Category: Health Insurance

One of the more interesting things the Affordable Care Act did to the private health insurance business was to tell health insurance companies that the Feds were now in control of their profit margins. What does that mean?

Imagine you are the CEO of your own health insurance company. In fact, let’s call it Your Own Health Insurance Company, or YOHIC for short! How do you think you would feel if YOHIC collected $1 billion in premiums over a year, but only had to pay out $500 million in healthcare costs? Sounds like YOHIC is doing really well, turning a 50% profit. Does YOHIC get to keep the rest of the premiums for its own payroll and profits?

Since 2010, the answer to that question is a resounding NO! Read more

It’s the eve of your 26th birthday, you must take your first steps into this alien world alone. For 25 years, you’ve lived in safety on the Mother Ship, er, your parents’ health insurance plan. PPOs, HMOs, cost shares and deductibles weren’t even on your radar.

What should you (or your kid who is turning 26) do? Healthcare Economist Mike Bertaut explains your options. Read more

EDITOR’S NOTE: Mike is out this week, and he’s given the Straight Talk floor to another Mike – Michael Tipton, that is. Michael is president of the Blue Cross and Blue Shield of Louisiana Foundation and head of Community Relations. This week, he’s sharing details on the great work he and his team are leading at Blue Cross. 

Hello, Straight Talkers! I’m delighted to be a guest blogger for Mike this week to share news about Blue Cross’ and its Foundation’s responses to COVID-19, particularly related to grant making and charitable investments.

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As we made our way through March, April and May 2020, we saw the number of COVID-19 cases in Louisiana rising very quickly, especially before the governor issued his “stay-at-home” order on March 22.

In response to this unprecedented health crisis, health insurance companies like Blue Cross and Blue Shield of Louisiana began to add, amend and alter their coverage to make it easier for people to get tested and treated for COVID-19. At Blue Cross, we also made changes to make it easier for people to get healthcare treatment while staying at home. Read more

The other day, I was lamenting the fact that I haven’t seen a disinfecting wipe container in any store in a few months. I find them VERY handy nowadays for wiping doorknobs and other frequently touched surfaces or using them at the gas station and grocery store. I was just about out of wipes when I popped open a seldom-used cabinet and found a whole new package — NEVER OPENED.

A couple of years ago, with no idea that we’d be battling COVID-19, I stashed those away. I wasn’t “planning for a rainy day;” it was just luck.

But thanks to the talented team of data scientists we have here at Blue Cross, luck isn’t our only method of being prepared and ready to respond to COVID-19. Read more

Sometimes, dealing with a big bureaucracy with a ton of rules can be really, really frustrating. Dealing with lots of rules and regulations often makes folks want to tear their hair out. Life can be pretty complex on its own, without tons of rules to follow.

Every now and then, though, having a bunch of rules and regulations is a good thing. Like the many different ways you can trigger a Special Enrollment Period on healthcare.gov. Many of these also work for seniors who are Medicare eligible. We’ll talk about each of those and their options for healthcare coverage. Read more