Report Critical Of Coverage Limit in Massachusetts Plan
New health insurance plans targeted at young adults in Massachusetts contain coverage limits that could result in costly treatment bills for some policyholders, according to a report released Tuesday by the Access Project, the Boston Globe reports.
The plans are part of a Massachusetts law enacted last year that requires all residents to obtain health insurance. The Massachusetts Commonwealth Health Insurance Connector, the agency overseeing the law, authorized coverage limits for plans for 19-to 26-year-olds, but prohibited similar limitations for other age groups because of the greater likelihood of serious illness.
The coverage limits are modeled on health plans for Massachusetts students. Such plans include annual coverage limits for each illness, as well as caps on outpatient care and surgeons' fees, according to the Globe.
The new plans for young adults contain more protections than the student plans, but most limit annual coverage at $50,000 or $100,000 to keep premium costs low. The young adult population represents the largest segment of the uninsured population in the state.
The report recommends that the state reform the student plans and eliminate the coverage limits in the new young adult plans. Access Project officials noted in the report that Blue Cross Blue Shield is offering a low-cost young adult plan that does not limit costs.
Richard Powers, a spokesperson for the connector, said the young adult plans are more comprehensive than the student plans and limit out-of-pocket costs until they exceed the spending cap (Dembner, Boston Globe, 5/29).