HARTFORD, Conn. – September 20, 2008. – Aetna announced that it has contracted with Maxim Health Systems for the fifth year in a row to administer influenza vaccinations (flu shots) to all members enrolled in its health benefit plans. In addition to receiving the vaccination from their physicians, Aetna members will have the option to get their flu shot at one of Maxim’s more than 25,000 sites in retail facilities and corporations, as well as other clinics across the country. The flu shot clinics will begin on October 1 and continue through mid-November 2008.
“We want to make it as easy as possible for our members, especially those in the high risk groups for influenza, to take this important preventive step,” said Troyen Brennan, M.D., Aetna’s chief medical officer. “These flu shot clinics allow our members and their families to find times and locations that are convenient for them.”
To find a Maxim flu clinic, members can go to a website Maxim has set up (www.findaflushot.com) and enter their zip code and the distance they want to travel. They can also call a toll-free phone number (1-866-466-2976) to help locate a clinic or obtain information about the flu shots in either English or Spanish.
Assurant Health has removed waiting periods for the treatment of tonsils, adenoids, hernias, bunions, hemorrhoids, and varicose veins have been removed from the contracts for new policies effective
November 1, 2008 and later.
Assurant Health is expanding the 24 month and 36 month rate guarantee buy-up option on OneDeductible and SaveRight plans. The rate guarantee option locks in the premium rate for up to 36 months. The following OneDeductible and SaveRight deductible levels have an initial 12-month rate guarantee and now include the 24 or 36 month buy-up options:
OneDeductible: $2,100 individual deductible/$4,200 family deductible
$2,850 individual deductible/$5,700 family deductible
SaveRight: $2,200 individual deductible/$4,400 family deductible
$3,000 individual deductible/$6,000 family deductible
Seniors enrolled in Medicare’s drug benefit will pay average monthly premiums of $28 next year, government officials announced today.
That’s about $3 higher than the 2008 average premium, or a 12 percent increase.
“Average plan bids have increased at roughly the same rate as drug costs,” said Paul Spitalnic, an official with the federal Centers for Medicare & Medicaid Services.
Premiums are set by the private plans that offer drug benefits under Medicare and will vary depending on the plan and location.
The average increase affects nearly 25 million Medicare beneficiaries — 7.6 million in Medicare Advantage plans with comprehensive coverage and 17.4 million plans that cover only drugs.
While officials said the premium increase was well below projections, advocates noted that it exceeds the annual cost of living increase for Social Security, which remains under 3 percent.
The problem is “the government is failing to do anything about the runaway prices that Americans pay for drugs” because it won’t negotiate price discounts directly with drug companies, said Robert Hayes of the Medicare Rights Center.
The annual enrollment period for Medicare Part D begins Nov. 15 and extends through the end of the year. This is the only time of year that seniors can elect to change their plans.
For 2009, the annual deductible for Part D plans (the amount consumers pay before coverage kicks in) will be $295. Once you pay the deductible, your Medicare Part D plan will pay 75 percent of your drug costs up to $2,700.
Then, you enter the so-called “donut hole,” and you’re responsible for 100 percent of your drug costs up to $6,153.75. After that, the government will pay 100 percent of your drug bills.
In other words, you could end up paying $4,350 in 2009 out-of-pocket for drug expenses before Medicare will take over paying for all your drugs.
In Illinois, seniors with low incomes will want to make sure they consider applying for assistance that can help cover these extra expenses. For more information about Illinois Cares Rx, one of these programs, click here. To obtain this assistance, you have to work with a Medicare drug plan that partners with Illinois Cares Rx.
If you’re very low income, you probably qualify for a program known as Extra Help. For more information about Extra Help, click here. To qualify, you’ll have to apply and be approved by the Social Security Administration.
For help figuring out how Medicare Part D works, counselors are available at the organizations listed below.
Illinois Department of Aging Senior Help Line 1-800-252-8966
Illinois Senior Health Insurance Program 1-800-548-9034
AgeOptions, suburban Cook County 1-800-699-9043
Chicago Department of Senior Services 1-312-744-4016
Aetna Helps Medicare Members Organize Medical Information and Monitor Health with CareEngine-Powered Personal Health RecordSeptember 4, 2008
HARTFORD, Conn. – September 3, 2008. – Aetna announced today that it has made its CareEngine-powered Personal Health Record (PHR) available to current Aetna Medicare members who purchased their Medicare plans individually. This unique, interactive tool is designed to better engage Medicare members in managing their own health, as well as make it easier for members to share health information with their physicians.
