Anthem Blue Cross And Boulder Chamber Offer New Health Insurance
Anthem Blue Cross Blue Shield and the Boulder Chamber of Commerce have partnered to create a health plan option for Boulder Chamber members that includes coverage for alternative as well as traditional care. The Chamber Plan’s Blue Freedom coverage offers all of the typical benefits we tend to associate with small group coverage, but most of the plans also cover things like accupuncture, chiropractic care, herbology, and massage therapy.
This is a big step forward for health insurance, and one that I hope we’ll see in other areas and from other carriers. Boulder is a great place to start something like this, as Boulder residents do tend to utilize alternative health care more than the average Colorado resident. But over the years, we’ve had inquiries from people all over the state who are looking for a health insurance policy that will allow them to utilize alternative care.
The Boulder Chamber plan is a good start. It’s currently available to Boulder Chamber of Commerce members who have between 1 and 50 employees. Eventually I’d like to see alternative care available as an option for people throughout Colorado, regardless of where they live or work. On a personal note, I’d also like to eventually see plans that offer maternity coverage include midwifery and homebirths in their benefits package.
It’s great to see Anthem Blue Cross Blue Shield recognizing the importance of alternative medicine for some people. Obviously this would not be a benefit for everyone, but no one health insurance benefit will be utilized by everyone who has a particular policy (and the Boulder Chamber is offering several other Anthem plans with various designs, so the alternative care isn’t being forced on anyone who doesn’t want it). Choices and options are important, as everyone has different views on health and wellness. And with the advent of this new plan, a small business owner who is committed to alternative medicine and turned off by traditional health insurance policies might get on board with health insurance for her employees – and that’s a good thing.
Is the coverage real? Here in Montana we have a lot of what I would call “fake coverage”. For example, the insurance company might cover twelve acupuncture visits a year, but have a limit of $40 per visit, and an acupuncture specific deductible of $1200 a year. You use up the visit limit before you ever reach the deductible, thus never actually receiving any coverage.
Hans Conser D.C.
Hans,
Yes, I would consider the coverage to be genuine. Here is a link to the plan description form:
http://www.anthem.com/agent/co/f3/s1/t0/pw_b131963.pdf?refer=ahpemployer&state=co
On page 6, the alternative medicine benefits are described. chiropractic care, massage therapy, and acupuncture are allowed a combined total of 20 visits per year, and the member pays only a $25 copay, as long as the provider is in the network. The policy will also pay for up to 4 visits to a nutritional therapist per year, with $25 copays. And the policy will also pay up to $500 per year for additional alternative therapies (ayurvedic medicine, Chinese medicine, herbology, homeopathy, and naturopathic medicine).
Well, I looked at the plan description form, and what is missing of course are the allowable charges by in network providers. So I made a call to an in-network alternative provider in Boulder and found out the daily limit for massage, chiropractic and acupuncture for Anthem BCBS in Colorado is $41. You pay $25 and the practitioner gets to bill BCBS for $16 per visit. So your combined yearly coverage for massage, chiropractic and accupuncture is $320 ($16/visit times 20 visits). Pretty meager. It probably costs the practitioner at least $4 to pay someone to bill BSBC for the $16. The next question is, does the deductible count against the alternative care? Since the pdf doesn’t say that it is separate, then most likely it does. So, if you have seen no other practitioners to use up your $500 deductible, you have no coverage. You can go see your in-network acupuncturist twenty times, you will only pay the discounted rate of $41, but you still will have only used up $320 of your deductible and you are now over the allowed visits per year. Not completely fake coverage, but close.
Dr. Hans
“The next question is, does the deductible count against the alternative care? Since the pdf doesn’t say that it is separate, then most likely it does.”
Dr. Conser,
Generally speaking, usually when there is a copay on a doctors visit, it means that it’s covered before or after the deductible has been met. Copays are separate. Whether the patient has met their deductible or not, they have a $25 copay.
Those are good questions so far, thanks. Let us know if you have any more.