Applauding a Health Benefit Change

Senator Benjamin L. Cardin (D-MD) is cheering the decision by the Office of Personnel Management and Blue Cross/Blue Shield to revamp the insurance company’s non-emergency, out-of-network surgical benefit.

As today’s Federal Diary reports:
In response to outraged workers who have the Blues standard option, and troubled members of Congress, the company announced that it will pay 70 percent of the fee it allows for such procedures, leaving the patients responsible for 30 percent, plus any difference between the allowed amount and the actual charge.

The patients’ 30 percent share amounts to a five-percentage-point increase from the existing plan and is consistent with other out-of-network fees for the coming year.
Under a plan previously announced for 2009, Blue Cross/Blue Shield members would have had to pay 100 percent of the surgery fee, to a maximum of $7,500, per surgeon, per surgical day.

“OPM did the right thing for federal employees, retirees, and their families,” Cardin said. Once this problem came to light, I was encouraged by OPM’s actions.”

Like all good politicians, he gave himself a good share of the credit:
“On behalf of the federal employees and retirees across Maryland and across the nation, I also thank OPM for following my recommendation to extend the Open Season enrollment period for the Federal Employees Health Plan through the end of January 2009. Federal employees now have six additional weeks to review all of the details each plan has to offer and select the best option for themselves and their families.”

-- Joe Davidson

By Steven E. Levingston  |  December 17, 2008; 12:11 PM ET  | Category:  Health Care
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