Blue Cross Blue Shield

The Blue Cross and Blue Shield Association is the national trade organization that associates 38 independent regional health insurance companies in the United States and Canada. It was formed in the 1982 fusion of the Blue Cross Association and the National Association of Blue Shield Plans that are founded basically in Chicago, Illinois. Both organizations trace their histories to health plans that were created around the same time in two different parts of the U.S. The progression of managed health care in the United States is closely linked to the designs of Blue Cross-Blue Shield.

Blue Cross and Blue Shield Plans are presenting Medicare Advantage and Medicare Prescription Drug Plans in local markets across the country. Blue Cross and Blue Cross of California are being scrutinized by California regulators after 10 lawsuits were filed against Blue Cross in March 2006 claiming that the company had not acted in a good loyalty to thwart fraud and it also had a special department specifically set up to methodically look for any justification to reject coverage for large claims.

When the company issues a medical insurance policy, the person insured thinks he or she has medical coverage and relies on it and the person can find out other coverage if the company has a legitimate reason for denying coverage and tells the person at the time of the insurance application. If the insurance company doesn’t review applications until claims are filed and then retroactively cancels the policies, the people insured by the company find themselves without insurance and prone for all the medical expenses they thought were covered by their medical insurance. This is a very serious injury caused by the insurance company’s bad faith failure to assess the application in a timely manner.

Blue Cross offers the Healthy Families Programme in all 58 California counties, as a Health Management Organization (HMO) product in 11 counties and as an Exclusive Provider Organization (EPO) product in the remainder of counties. Blue Cross of California is the largest health coverage provider with more than 125.000 members, nearly 40 percent of the total programme membership and it has approximately 323.000 children contributing in the Healthy Families Programme statewide.

Blue Cross of California, with 5.4 million medical members, is the California operating auxiliary of Well Point Health Networks Inc. Well Point serves the health care needs of more than 7.6 million medical and approximately 34 million specialty members nationally. Well Point offers a broad spectrum of quality network-based health products including open access PPO, POS and hybrid products, and HMO and specialty products. Specialty products include dental, vision, mental health, life and disability insurance, long term care insurance, pharmacy benefit management, utilization management, flexible spending accounts, COBRA administration, and Medicare supplements.

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California Blue Cross Health Insurance – An Overview

Blue Cross of California, one of the state’s largest and most respected healthcare providers, has been in business for over 60 years. As times have changed, so has the company – making sure the almost 7 million people they serve get adequate health insurance.

The numbers are impressive – Blue Cross of California boasts more than 40,000 preferred provider physicians, 27,000 HMO physicians, and almost 4,000 vision providers. The company has over 400 participating hospitals and medical facilities. Blue Cross employs around 6500 employees statewide.

Not surprisingly, Blue Cross offers a wide range of plans and services ranging from several different medical and dental plans to disability and life insurance. Their wide range of plans, services and deductibles means a health plan for everybody, regardless of income or situation. They also offer several dental and vision plans as well as the workers’ compensation coverage, as required under state law.

Blue cross also offers health insurance under its “tonik health” subsidiary, aimed at young active people and priced with several different deductible plans offered.

Obtaining prescription drugs is inexpensive and convenient under most Blue Cross plans. The company administers prescription drugs and medication through its subsidiary company called Wellpoint. The company also offers a diverse array of specialist insurance products such as COBRA coverage, flexible spending accounts and pharmacy benefit management.

Blue Cross of California has a strong track record of innovation, and is proud of its ability to offer products to a diverse population – individuals, businesses of all sizes and seniors. They also provide health insurance for seniors and others eligible for state health insurance.

They also have a proud record of collaboration with education institutions and local organizations in helping with various health-related research projects. Blue Cross recently won a prestigious award from the EPA (Environmental Protection Agency) for its work in helping asthma sufferers – it’s the only health plan to receive such an award.

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Is Blue Cross And Blue Shield Health Insurance Right For Me?

You have plenty of options when choosing a family insurance plan that suits your needs. Whether choosing a plan through an employer or through a private company, you will have a choice at what type of family Blue Shield plan is right for you. You have the option of PPO, HMO, and POS insurance plans that fit almost all budgets. The size of your co-pay will determine how much you pay in monthly coverage fees and can be raised or lowed depending on your family’s medical needs.

For those families who do not have any chronic medical needs, the Blue Shield POS or PPO plans can be highly affordable and flexible. This plan offers the carrier the option of how much of a deductible they are willing to pay per year. Deductibles under the family Blue Shield insurance plans can range from $250-$2500, depending on what the buyer can afford each month for coverage. Most Blue Shield, PPO and POS plans that are most popular carry a $1000 deductible. This makes monthly coverage fees and co-pays affordable as well as the deductible itself.

If you or a member of your family needs more chronic or consistent medical attention, the family Blue Shield HMO insurance plan may be a better deal. This type of plan covers your primary physician in the network and all your referrals to specialists in the network as well. You will also not have to meet a deductible and have a smaller co-pay. The difference lies in a slightly higher monthly coverage fee. For those who need a lot of medical coverage more regularly the HMO is the better plan for them.

When choosing the right insurance plan, be sure to not only know what your medical needs are, but your budget as well. It is important to pick a plan that offers you the most services at the best cost. If your family Blue Shield plan is through your employer you will most likely not be able to choose the type, but will get a lower cost. If you are purchasing your plan through a private company you will be more able to choose options that best suit your family’s individual needs at a price that is affordable for you. As your needs and financial situations change, you will be able to modify your family Blue Shield plan. Choosing the right insurance plan may not always be easy, but choosing a family Blue Shield plan will be beneficial and serve your family well.

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