We have helped some of our clients apply for the plan, and a few of them have had negative experiences. We are curious how the experience has been for others. If the customer service and application process do not improve, I am not sure if we can continue to recommend the plan to our clients.

If you have applied for and/or obtained PCIP coverage, we would love to hear from you.

How was the overall process for you? Would you recommend the plan to others? How long did it take for you to hear back from PCIP that you were approved? Are you satisfied with the coverage? Are you satisfied with the customer service you have received?

Please leave a comment below or send us an email!

The average annual cost of a nursing home is $80,000 today. Ten years from now that average will be more than $100,000. Per year. How much money have you put aside to pay these bills? Self-insuring for this situation puts your entire portfolio at risk. Fortunately, there is a much better solution, and the sooner you take action, the better.

Long term care insurance is the perfect solution, but don’t wait too long before investigating these plans – many applicants are rejected for a policy due to age-related issues as they grow older. Waiting might be your biggest mistake. These plans are much more affordable than you may think, and when you end up needing the benefits they provide, you and your family will find the plan to be priceless.

If you are an Arizona resident, see our Arizona Long Term Care Insurance Plans link for more information or to receive a free quote for long term care insurance plans. Or call us at (800) 600-9663.

Lehrman Group offers long term care insurance plans in Phoenix, Tucson, Yuma, Scottsdale, Flagstaff and all other Arizona communities.

Below you’ll find an image with data provided by MetLife. It shows what the average daily costs are for nursing homes here in Arizona. The average daily cost for long term care in Phoenix, as of 2009, is $212 per day, or $6,360 per month. In Tucson, the daily cost is even higher, at an average of $221, or $6,630 per month, or more than $79,000 per year. These rates are for a private room. If you share a room with someone else, the daily rate in Phoenix is $169; in Tucson the daily rate is $170 — $5,100 per month or over $61,000 per year.

One out of two Americans over the age of 65 end up needing long term care services. And, here’s a shocker — 44% of all people currently receiving long term care are UNDER the age of 65. Suppose you need long term care services one day — how would you pay for these high costs? Medicare only pays a very limited amount for long term care, and then only for a little while. Your health insurance policy will NOT pay for it. There are only a few ways to pay these high bills: (1) pay for them using your personal savings (which may dwindle your estate down to less than zero); (2) ask your children to pay them; (3) pay for them yourself as long as you have assets and income, and then when your assets have dwindled away, maybe Medicaid will pay. Are any of these good choices for you?

A long term care insurance policy costs less than you may think, and if you end up needing the benefits the policy would provide, you’ll find it to be invaluable. A 60-year-old married male living in Phoenix can purchase a policy that would give him $6000 per month in long term care benefits for around $2500 per year. The older you are, the more it will cost. On the other hand, the younger you are, the less it would cost.

To learn more about long term care plans, give Lehrman Group a call at (800) 600-9663, or click here to get premium rates. Simply complete the small form to request rates, or call us to explore all of the details regarding long term care policies. But do it before you require long term care benefits — no long term care insurance company will sell a policy to you once you need those benefits. That would be like trying to buy home owner’s insurance while your house is on fire.

If you are an ASBA member with the CIGNA plan and are unhappy with your new rate, please contact us at 1-800-600-9663 or click here to fill out our online request form. We will help you look into other more affordable healthcare options. Please note that if you have significant pre-existing conditions, your options may be limited.

For all Blue Cross Blue Shield of Arizona plans, preventative – or wellness – is covered at no charge. All plans also utilize the same network. It’s one of the largest networks in the state. It’s extremely likely your doctor is in it.

Deductible

BlueOptimum Plus is Blue Cross Blue Shield of Arizona’s most comprehensive plan. It’s their “Cadillac” plan, if you will. It is also their most expensive plan, depending on your deductible.

Here are the deductibles available on BlueOptimum Plus:

• $250
• $500
• $1,000
• $2,000
• $3,000
• $5,000
• $7,500
• $10,000

The deductible only applies to major services such as lab work, inpatient and outpatient, ambulance, and hospitalizations.

Copays To See a Doctor

For visits to your regular doctor, you’ll pay a $30 copay. That covers everything that happens during the visit. For visits to a specialist, it’s the same thing, however those visits are a $50 copay. If you need to go to urgent care, you’ll pay $60. If during any visit to a regular doctor, specialist, or urgent care center you are sent to get additional testing done at a separate location, the testing will fall under deductible and coinsurance.

Copays for BlueOptimum Plus:

• $30 for Primary Care Physician
• $50 for Specialist
• $60 for Urgent Care

Coinsurance

The coinsurance on BlueOptimum Plus is 80/20 with an Out-Of-Pocket Maximum (OOPM) of $2,500. This means that after you’ve met your deductible, you are still required to pay 20% of all expenses until you’ve reached your OOPM. If you have a $500 deductible and ended up in a situation in which there was a very large bill, you would never pay more than $3,000 for the year. Any copays you may have paid do not contribute towards the deductible.

Prescriptions

If you need a prescription, BlueOptimum Plus has the richest offering. For generics you’ll pay the lesser of what the pharmacy charges or $15. For name brand prescriptions, what you’ll pay depends on the drug. It wall fall into either a Level 2 Drug for $40, a Level 3 Drug for $70, or a Level 4 Drug for $120. If you are on a certain drug and need to know which Level it is, give us a call and we can find out for you.

Copays for Prescriptions on BlueOptimum Plus:

• $15 for Level 1 (Generic)
• $40 for Level 2
• $70 for Level 3
• $120 for Level 4

Who is this plan for?