Aetna’s PHR combines a wide variety of health information gathered from across the health care spectrum — such as physician offices, labs, diagnostic treatment and pharmacies — with user-entered information such as family history or allergies, and houses it in a secure, online location. This type of tool is especially important to Medicare members as more and more of them use the Internet. A May 2008 study from the Pew Internet & American Life Society estimates that 35 percent of individuals age 65 and over use the Internet, and the percentage increase for this age group has been greater than any other since 2000.
“This is a great example of the value that we provide to our Medicare members,” said Frank McCauley, head of Aetna’s Consumer Business Segment. “Instead of storing medical records in a file cabinet or a shoe box, Aetna’s PHR allows members to access their medical information any place an Internet connection is available.”
With permission from the member, the Personal Health Record can be shared online with physicians and other health care professionals. In addition, members can easily print copies to bring to office visits to help fill out forms. They also have the ability to create and print a wallet-sized Emergency Information Card that contains important information such as name, date of birth, blood type, emergency contacts, allergies, medications, and physician and insurance information.
Aetna’s PHR also uses patented CareEngine technology that continuously scans an individual’s health data and claims information and compares it to current, established medical best practices. It can then alert members and doctors about possible urgent situations and opportunities to improve care.
Through a recent pilot program that made the PHR available to more than 750,000 members, Aetna discovered that members with an ongoing health condition were twice as likely to use their PHR as those without one. In part because of this finding, Aetna added Health Trackers to the PHR to help members better follow their health data. With this new feature, members can more effectively monitor their blood glucose levels, blood pressure, cholesterol, BMI and more.
Aetna has also made the PHR available online to treating physicians’ offices (if given access by the member) through Aetna’s secure provider website via NaviNet®.
“With age usually comes an increased need for health care services, and our Medicare members are more likely to have chronic conditions they need to monitor on an ongoing basis,” McCauley said. “These new features will give them the ability to better track their own health information and share it with their physicians. Improvements in both of these areas can help our members make better decisions concerning their health care.”
Blue Cross and Blue Shield of Illinois, the state’s largest health insurer, soon will no longer administer claims and provide customer service to employees of Wal-Mart Stores Inc., the world’s largest retailer, losing the business to another Blue Cross plan in Arkansas.
Starting in January 2010, Illinois Blue Cross won’t be performing administrative functions, such as staffing customer-service call centers, for employees of Wal-Mart, the health plan confirmed. Wal-Mart employees in the state still should be able to access benefits through Illinois Blue Cross because the new contract is largely related to behind-the-scenes work, the insurer said.
Such administrative tasks will begin in 2010 to transition over to Arkansas Blue Cross and Blue Shield, Illinois Blue Cross said.
Illinois Blue Cross would not disclose the financial impact of this change. Bentonville, Ark.-based Wal-Mart has more than 1.4 million U.S. employees and is known for its clout in negotiating with its many vendors.
“The membership in our four states will still be captured as part of our market share,” Illinois Blue Cross spokesman Jack Segalsaid of its parent, Chicago-based Health Care Service Corp., which also operates three other Blue Cross plans in Oklahoma, Texas and New Mexico.
In its new role, Health Care Service’s four Blue Cross providers will “become what’s known as ‘host plans’ for Wal-Mart’s approximately 200,000 members that live in our four states,” Segal said. “As host plans, we’ll provide our [medical-care provider] networks and our discounts, continue to reimburse providers and continue to determine claims pricing.”
As a home plan, Illinois Blue Cross has 445,000 members at Wal-Mart.
Wal-Mart would not confirm the change in the contract or financial terms of its relationships with any of the Blue Cross plans that process its health care.
“We regularly assess the quality and costs of the health-care plans offered by our providers, including those plans owned by Health Care Service Corp., and we don’t have any changes to those plans to announce at this time,” said Greg Rossiter, spokesman for Wal-Mart.
But Illinois Blue Cross said, “Wal-Mart was looking to consolidate into a single platform, so Arkansas [Blue Cross] decided to take this on and become the single home plan or administrator.”
Until the transition, Illinois Blue Cross will continue to share administrative duties with the Arkansas Blue Cross plan and Blue Cross and Blue Shield of Alabama.
Health Care Service had $865 million in net income last year on $14.3 billion in premium revenue. The nation’s fourth-largest insurer, the Chicago company has 12.4 million members, including 7.4 million in Illinois.