Arizona Health Insurance Brokers Since 1988
Blue Cross Blue Shield of Arizona has released their new rates for existing customers. We are pleased to see that this will be the lowest rate increase Blue Cross has had since 1995.
All members of Blue Cross individual/family products will receive the rate increase. It will go into effect on the annual renewal date of your policy, beginning with October 1st, 2011. For example, if your plan renews on March 15, then you will not receive the rate-up until March 15, 2012.
by Chad Lehrman
If you are already pregnant, no health insurance company in Arizona will give you an individual/family policy. They will make you wait until after the baby is born before they will consider your application.
Here are three possible ways for you to find coverage for your pregnancy in Arizona. Please feel free to give us a call at 1-800-600-9663 with any questions.
1. Group Health Coverage
If you have the option to join a group health plan through an employer, that is probably your best choice. The group plan will be required to accept you even though you are already pregnant, and it will cover your pregnancy right away with no waiting period.
The cost of health insurance for an individual or family in Arizona is based on several factors, including your age, gender, location, and health status.
For example, a family in the Phoenix area (Tempe, Mesa, Scottsdale, etc) pays slightly more than a family in Tucson. And a 50 year old pays more than a 20 year old, due to a higher risk factor.
In addition, there are certain medical conditions that will cause the insurance companies to offer you a higher rate. For example, if you have asthma, high blood pressure or high cholesterol, Blue Cross Blue Shield will probably raise your rate 15%.
You’ve started a small business, so that means you’d be better off switching to group health insurance, right? Well, maybe it makes sense for you, and maybe it doesn’t. Here’s a few reasons why you may be better off hanging on to your individual/family coverage.
1. You have a very small company and you don’t plan on growing much bigger.
If you have a small company with only a few employees, it is probably less expensive for each employee to get his or her own individual policy. Some businesses even offer medical insurance stipends to their employees and it works out well for everybody. If an employee leaves the company, they don’t have to worry about getting on COBRA. They simply keep the coverage they have. And unlike COBRA, which only lasts 18 months, they can keep their policy as long as they like. The main drawback is that if you have an employee that gets denied due to pre-existing conditions, they may be stuck without coverage.
Congress and President Obama have enacted the Patient Protection and Affordable Care Act, a major health care reform bill that will drastically change the U.S. health care system.
As part of the reform bill, new high risk pool plans are being created to help cover people with pre-existing medical conditions. This is called the Pre-Existing Condition Insurance Plan (PCIP).
In Arizona, the new plan is operated by the U.S. Department of Health and Human Services. (In some states, the plan is run by the state itself.)
For individuals, there are only two health insurance plans available in Arizona that provide maternity benefits. Health Net offers a plan, and so does Cigna. However, the Cigna plan is actually quite difficult to purchase because Cigna does not want you to know that it is available.
The rating engine that Lehrman Group uses to calculate our customer’s monthly premium rates has removed, at Cigna’s request, their plan that includes maternity benefits from that rating engine. If you were to go to our web site’s rate request page and get instant health insurance rates for an Arizona policy (by going to http://www.lehrmangroup.com/online-quote.php) you would receive rates for most all of the health insurance plans that we recommend here to Arizona residents, including the Cigna plans that do not include maternity benefits — but their maternity plan has been removed from that system.
As brokers, we can log in to the broker portal web site for Cigna, and we can get rates for their maternity plan that way, and that is the only way. We have spoken with several Arizona-based health insurance brokers who were not aware of this capability — they thought Cigna has simply stopped offering the maternity plan. If this is what professional health insurance agents here in Arizona think, how in the world would the average person know that a maternity plan was, in fact, available from Cigna?
From a cost-outlay and “time until maternity benefits kick in” point of view, we have a much better and less costly suggestion for anyone in Arizona who is shopping for a health insurance plan that includes maternity benefits. Our suggestion is much better and a lot less expensive than either the Health Net or the Cigna option. Give us a call at (800) 600-9663 and we’ll explain that option to you.
Have you been hospitalized recently? If so, did you have health insurance at the time? If you had insurance, did your health insurance agent come to see you while you were in the hospital? Did your agent even know that you were in the hospital? How would he or she know you were in the hospital if you or someone close to you didn’t contact your agent? Did it even cross your mind to contact your agent while you were lying in your hospital bed?
1. “Your deductible is only the beginning.”
Ellen Stephenson, 57, was fully insured when she was diagnosed with an aggressive form of breast cancer eight years ago, so she never imagined she would be on the hook for $100,000 in medical bills. But after meeting her plan’s $3,500 annual deductible, she has to pay another $40 for each doctor visit and another $250 for each test. Over years of treatment, those extra costs have added up, and there’s no end in sight. She’s still being treated for the cancer, which has spread to her pelvis, spine, brain and lungs. “It’s a challenge,” says Stephenson, who was the director of a nonprofit before her illness. “I don’t know what will happen, but right now my physician’s office is very, very kind and is working with me.”
Consumers typically assume that once they meet their health plan’s annual deductible, the plan pays the rest. Not true, says Nancy Metcalf, a senior program editor at Consumer Reports Health, who notes consumers still often have to kick in thousands of dollars in co-pays and other expenses. And those costs seem to be rising.
[This is one of the reasons why we at Lehrman Group recommend HSA-compatible policies. Your out-of-pocket exposure is definitely limited on HSA plans, and you'll always know what your maximum annual exposure is.
2.”We will pay out-of-network expenses.”
Yes, there are times when insurance companies will completely cover care even if it’s provided by an out-of-network provider. That typically occurs when a plan covers the treatment but an in-network provider – often a specialist – is not available close to home or when there’s an emergency and you have to get care at an out-of-network hospital. If you know ahead that you’re going to an out-of-network provider because no one is available in your community, get the insurance company’s permission in writing, says Helen Darling, president of the National Business Group on Health, a nonprofit association of large employers. That way, months later if the insurer disputes the claim, there’s proof of the agreement.
By a very large margin, Blue Cross Blue Shield of Arizona has more policyholders in Arizona than any other health insurance company. They currently insure over 1,300,000 Arizonans. Their provider network, consisting of doctors, hospitals, clinics and more contains thousands providers. Over 80% of all doctors in Arizona and over 90% of all hospitals in Arizona accept the Blue Cross plans.
Blue Cross Blue Shield of Arizona’s rates are usually very competitive, and one never reads anything bad about them in the newspapers. They are a very honorable and reputable company, and have been offering policies here in Arizona since 1939. They support hundreds of charities across the state.
