By Coleen Elkins 24-7 Health Insurance
How can that happen? It happened because Blue Cross Blue Shield of Tennessee decided to exit the market in those cities. The carrier is taking drastic measure to recover losses sustained over the last 2 years of insuring under the mandated benefit guidelines.
Safeguards were not put into place to protect insurers from abuse during enrollment.
Consider this example. The average stay in a drug and alcohol rehab center is $30k a month. Drug and alcohol rehab is a mandated covered benefit. Anyone watching television must have noticed the commercials cropping up that your insurance will cover your recovery from your addiction. That is an admirable added benefit that has been completely abused. An uninsured person is able to change their address when they moved to rehab. This created a special election period allowing them to enroll in the insurance plan of their choice. The carrier is forced to cover the expense of their stay for the duration. If they relapsed they got to go back again and have the insurance company pay additional claims on their behalf for any readmissions.
Carriers can still exit the market for 2017 and we expect to see that happen. Blue Cross of Nebraska announced yesterday they will not be insuring ACA Plans. CIGNA has not announced any intentions either way. If CIGNA decides to leave the market it could leave some counties in the United States without an insurance carrier option.
You can read more about Blue Cross of Tennessee's decision here.