Blue Cross and Blue Shield of Minnesota is targeting young adults with a new health plan that offers lower costs but excludes maternity benefits.

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Called Simply Blue, the plan is part of Blue Cross' strategy to chip away at the clusters of Minnesotans who lack health insurance. Young adults in the state are almost three times more likely to be uninsured, partly because they are so healthy that they don't see the need to spend starting wages on insurance.

By trading off expensive maternity coverage, Blue Cross leaders believe the plan gives these twentysomethings what they want: low premiums, full payment for routine doctor visits and protection if injured in car wrecks, ski crashes or other accidents common to young adults.

However, doctors and other critics question the wisdom of selling insurance without maternity benefits to a sexually active demographic that is prone to unplanned pregnancies.

Reducing the state's uninsured rate is noble, but a plan without maternity benefits is the wrong approach because it adversely affects women, said Dr. John Wust, an obstetrician in Coon Rapids.

"I understand their intent," Wust said, "but the bottom line is it ends up being discriminatory against women and children."

Most group health plans are required by federal and state laws to include maternity benefits, but those laws don't apply to plans such as Simply Blue that are sold to individuals. The lone exception is a state law requiring all plans to cover basic prenatal care.

Blue Cross leaders said they wrestled with the decision and received divided opinions when they tested the idea in focus groups. In the end, cutting maternity benefits was the only way to make the plan affordable and appealing to young adults, said Judy Johnson, Blue Cross' product manager for individual and small group plans.

"We want to give them something they are looking for at this time in their lives," Johnson said.

The plan is modeled after a popular Blue Cross plan in California called Tonik, which was named to appeal to young adults. Local Blue Cross leaders also tested out some jazzy names, such as Fusion, but young Minnesotans just found them unclear or deceptive.

They wanted something simple, hence the name. So Blue Cross leaders created a plan with 100 percent coverage of doctors' visits, lab tests and X-ray services up to $500 to $1,000. The plan costs $60 to $110 per month and has deductibles ranging from $5,000 to $10,000 per year.

Those costs may seem high, but they keep the premiums low and protect young adults from hospital bills that can easily exceed $10,000, said Brian Davis, Blue Cross' manager of individual sales

If Simply Blue does entice young adults, it will address one of the most significant reasons for Minnesota's rising uninsured rate. Some of that increase is due to young adults who aren't receiving workplace benefits because they work in temporary jobs or for small employers that can no longer afford health plans, according to a 2004 state health survey.

The uninsured rate among adults 24 and younger is about 19 percent, according to the survey. The overall state rate is about 7 percent, which remains one of the lowest in the nation.

While young adults probably don't need health insurance for heart attacks or high cholesterol, they do have their own risks. They have the highest rate of accidental or violent injuries of any age group, according to the U.S. Centers for Disease Control and Prevention. They also have the highest rate of accidents resulting in hospital admissions of any age group under 65.

What troubles doctors is that young adults also have the highest rate of unplanned pregnancies. This year, the Minnesota Medical Association took a position against health plans that exclude maternity coverage.

Wust, the Coon Rapids doctor, led that effort because he feared that small employers might use exceptions in government laws to drop maternity benefits. He only later learned of Simply Blue.

"It's very narrow-minded to offer policies that don't have maternity coverage," he said, "because (about four in 10) women don't plan for their pregnancies, whether they are married or not."

Blue Cross leaders did contemplate what would happen to people under Simply Blue who had unplanned pregnancies, Davis said.

Many would end up in the Minnesota Comprehensive Health Association, a state-supported plan for people who can't obtain insurance because of their medical conditions.

Davis stressed that Blue Cross is marketing the plan to people who are uninsured, which means they have no maternity benefits anyway. He added there are several plans that include maternity benefits. However, those plans don't cover maternity care until women have been enrolled for 10 months or more.


Source:HaraldToday.com