If you want unlimited copays for doctor visits, specialists, and urgent care, the best pricing for prescriptions, and a lower Out-of-Pocket Maximum, this is the plan for you. This plan is best for parents who want the most comprehensive coverage possible and don’t mind paying extra for it.

Why wouldn’t I want this plan?

This plan is expensive. In some cases, you end up paying more on this plan in the event of a major medical emergency. For example, using the example underneath the Coinsurance heading with a $500 deductible, 80/20 coinsurance and a $2,500 OOPM, you could be out $3,000 in the event of a major medical emergency. If you jump to a $1,000 deductible, that amount goes up to $3,500 ($1,000 deductible plus $2,500 OOPM). Compare that to Blue Cross Blue Shield’s BluePortfolio Plus 100/0 plan with a $3,000 deductible. For a family of four, BlueOptimum Plus’s monthly premium is $831 while BluePortfolio Plus’s is $446. You won’t get copays for doctor visits on BluePortfolio Plus, but most people aren’t spending $400 per month on doctor visits, which is what you would be saving. Also, BluePortfolio Plus is a 100% plan, meaning once you reach your deductible, there is no coinsurance left to pay.

Conclusion

BlueOptimum Plus is a great plan. It covers everything. It has a low Out-of-Pocket Maximum, generous 80/20 coinsurance, and unlimited copays for doctor visits and prescriptions. It might be the plan for you if you wish to pay more for the most comprehensive coverage Blue Cross Blue Shield of Arizona has to offer. However, what you gain in a comprehensive plan, you make up for in higher monthly premiums. Explore other plans before deciding if BlueOptimum Plus is the plan for you.

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.

Why are the increases so low? Blue Cross has pointed to several factors, including:
• “Successful cost control on behalf of customers”
• “Aggressive control of administrative expenses”
• “A temporary dip in utilization levels, resulting in historically low utilization trends”

In addition to the rate increase, Blue Cross has announced other changes to their policies as well. Benefits that will be affected include emergency room benefits, preventive care, durable medical equipment, vision, nutritional counseling and others.

There are also new rules regarding transfer options (which Blue Cross plan you’re allowed to transfer to without going through medical underwriting).

Existing Blue Cross customers will receive a mailing soon with more details.

For more specific information about these new changes and how they might affect you, please give us a call at 1-800-600-9663.

The major candidates currently running for President in 2012 have each spoken about repealing President Obama’s plan and introducing more competition into the healthcare industry.

Here is a quick breakdown of what each candidate has had to say about our nation’s healthcare system…

• “Obama-care is the greatest intrusion on individual freedom in a generation. This budget-busting, government takeover of health care will rob half a billion dollars from Medicare and saddle America with massive tax hikes and higher costs in the long term.”
• “The first thing the new President needs to do is abolish Obamacare.”
• “Allow the states to compete.”
• “Every state is different. The idea that you can make one size fits all healthcare is nonsense.”

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.

2. AHCCCS

If your income is low, you may qualify for AHCCCS, Arizona’s Medicaid program for low-income residents. The fastest way for pregnant women to apply and begin getting medical treatment is through their program called Baby Arizona.

3. Maternity Packages

Another option for maternity coverage is to purchase a self-pay maternity package from a hospital. Because the insurance companies are all dropping maternity coverage on their individual plans, these self-pay packages are becoming a more popular option. Here is a PDF from Blue Cross Blue Shield of Arizona that lists hospitals offering maternity packages. The rates vary, but for a routine delivery, expect to pay about $3,000-$5,000 for your hospital stay, plus doctor’s fees.

Do you know of any other good options for women who are already pregnant? Got a personal experience to share? Please leave a comment below! There are many women who look at this page and would love to hear from you.

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%.

There are many other factors to consider when shopping for health insurance, and it helps if we know more about your specific circumstances. Such as, do you only need coverage for a short period of time? Do you need maternity coverage? What pre-existing conditions do you have?

If you’d like to view medical insurance rates for yourself and/or your family, please fill out this online form or give us a call at 1-800-600-9663. We have been marketing health insurance products to AZ residents since 1988, and we look forward to helping you.

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.

2. You can’t afford it.
When purchasing a group health insurance policy, you are required by law to pay at least 50% of the monthly premium for each employee. The average employee’s premium costs anywhere from about $150 to $300 a month. So if you have 4 employees, you can estimate that you’ll be paying at least $300 a month ($75 x 4 employees).

3. Choice of doctors and hospitals
When shopping for an individual plan, you can pick the plan you want that will include the doctors and other providers you’d want to use. However, if you purchase a group plan, maybe you will be happy with the doctor selections, but what if even just one of your employees is not? Are you going to select your group plan based upon what your employees decide, or on what you think is best?

4. What if the new business fails?
If your business were to go under, you’d lose your health insurance benefits. It’s bad enough to see your business fail, but do you need the added aggravation of losing your health insurance at the same time? An individual policy is not tied in to your business, and will stay in force as long as you continue to make the premium payment.

5. Paying for benefits you don’t need
Employer group plans have state mandated benefits. When you purchase a group plan, you may be forced to pay for benefits that no one will ever use, such as maternity benefits or very rich mental health benefits. When the group is very small, this can have an impact on your group’s rates. With an individual plan, you can get what you want and not have to pay for medical services that you’ll never use.

Those are a few reasons why a group health plan may not be right for you. There are also many reasons why a group plan may be your best bet. For example, if you and/or your employees are unable to qualify for individual coverage due to pre-existing conditions, group health insurance is probably the way to go. In addition, group plans currently offer the best available maternity coverage.

If you’d like to receive an individual/family quote for health insurance, click here. If you’d like more information about group health coverage for your business, click here. If you have questions, feel free to shoot us an email or give us a call at 1-800-600-9663.