WASHINGTON – Blue Cross and Blue Shield (BCBS) companies across the country are offering consumers who purchase coverage on the individual market access to expanded primary care and other important benefits before they reach their plan deductibles. Recognizing that access to ongoing care is important to stay healthy, BCBS companies are offering these smart benefit packages to ease consumer concerns about meeting out-of-pocket expenses for their healthcare services.
The majority of Blue Cross Blue Shield Association (BCBSA) members are providing consumers in the individual market, both on and off the Affordable Care Act’s marketplaces, with pre-deductible coverage. This is in addition to the preventive services, such as cancer screenings, immunizations and well child visits, that all BCBS companies already cover without cost-sharing.
Deductibles can vary widely by plan and are an important factor in choosing health insurance. The types of benefits BCBS companies are offering are tailored to meet the needs of the local communities they serve but can include visits to primary care physicians, specialist visits, generic drugs and brand-name drugs. In 2017, even more BCBS companies are expected to offer pre-deductible benefits.
“We’re working to make our benefit packages as attractive as possible to ensure people get the care they need at the best possible price,” said Alissa Fox, senior vice president for the office of policy and representation at BCBSA. “By expanding services that are offered before the deductible kicks in, we are empowering members to get the ongoing care they need to stay healthy.”
Although some requirements in the Affordable Care Act limit what health plans can do in this area, “pre-deductible” benefit offerings are becoming increasingly important as more and more consumers enroll in health insurance plans with higher deductibles, choosing a lower monthly premium while paying more for their healthcare costs (the deductible) before the insurance company starts to pay its share. While higher deductibles help keep monthly premiums down, they also may discourage people from seeking care due to concerns about out-of-pocket costs.
Not surprisingly, individuals are flocking to plans with this benefit, with 80 percent of silver plan enrollees choosing them and 62 percent of gold plan enrollees making this choice. Among bronze plan enrollees, 41 percent are choosing this type of plan.
Blue Cross and Blue Shield companies continue to work to develop innovative products to meet consumer needs, but changes are needed to give health plans more flexibility in what can be offered as a pre-deductible service. By making small changes to current individual market regulations on required benefits and actuarial value, health plans would have more flexibility to innovate and offer pre-deductible benefits that can provide even more value to consumers.