Insurers Offering New Types of Low-Cost Health Coverage, But Do They Adequately Protect Consumers?


Blue Cross Blue Shield of North Carolina is now offering a “My Choice” plan. Instead of a network of providers, the plan offers flat reimbursements for health care services. The plan uses a “reference pricing” model and reimburses providers at 40% more than what Medicare would pay for the same services. While this plan could be more attractive to consumers because it is more affordable than more comprehensive plans and gives them the freedom to potentially see any provider, it could put consumers at risk if they are not diligent in ensuring that the health care providers they visit will accept the plan’s reimbursement amount. If a provider rejects the reimbursement, patients could be directly billed for a greater amount.

In Minnesota, a startup company named Bind Benefits is offering “on-demand” plans to self-insured employers. These plans don’t feature deductibles, and instead, enrollees are responsible for flat-dollar copayments for any health care services they receive. However, many types of services are excluded from the plan, such as back surgery and a coronary artery bypass. Enrollees would need to “opt-in” to receive these types of benefits, which would make them responsible for additional “add-in” premium payments. This type of plan could be a good fit for a certain type of consumer, but the plans could expose employers to greater financial liability if their employees receive expensive health care services and then change jobs before defraying those costs through add-in premium payments. Keep reading here.


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