click http://docs.healthplansofnorthcarolina.com/page7/files/Surgery%20for%20Morbid%20Obesity.pdf