"Preventive Services Coverage" Mandate Effective 9/23/2010.

[AllenChicago]

Hey Everyone,

I realized that all plans effective September 23, 2010 and after must contain new "Wellness / Preventive Care" benefits, but I had no idea that the list was so large! Check it out...
Preventive Services Covered under the Affordable Care Act

How in the heck are health insurance companies going to be able to afford paying for all these services at 100% with no Co-pay required by the insured?!?!

The insurance companies seem to be oblivious to this financial drain that will be unleashed on them in just over a month from now. A lot of people will cancel their "grandfathered" policies to get a new one, if their health is good.

Perhaps this is not as big of a financial burden on insurance companies as it appears?? I don't see where any of them in Illinois have requested any big rate increase approvals from the state.

On a positive note from our (the agent's) point of view, this, along with some other aspects of the post-9/23/10 policy requirements, will make for a great sales opportunity!

-A.C.

 

[HealthGuy]

Why would they cancel their cheaper grandfathered plan to get preventative if these new plans are $200 more per month? Just wondering.

 

[djs]

List really isn't that large (in terms of cost). Many plans already covered a lot of this for a nominal copay anyway.

This won't have much impact on pricing, compared to many other things in the bill.

Dan

 

[AllenChicago]

Why would they cancel their cheaper grandfathered plan to get preventative if these new plans are $200 more per month? Just wondering.

This is one of the aspects of the new mandate that leads me to think that most carriers are asleep at the wheel. I can run quotes right now for October 1st effective dates and there is only the normal "trend" increase.

The exact same policies that are being sold with September 1st effective dates can be sold with October 1st effective dates. The big difference will be that the policies that are effective 10/1/2010 will have a ton of free wellness benefits included for the entire family. I call that a sales opportunity, HealthGuy. Agreed?
-A.C.
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List really isn't that large (in terms of cost). Many plans already covered a lot of this for a nominal copay anyway.

This won't have much impact on pricing, compared to many other things in the bill.

Dan

Well, you must work in a state, or in states that has a mandate for preventive and wellness, Dan. Here in Illinois, I can't think of any individual policies that cover child immunizations, colorectal screenings, depression screening, etc.. with no cap and no co-pay.
-A.C.

 

[HealthGuy]

Allen Chicago: I see your point now, you may be right, but I suspect the rates will be a lot higher than you might suspect at this point.

 

[djs]

Well, you must work in a state, or in states that has a mandate for preventive and wellness, Dan. Here in Illinois, I can't think of any individual policies that cover child immunizations, colorectal screenings, depression screening, etc.. with no cap and no co-pay.
-A.C.

You missed my point....
A child immunization costs what? $40? Not the end of the world, copay or no.
Depression screening costs what? $75? Not the end of the world, copay or no.

I don't know what some of this stuff actually costs, but if you add up what gets actually used, its probably not a lot of money in the big scheme of things.

It's not like everyone will get them all every year. Most people who have these types of benefits already don't use them. Might be an initial spike in usage, but well within the cost structure long term.

Dan

P.S. Yes, some plans in California include a wealth of wellness benefits, without meeting deductible. No mandate, just an option to get it. Not all plans include this.

 

[TXINSURANCE]

I have heard 2% additional premium floated around a lot for unlimited life time max and unlimited preventative.

The unlimited lifetime max is a small fraction of 1% increase. .000 something.

Unlimited preventative is 1 or 2 points by all estimations I have read. Look closely at the list of services.

I didn't see PSA tests? I may have overlooked that one. I definitely didn't see colonoscopy which is potentially thousands of dollars.

 

[somarco]

Preventive will have a negligible impact on premiums as Dan has illustrated. Probably 2% or less.

Will more people go for annual physicals and submit to the entire battery of tests?

Not really.

I read something, perhaps a year ago, that said women would have a mammography if it were $0 - $10, but when the cost went to $15 they would skip the mamm. This was even true of high risk women.

There is something terribly wrong here.

I didn't see PSA tests? I may have overlooked that one. I definitely didn't see colonoscopy which is potentially thousands of dollars.

Some states, GA being one of them, mandate PSA tests which costs virtually nothing. Most carriers already cover colorectal screening which is on the list. That is a $20 test.

 

[DS4]

Preventive Services Covered under the Affordable Care Act

I'm very sad to see that Korean Massage Parlors didn't make the list.

 

[AllenChicago]

The Colonoscopy IS covered under this mandate. Scroll to the bottom of the Preventive Services webpage and you'll see a link that takes you to the page that explains all the mandated wellness tests. Here's an excerpt from the "Screening for Colorectal Cancer" paragraph:

"The USPSTF recommends screening for colorectal cancer (CRC) using fecal occult blood testing, sigmoidoscopy, or colonoscopy, in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary."

If the colonoscopy is free, I would opt for that over the other tests. As is often the case, the devil is in the details.

Also, immunizations for children cost a bundle here in Illinois, which is why most individual plans put a $300 annual cap on this benefit.

This graphic illustrates the recommended immunizations for children.
http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2010/10_0-6yrs-schedule-pr.pdf

Additionally, in Illinois, several of them are required before a child can enter school. Each of the required immunizations are in excess of $300. They will now be FREE with policies that have an October 1st or later effective date.

This will be some exciting new material to put forth at the next sales meeting... "Educate the public and sell sell sell, before the insurance companies figure things out!"
-A.C.