GI for Children

[AllenChicago]

Just wrote a family that has a child that has health issues with RX costs of 700 per month. BC rated the boy up 300% ($300) and the family is tickled to death to get the coverage. How can a company write many of these types of cases where the cost for one family members drugs is more than the entire family's premium????

Considering the medication costs, Blue Cross would have rated this child higher if they could have. Since Somarco says that HHS and the ACA is not the reason for the 300% rate-up ceiling, I wonder what authority imposed this limit? Company Policy? State Department of Insurance? If it's an internal BCBS decision, it gives the company a higher stature than the companies that have higher rate-up ceilings...or none at all.

BlueMarlin, what type of BCBS policy did this family get approved for? Was it one with really good prescription coverage built in?
-AC

 

[bluemarlin08]

Yes, 2500 deductible full script co pays with no separate deductible. Talked with 3 other families this morning that we couldn't write previously that will be applying as well. I can't see this working out well for the carriers, especially when 2014 arrives. What will rates look like after a few years of this?

 

[Crabcake Johnny]

What's it going to look like? Research Massachusetts.

 

[HealthGuy]

Maybe Romney can help us then when our health rates jump 500%...Oh the subsidies are supposed to take care of that. I want a Michelle Obama fee health care subsidy voucher. Idiots.

 

[Crabcake Johnny]

Gaming has become an art form in MA. People are buying the highest deductible possible through Carrier A then switching to a low deductible for Carrier B for their upcoming procedure, then it's back to Carrier A for the high deductible.

 

[dgoldenz]

Gaming has become an art form in MA. People are buying the highest deductible possible through Carrier A then switching to a low deductible for Carrier B for their upcoming procedure, then it's back to Carrier A for the high deductible.

I'd do the same thing....can't blame the people for taking advantage of the rules, but you sure can blame the idiots that came up with the system.

 

[VolAgent]

Gaming has become an art form in MA. People are buying the highest deductible possible through Carrier A then switching to a low deductible for Carrier B for their upcoming procedure, then it's back to Carrier A for the high deductible.

I can see the press release now...

We'd like to announce our newest plan offerings, with deductibles as low as $20,000 per person...

 

[Crabcake Johnny]

I totally agree. When stupid systems like this are designed they almost deserve to be gamed.

 

[ins.dave]

Because current Federal law requires these cases to be covered DAY ONE with NO pre existing waiting periods. I don't think the government cares if the big bad insurance company loses money - or maybe that is the plan???

We haven't figured that much out yet?
ABSOLUTELY every piece of legislation is designed to push toward a govt. run system.

 

[somarco]

Gaming has become an art form in MA. People are buying the highest deductible possible through Carrier A then switching to a low deductible for Carrier B for their upcoming procedure, then it's back to Carrier A for the high deductible.

Say it ain't so!

Somehow when carriers try this stuff the lame stream media get their panties in a wad, but when an individual tries the same thing it is OK.

Allen, the limit on rate up is supposedly handled by the DOI. I heard Coventry asked for a 900% max rate up on kids. No word on if it was approved or not.

David, called my GR rep and asked again what the max rate up is. He can't (or won't) tell me. Says it is above his pay grade.

He did tell me that "unlimited" is not an official response. Supposedly neither is, take a guess, if you have to ask you can't afford it or we can tell you but we will have to kill you.

He also said nation wide GR has only had 18 family applications for GI kids. I don't know if that is 18 approved or applied but I suspect approved. When I asked what kind of rate up they got, again he didn't know or wasn't saying.

If waterboarding wasn't illegal now I would seriously give it a try if I thought it would save lives.