Floridians Encouraged To Consider Cover Florida Health Care

Governor Charlie Crist today encouraged Floridians without health insurance benefits to learn more about the Cover Florida Health Care Access Program during a two-day public awareness campaign focused on help available to Floridians during times of economic challenge.

The health insurance plans make affordable, quality health insurance coverage and access to health care available to Florida’s nearly four million uninsured applicants age 19 to 64. Later today, Lt. Governor Kottkamp will visit Gulf Coast Medical Center in Panama City and the Florida Small Business Development Center in Pensacola to promote Cover Florida Health Care. Tomorrow, Governor Crist will highlight the program in Miami, Daytona Beach and Tampa.

“Lack of health insurance is the number-one barrier to accessing health care, and Cover Florida can help Floridians remove that barrier. Cover Florida isn’t bare-bones, one-size-fits-all health insurance because people choose what works for their health and for their wallet,” Governor Crist said. “Even if you have a pre-existing health condition, you won’t be turned away.”

Governor Crist encouraged interested Floridians to visit the http://www.CoverFloridaHealthCare.com Web site to compare the sample benefits and premium information from the six insurers. Each company operates a Cover Florida-specific toll-free telephone line and Web page making it possible for interested individuals to discuss their health care options with each insurer directly.

Joining Governor Crist and Lt. Governor Kottkamp in Tallahassee were Secretary Holly Benson of the Agency for Health Care Administration and Insurance Commissioner Kevin McCarty.

“Parents should not have to rush their children to an emergency room because their family lacks basic health care,” Lt. Governor Kottkamp said. “Florida families and small business owners who have been waiting for affordable health insurance options should consider the Cover Florida plans.”

Cover Florida plans are available to Florida applicants age 19 to 64 who have been without health insurance for at least six months, or who are recently unemployed – even if there are pre-existing health conditions. Floridians may also be eligible if, during the previous six months, they have lost employer-sponsored health benefits or are no longer covered by a public health insurance program.

Cover Florida Health Care Providers and Benefits

Six health insurance providers have been authorized by the Agency for Health Care Administration, the Office of Insurance Regulation and the Executive Office of the Governor to offer Cover Florida Health Care plans. Blue Cross Blue Shield of Florida and United Healthcare are available in all 67 Florida counties. In addition, four counties have further options. Florida Health Care Plans is available in Flagler and Volusia counties; Medica Health Plan of Florida and Total Health Choice are available in Broward and Miami-Dade counties. In addition, JMH Health Plan also serves Miami-Dade County.

Consumers interested in purchasing Cover Florida benefits should contact the insurance carriers directly. The six companies have designed 25 creative health insurance products, and each insurer offers at least two benefit options – one with catastrophic and hospital coverage, and one focusing on preventive care. Each plan has a robust set of benefit options that include coverage for preventive services, screenings, office visits, as well as office surgery, urgent care, hospital coverage, emergency care, prescription drugs, durable medical equipment, and diabetic supplies.

Cover Florida plans contain no mandates for participation and are portable from one employer to another because they are individual policies. Voluntary for both employers and policyholders, employers also may voluntarily share in the cost of the plan with their employees or may assist employees with a payroll deduction, providing a pre-tax benefit for the employee and a payroll tax break for the employer.

Details About Cover Florida Coverage

The cost of plans varies, depending on the applicant’s age, gender and choice of preventive coverage or catastrophic and hospital coverage. Fourteen of the 25 Cover Florida plans have monthly premiums averaging $155 or less, with all of the preventive plans offering coverage for, on average, $155 or less. Examples of coverage and costs include the following:

* Available anywhere in Florida is a plan that offers preventive coverage to a 25-year-old female for $83.55 a month, with no annual deductible. A 25-year-old male would pay $50.75 for the same coverage. Benefits would include the following:

1. Doctor Office Visits: $10 co-pay for a primary care physician; up to 45 visits per year.

2. Preventive Care: $0 co-pay for preventive services. Includes annual adult exam; annual gynecological, prostate, colorectal, cervical cancer screening and mammogram.

3. Hospital Emergency Care Services: Consumer pays 20 percent; insurer pays 80 percent of charges, Up to $1,500 per year.

4. Prescription Drugs: $10 co-payment for generic drugs; $45 co-pay for brand diabetic supply use.

5. Behavioral Health Services: $40 co-payment; up to five office visits per year.

6. Diabetic Supplies: $25 co-pay.

7. Health Discounts for Other Services: Enrollees will receive a discount on other services, including dental, vision, wellness, infertility, hearing, and chiropractic care.

* One of the plans available only in Miami-Dade County offers a 50-year-old female catastrophic coverage with no annual deductible for $151.85 a month while a 50-year-old male would pay a monthly premium of $172.11 for the same coverage. Some of the benefits include, but are not limited to the following:

1. Doctor Office Visits: $25 co-pay for a primary care physician and $50 co-pay for a specialist.

2. Annual Adult Wellness/Health Exam: $25 co-payment.

3. Hospital coverage: $200 per day co-payment for first five days of admission; $0 after the fifth day.

4. Urgent Care: $50 co-payment.

5. Emergency Services: $200 co-payment; waived if admitted.

6. Prescription Drugs: $10 co-payment for generic drugs and plan discounts for brand name drugs.

7. Behavioral Health Services: $50 co-payment for office counseling services; up to $1,200 per year.

8. Diabetic Supplies: Consumer pays 20 percent; insurer pays 80 percent of charges for lancets, syringes, insulin, strips and monitor.

* A 30-year-old male in Volusia County could purchase catastrophic coverage for $109.17 monthly, with a $250 annual deductible. The same coverage for a 30-year-old female costs $177.28 monthly and includes the following:

1. Doctor Office Visits: $20 co-pay for a primary care physician and $75 co-pay for a specialist.

2. Annual Adult Wellness/Health: $20 co-payment.

3. Hospital Coverage: $750 per day co-payment; up to 12 days per year.

4. Urgent Care: $75 co-payment.

5. Emergency Services: $250 co-payment.

6. Prescription Drugs: $10 co-payment for generic preferred/ $10 co-pay for generic non-preferred

7. Behavioral Health Services: $50 co-payment for individual services; $25 co-pay for group counseling session; Up to 12 outpatient visits per year.

8. Diabetic Supplies: Glucometer covered in full; $12 co-pay for lancets and 50 test strips.

How the Cover Florida Health Care Access Program Was Created

The Cover Florida plan was unanimously approved by the 2008 Legislature, and no tax dollars are required to make the plans available to Floridians. Selected by the State of Florida through a competitive bidding process, the six private insurance carriers were chosen based on their proposed robust, innovative and affordable health insurance products.

Acting jointly on behalf of the State of Florida, the Agency for Health Care Administration and the Office of Insurance Regulation issued the competitive Invitation to Negotiate and reviewed insurers’ responses, along with representatives from the Executive Office of the Governor. Once the six providers were selected, the state agencies worked jointly with the insurance carriers to finalize the contracts. Throughout the competitive process, the state agencies worked to ensure that Cover Florida products would not only offer robust benefits but also be financially sound. Moving forward, the state agencies are monitoring the sale of the products and addressing consumer concerns.

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Health Insurance Top Worry For Utah Racial/Ethnic Groups

The Utah Department of Health (UDOH) Center for Multicultural Health (CMH) is pleased to announce the 2008 Qualitative Report: Public Health Messages from Utah’s Racial and Ethnic Minority Populations. The report describes 17 community focus group discussions about health with 180 members of some of Utah’s most prominent racial and ethnic minority communities: African Americans, Asian Americans, Hispanics/Latinos, and Pacific Islanders.

UDOH spent several weeks interviewing the groups about their attitudes on health insurance, medical care, health risks like HIV/AIDS and tobacco use, and about UDOH marketing efforts to reach their communities with helpful information.

“We began this project over a year ago to get insight into Utah minority health issues beyond the usual data and statistics,” said Owen Quiñonez, Director, CMH, UDOH. “Through this process, we’ve achieved communication between public health workers and minority community members, analyzed health needs, and made plans for addressing health disparities.”

In response, UDOH developed We Heard You: Letters from Public Health Workers to the Multicultural Communities of Utah, which details how UDOH employees intend to incorporate suggestions from multicultural community members into health programs.

The document also explains what public health is already doing to address those, and lists the limitations that preclude them from implementing all community recommendations. The 2008 project is the first time public health workers have written back to the multicultural communities to share how they plan to use the study results to improve health care for the groups.

The qualitative project identified minority community challenges and opportunities related to access to health services, asthma, heart disease and stroke, HIV, immunizations, reproductive health and tobacco prevention. The qualitative report was completed by the University of Utah Department of Family and Preventive Medicine and sponsored by the CMH and other UDOH programs that address these topics.

“The primary message is that Utah’s racial and ethnic communities are very worried about the lack of health insurance,” said CMH Multicultural Health Specialist April Young Bennett, “We also learned they want to have a say in public health decisionmaking and to be reimbursed for the time they spend on boards and committees.”

Respondents also said repeatedly they want health messages to be concise and culturespecific, and they prefer person-to-person communication over mass marketing.

“Public health workers are deeply concerned about Utah minority health disparities and they’re excited to have input from these communities,” said Bennett. “We are now ready to find creative ways to meet their needs in light of current budget constraints.” One immediate plan is to begin sponsoring smaller, annual community forums and use other methods seek community input more frequently.

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Medical Tourism Or Health-Seeking Travel

Traveling abroad for the purpose of improving one’s physical, mental, and spiritual well-being is increasing in popularity. Such “health tourism” includes, but is not limited to, traveling for alternative therapies, such as balneotherapy (treatment by baths) and thalassotherapy (treatment based on the use of sea water), religious pilgrimages, and modern medical treatments, including elective surgery.

Therapies that are considered “natural” are not without hazards. Mineral and “holy” waters may not be potable by U.S. standards and have been sources of infectious diseases. Moreover, pilgrims are subject to the same destination-associated risks as other travelers (e.g., heat and altitude-associated illnesses), but many may be traveling in ill-health. Outbreaks of meningitis due to Neisseria meningitidis have occurred in Hajj pilgrims, leading to the requirement that all pilgrims participating in the Hajj be immunized before their departure. With the shift in the timing of the Hajj to winter months, pilgrims may also be at increased risk for respiratory tract infections, such as influenza and adenovirus.

Medical tourism, traveling to another country for medical, dental, or surgical care, is a rapidly growing industry. Traditionally, people who could afford to do so traveled from lower-income counties to more developed countries in order to seek care not available in their home country. In recent years, however, people from higher-income countries have started traveling to lower income countries in seek of lower medical costs and shorter waiting times, Companies offering vacation packages bundled with medical consultations and financing options provide direct-to-consumer advertising over the internet.

Enter “medical tourism” into any internet search engine and one will find a variety of tourism packages from travel agencies and health-care facilities worldwide.

Recognizing the potential revenue to be gained through medical tourism, countries such as India, Thailand, Costa Rica, Turkey, and others have promotional campaigns to attract tourists seeking traditional and alternative therapies. Such medical packages often claim to provide high-quality care, but as mentioned above, the quality of health care in developing countries is highly variable, and only a handful of international health-care facilities are accredited by the Joint Commission International.

For the most part, medical insurance companies do not pay for medical procedures performed abroad, although some health insurance providers in the U.S, recognizing the cost benefits, allow policy holders to seek care in Mexico. Another problem with medical tourism is that there is little follow-up care. The patient usually is in the hospital for only a few days and then returns home. Complications are then the responsibility of the health-care system in the traveler’s home country. For example, CDC received a number of reports of nontuberculous mycobacterial infections after elective cosmetic surgery abroad.

In addition to these postoperative complications, procedures that result in significant blood loss and require transfusion subject the traveler to greater risk for blood-related complications, including compatibility errors and infection with hepatitis viruses or HIV. Finally, countries that offer medical tourism may have weaker malpractice laws than those in the U.S, giving the patient little recourse to local courts or medical boards if something goes wrong.

“Transplant Tourism,” a special type of medical tourism, has been increasing as the number of available organs, especially kidneys, is decreasing relative to the increasing demand. A number of international transplantation rings have been discovered, in which people from developing countries are paid for donating organs. This practice is considered legal in only a few countries. Recently the World Health Assembly met to discuss the challenges of transplantation and to address international transplantation guidelines. It encouraged countries to protect those most vulnerable to such exploitation, but there is still no international consensus on incentives for organ donation. In June 2006, the Organ Procurement and Transplantation Network (OPTN) and the United Network for Organ Sharing (UNOS) Board of Directors unanimously approved a statement opposing transplant tourism.

Regardless of the reason, people seeking health care abroad should understand that medical systems outside the United States may operate differently from those in the United States and are not subject to the same rules and regulations. Those who are considering seeking health care outside the United States should consult with their local physician before traveling.

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Health Insurance Option Called No Insurance Club

An Arizona-based company called the No Insurance Club is offering a no-frills option to health insurance for people who want basic, preventive health care. The company was founded by Chad Harris and Sam Sannoufi, a Gilbert physician, and opened for business in January 2009.

For a yearly fee of $480 for single people, $580 for couples, and $680 for families (regardless of size), those who Join the No Insurance Club get 12 doctor visits (16 for families) and services such as flu shots, discount prescriptions (generics), physical examinations, blood tests, and other preventive testing. Participants in this Club have no co-pays for their doctor visits, and no physical is required before enrolling. People who have a pre-existing condition can sign up with no questions asked.

