PacifiCare to Offer Plans with Lower Premiums, Higher Copays for Doctor Visits, Certain Hospitals
PacifiCare of California formally announced last Thursday that it will offer new health plans that "substantially" raise copayments for doctor visits and hospital procedures performed outside of "select" facilities in exchange for lower premiums, the Contra Costa Times reports. The plans, which PacifiCare first publicized last month, are intended to provide employers with a way to "offset premiums," which are expected to increase more than 10% next year. Employers selecting the new plans are expected to save 5% to 20%, the Times reports. However, employees will see copayments for physician visits increase to between $10 and $20 and fees for specialists to between $20 and $40. (Silber, Contra Costa Times, 11/2). In addition, PacifiCare members will be charged a copay ranging from $100 to $400 a day to use a hospital that is not on the plan's select list, while members treated at select hospitals will not be charged a copay (California Healthline, 10/24). Those facilities designated as select hospitals have the "most favorable contracts" with PacifiCare and include about half of the 230 facilities currently contracting with the insurer. Under the new plans, members in Contra Costa County will have access to three hospitals, while members in Alameda County will be restricted to six facilities, the Times reports (Contra Costa Times, 11/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.