What national health care reform means for Michigan Blues members

Today’s signing of health care reform legislation by President Barack Obama has many Blues members asking what the changes mean for them. While Blue Cross Blue Shield health policy staff continues to review the impact of what happened today, here is information that may be of help to BCBSM members.
 Q: I have coverage through an individual policy with Blue Cross Blue Shield of Michigan. What’s going to change?
A: If you currently have health insurance in our individual market, almost nothing will change.
Plans that were in existence up until March 23, 2010, when President Obama signed the underlying national health care reform bill into law, largely do not have to change, and nothing will require you to change plans. However, there will be some small changes that will impact your benefits.
Starting next year, you will be able to retain dependents up to the age of 26 on your policy. Additionally, no lifetime dollar limit will apply to your policy.
Since Blue Cross Blue Shield of Michigan already largely acts in compliance with the new law, many of the reforms will necessitate changes in other carrier’s policies, but not for ours. For example, the new law requires an 80 percent minimum loss ratio that requires insurers to spend at least 80 percent of premium dollars on medical expenses, as opposed to administrative costs. Blue Cross already has an individual market minimum loss ratio of more than 100 percent, meaning we lose money on individual policies. Blue Cross also already covers most preventive services without any cost-sharing, another new requirement.
New policies, however, will have many more changes. Stay tuned to this blog for more information as it becomes available.
Q: I have Blue Cross Blue Shield of Michigan coverage offered through my employer. How will my policy change?
A: National health care reform largely does not impact employer-based coverage that is currently in existence. Except for a few key provisions, these policies are grandfathered in as of the bill’s enactment on March 23, 2010.
The changes coming next year include the ability to add dependents up to the age of 26 on your policy and the elimination of any lifetime dollar limit for paying out claims. If any of the dependents on your policy are under the age of 19, they will not have any of their pre-existing conditions excluded from coverage. Additionally, your plan must meet an 85 percent minimum loss ratio, meaning at least 85 percent of your premium dollars must go directly to pay for medical care costs, not administrative expenses.
However, starting in 2014, there will be many changes in the way employers provide this coverage. These changes are specific and would differ from employer to employer based on the way they currently provide coverage. Stay tuned to this blog for more information as it becomes available.

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