Increase in health insurance premium in Detroit

With open enrollment season in full swing, seniors and privately insured workers should expect to shell out more next year for their health coverage, as many employers face double-digit increases in their insurance costs.

To offset this rising expense, some employers will pass all or part of the cost increases onto workers through larger paycheck deductions. For some workers, that could mean as much as a 50 percent increase in their monthly payroll deductions for health care, insurance experts say.

Companies also are eliminating some benefits and increasing co-payments on drugs, emergency room visits and doctors' visits to keep workplace health insurance affordable after being socked year after year by premium increases, insurance brokers and benefits consultants say.

"This has been a particularly bad year," said Bryan Hirn, area president for Gallagher Benefit Solutions in Bingham Farms. In years past, the percentage increases for premiums would typically hover in the single digits in Michigan. Now, those increases are hitting the high teens, he said, as more people get laid off and companies have to spread the cost over fewer workers.

Workers, however, aren't the only ones being hit by larger out-of-pocket expenses.

Medicare rates are on the upswing, as well, and some seniors could see quite a few Medicare plans disappear next year. Experts advise seniors to pay close attention to any benefit changes outlined in their 2010 policies, particularly those affecting drug coverage, during this open enrollment season which began Sunday.

"It's going to be a big enrollment season," said Jo Murphy, executive director of the Michigan Medicare-Medicaid Assistance Program.

Already, the program is bracing for a flood of calls from seniors trying to navigate the onslaught of changes, she said.

Changes may be confusing

A confluence of forces is driving the premium increases, which come as Washington lawmakers work vigorously on legislation to reshape the nation's health insurance market.

Chief among them is the breakneck pace at which medical costs are rising across the country.

Additionally, a new law requiring all employers to broaden mental health and substance abuse coverage goes into effect next year and will push premium costs higher, said Joel Clark, founder and president of the J.S. Clark Agency in Southfield, a benefits consulting firm.

In response, companies are holding down costs by passing more out-of-pocket costs onto their workers, which in some instances has helped flatten year-to-year premium increases. Other employers are simply passing the full increase onto their workers, whereas in the past they would have absorbed the additional expense, Clark said.

Gone are the days of a health plan with blanket coverage, said Roy Lamphier, vice president of insurance services for the Detroit Regional Chamber. Employers are getting savvier at nipping and tucking coverage to curb rates, which make changes more confusing for workers, he added.

For instance, in the past workers might have one co-payment for prescription drugs; now, those drugs are being sectioned into tiered categories -- generic, preferred brand and non-preferred brand -- with higher co-pays for brand name drugs than generics.

Plans alter coverage

On the Medicare side, seniors should brace for sweeping changes to their plan coverage.

With Medicare Advantage plans, rates are going up between $50 and $70 a month in some cases, "which is a big increase if you're on a fixed income," Murphy said.

Similarly, many fee-for-service Advantage plans -- policies that don't limit members to a doctor network -- will vanish next year and others will see steep price increases as insurers attempt to phase out this type of coverage by 2011.

The federal government has slashed payments to insurers that offer Medicare Advantage plans, prompting many to discontinue the pricier fee-for-service plans.

Blue Cross Blue Shield of Michigan, for instance, introduced a new Medicare Advantage PPO (Preferred Provider Organization) to replace two fee-for-service plans that will be eliminated next year.

Rates for two other fee-for-service Medicare Advantage plans under Blue Cross will be sharply increased next year. Members in Blue Cross's Option A, for example, will see their monthly rates come close to tripling in 2010, going from $62 to $177.

Altogether, these changes will affect about 100,000 seniors enrolled in Blue Cross's fee-for-service Advantage plans.

Murphy, of the Michigan Medicare-Medicaid Assistance Program, said seniors should be vigilant in choosing their plans for next year because big changes are afoot.

Not only are monthly rates on the rise, but many plans are altering their Rx coverage, meaning seniors could see some drugs dropped from their benefits or come with higher co-pays.

"We all get comfortable and used to one brand name, but with insurance prices going up, it's really worth it to look around," Murphy said. "There may be something else that meets your needs and would be less."

read more

gov health
2009-11-16
Case in point: If a person has health care insurance, he/she pays premiums dutifully, Becomes ill with a chronic condition like Diabetes. Insurance company goes out of business. No other insurance will accept him/her because of preexisting conditions What should the government do to protect the consumer in cases like that? Some HMOs have gone out of business in Detroit, MI namely CHS. See related problem

all insurance coverage
2009-11-16
ere is an example of how government run health care will be: Waves of New Fund Cuts imperial US Nursing Homes, story ran today on Yahoo News, link below. As stated at he end of the story, "Too sick, too old, too bad." Pretty sad, the people in these nursing homes have nothing now, many not even the basics. And the funds are being cut. These people paid into social security and medicare and they are being blown off by the government. And dumb people believe that this health care bill being debated now, will be so much better for us. How stupid. And I believe, that this government run health care will put health insurers out of business. There is no way they can compete with the government. We will, if this passes, have one choice in insurance and that will be the government's.

Please Leave a Comment

Author:
Email:
Website:
Comment: