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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