What is notable is what the Club does not cover: emergency room visits, catastrophic illnesses, hospitalizations, visits to specialists, surgery, brand name prescriptions, and rehabilitation, among other services. But for some people who cannot afford the high premiums of the health insurance plans on the market, but who believe they will utilize the services offered by the No Insurance Club, this may be the option – albeit a temporary one perhaps – they are looking for.

The No Insurance Club is active in ten states, including Arizona, California, Georgia, Illinois, Indiana, Missouri, New York, North Carolina, Pennsylvania, and Washington. Each of these states has participating physicians who offer preventive services. An advantage for physicians who participate in the program is that they are paid directly by the Club instead of having to wait for reimbursement from an insurance company, and they get more per patient visit than they do from people who have health insurance.

The No Insurance Club health insurance option obviously is not for everyone. But for individuals and families who know they will use the limited services covered by the plan (especially doctor visits for children), enrolling in the Club, even for one year, could cover the gap until a more suitable health insurance option comes along.

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Infant estrogen levels tracked through diaper research

With the help of babies and more than 5,000 of their diapers, Emory University researchers have developed an accurate, noninvasive method to determine estrogen levels in infants. The method, previously used in nonhuman primates, will allow researchers to learn more about the association between estrogen levels in human infants and their long-term reproductive development as well as the development of sex-specific behaviors, such as toy preference or cognitive differences. What’s more, the method will also allow researchers to look at how early disruption of the endocrine system affects long-term maturation, a growing concern among researchers and physicians.

Surprisingly little is known about hormone levels during human infancy. Previous human research has focused on the measurement of hormones in blood, urine and saliva. The new data are the result of using fecal samples collected from cotton diapers. With this novel approach, the researchers successfully measured the fecal levels of estradiol, a type of estrogen.

The well-known importance of estradiol’s role in postnatal development of the body, brain and behavior has in recent years raised specific concerns about how exogenous estrogens, or environmental estrogens, such as those found in soy, fruits and vegetables, plastics and common household items, affect lifelong health.

“The development of robust, noninvasive methods to measure these hormones in infants allows us to further investigate the association between postnatal hormone production and the development of sex-specific biology and behavior,” says Michelle Lampl, PhD, MD, Emory University Samuel Candler Dobbs professor of anthropology, and senior author of a paper in Frontiers in Systems Biology describing the new method.

The study, conducted by researchers at Emory, the University of North Carolina at Chapel Hill and the University of Virginia Health System, Charlottesville, appears online at http://www.frontiersin.org/Journal/Abstract.aspx?s=1086&name=systems_biology&ART_DOI=10.3389/fphys.2010.00148 and in the current issue of Frontiers in Systems Biology.

“The development of an assay to measure estrogen from diapers might initially strike one as unnecessary or strange, but the need is real,” says Sara Berga, MD, James Robert McCord professor and chairman, Department of Gynecology and Obstetrics, Emory University School of Medicine.

“We understand very little about the hormonal dynamics that occur during early development precisely because we lack a reliable way to track hormones in neonates and very young children. Having a way to track this critical hormone that influences behavior and the development of many important tissues, including the brain, will allow us to understand normal. This really is a great leap forward, and the investigators should be congratulated on this advance.”

The paper’s lead author is Amanda L. Thompson, PhD, who conducted the research at Emory and is now assistant professor of anthropology at the University of North Carolina, Chapel Hill. Other authors are corresponding author Michael L. Johnson, PhD, University of Virginia Health System, and Patricia L. Whitten, Emory University.

Because of the ethical and practical difficulties of repeatedly taking blood samples from healthy infants, little data are currently available for charting the developmental pathways of estradiol. As such, existing data describe only the range of variability in hormonal levels–not developmental trends or what that variability might mean when it comes to individual physical and behavioral development.

The study included 32 infants, 15 male and 17 female, aged 7 days to 15 months. The infants’ parents retained soiled diapers after each diaper change during a 24-hour period. Bagged diapers were collected and then frozen and stored at – 80°C and analyzed 24 hours to 12 months after collection. In preparation for analysis, diapers were thawed overnight at 2 to 8°C.

Previous studies in primates have shown a close parallel between fecal levels of estradiol and serum values. Likewise, a comparison of fecal steroid levels between the study infants and previous studies of human adults shows an overlapping pattern, a pattern that is also seen in infant serum when compared with adult serum.

“These observations are the first report of human infant fecal estradiol levels and they provide a new tool for investigating early human development”, says Lampl. “Because infant diapers are plentiful, fecal samples can be collected frequently and over a long period of time. Future longitudinal studies will allow the association between fecal levels of steroids and physiological measures to be assessed, and expand our understanding independent of serum measures.”

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