Excellus BlueCross BlueShield will begin taking new members for its family Health Plus and HMOBlue Option plans in Oswego County starting Feb. 1. Excellus, which is Central New York’s largest health insurer, had stopped enrolling new members in those plans in recent years. It closed the plans to new enrollees in 2005 but continued to […]
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Excellus BlueCross BlueShield will begin taking new members for its family Health Plus and HMOBlue Option plans in Oswego County starting Feb. 1.
Excellus, which is Central New York’s largest health insurer, had stopped enrolling new members in those plans in recent years. It closed the plans to new enrollees in 2005 but continued to cover members who had signed up with the plans before that.
The insurer decided to sign up new members after a request from the New York State Department of Health, according to Sheila Betters, director of sales and marketing for safety net and state-government programs at Excellus. The state asked Excellus to renew its services in Oswego County after another insurer, Syracuse–based Total Care, Inc., decided to stop offering similar insurance in the county, she says.
“[The state] wanted to be able to keep a well-rounded set of options available to people in that community,” Betters says. “We’re happy to do it. It was something that had been discussed, so this was just a great way to make it happen.”
Family Health Plus is a state-sponsored, managed-care health-insurance program. It is aimed at adults 19 years old to 64 years old with incomes that are too high to qualify for Medicaid.
HMOBlue Option is Excellus’ Medicaid managed-care plan. It is for individuals who are eligible for Medicaid, although some people who receive Supplemental Security Income also qualify.
Members of the Excellus plans can choose from 9,000 doctors, specialists, and hospital providers throughout the insurer’s coverage area, which includes Central New York, Rochester, the Southern Tier, and Utica. The plans cover vital services, although co-pays sometimes apply.
Excellus decided to close enrollment in Family Health Plus and HMOBlue Option in 2005 to review the programs, according to Betters.
“We just decided to take a breather to make sure we had the structures that we wanted to have in place and the services available to support our membership,” she says. “It’s more about inner workings and everything that’s in place for membership.”
Excellus made no major changes to the plans now that they are being reopened in Oswego County, Betters says. Excellus will continue to review the programs and look for ways to improve them, she adds.
The health insurer expects to add about 3,500 Oswego County members to the two plans combined after enrollment opens Feb. 1. The new members will likely come quickly, Betters says, as individuals seek to maintain their health insurance while Total Care pulls out.
About 128,000 people are enrolled in Excellus HMOBlue Option plans throughout the insurer’s Utica, Rochester, Central New York, and Southern Tier regions. Another 21,000 are enrolled in Family Health Plus in those regions.
Excellus will not have to heavily advertise the opening of the programs to potential enrollees in Oswego County, Betters says. Local and state-government agencies typically help eligible individuals enroll in the programs, she says.
“There’s a natural flow of information,” Betters says. “They would help with the enrollment to any of the plans.”
Excellus BlueCross BlueShield is a not-for-profit independent licensee of the BlueCross BlueShield Association. The insurer is headquartered in Rochester and bases its Central New York operations in Syracuse.