Category: Insurance

As the health insurance enrollment season opens this week you may see big changes in your plan if any plan at all. Blue Cross Blue Shield of Texas, Oklahoma, Illinois, and possibly other cities are all discontinuing all PPO plans for individuals and families at the beginning of the year. In Texas alone it will affect around 367,000 people statewide. The company claims it paid out $400 million more in claims than it collected in premiums for its Blue Choice PPO product in 2014, the first year of open enrollment.

To add more salt to the wound the competitor Humana will no longer will sell any PPOs on HealthCare.gov, the only place where shoppers can get tax credits for individual or family coverage. The company said the change was necessary to preserve the “affordability and access” of its other health plans.

Some Blue Cross HMOs such as the Blue Advantage Plus plans will feature an added benefit in 2016 that allows some coverage if a policyholder goes out of network. Consumers will pay a higher premium for these HMOs and a policyholder going out of network still could be responsible for up to 50 percent of the costs after the deductible has been paid. This will cripple patients with HIV or Cancer who have highly expensive medications such as Truvada from Gilead. PPO plans give you flexibility where you don’t need a primary care physician and you can go to any health care professional you want without a referral—inside or outside of your network.

Blue Cross said it will automatically switch members enrolled in the broad PPO to the Blue Choice plan. Although one big difference.is that for example in Illionois the broad PPO included every hospital (209) and the Blue Choice’s network had 78 hospitals this year. Blue Choice left out some prominent Chicago-area hospitals, like Northwestern Memorial, University of Chicago Medicine, Rush University Medical Center, the Advocate Health Care system and the North Shore University HealthSystem.
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Pet ownership comes with the responsibility of providing prescription medications for the pet when necessary. Many pet prescriptions can be expensive unless purchasing $4 generic meds for pets. Super store pharmacies offer various medications for pets as generics just as they offer for people.

Kroger, Walmart and Target, along with other pharmacies, will fill prescriptions written by licensed veterinarians for pet meds. These stores carry generic medications as well as the brand name ones. It is in the pet owner’s best interest to obtain a list of which meds are offered as generics and their prices. Taking this list to the vet will allow the vet to decide if there is a medication on the list which will efficiently treat the animal and then write a prescription for it.

While many generic prescriptions are $4, there are also other generic medications available for $10 and the name brand meds which are more expensive. Not all pharmacies offer the same generic medications. Obtaining a list from several different pharmacies will allow the owner to know where to locate a prescribed medication for the best price. Some stores offer price matching. If this is the case, taking a price list from one store to a preferred pharmacy can allow an owner to get a medication for a lower price. This is especially true if one store has a medication on a $10 generic list while another store has it on a $4 generic list.

Types of medications available as generics varies. Some of the more common ones are antibiotics. Tetracycline and Amoxicillin are two popular prescriptions which fall in the $4 generic price range at most pharmacies. Other common meds prescribed are Tramadol HCL for motion sickness and Prednisone for allergies and skin irritations. These medications are the same ones used for human prescriptions. Pets normally receive the same medication but just at lower doses than what their human owners would be prescribed.
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