WellPoint Pilot Project Slated To Cover ‘Medical Tourism’ Services
On Wednesday, WellPoint is expected to announce a pilot program that will offer some of its group members the option of traveling to India for non-emergency medical procedures, the Indianapolis Star reports.
The medical tourism benefit is set to begin in January and initially would cover about 700 group members and their dependents at Serigraph, a Wisconsin-based specialty printing company. Members participating in the pilot will be able to travel to India with a companion at no travel or other out-of-pocket cost for procedures such as joint-replacement surgeries.
Under the program, WellPoint case managers would collaborate with patients on their travel and medical arrangements with Joint Commission International-accredited hospitals in the Indian cities of Bangalore and New Delhi.
WellPoint said the pilot program meets the medical tourism standards of the American Medical Association.
WellPoint spokesperson Kristin Binns said patients who seek legal recourse regarding the outcome of a surgical procedure are "entitled to all rights and remedies available under applicable law."
Binns did not indicate which country's laws are applicable, the Star reports.
According to the Star, WellPoint joins a "limited list" of U.S. insurers that offer medical tourism benefits. BlueCross and BlueShield of South Carolina offers medical tourism benefits through a company called Companion Global Healthcare.
Implications
According to the Star, the proliferation of medical tourism programs like WellPoint's could "create even more friction between insurers and health care providers when it comes to the contentious point of reimbursement rates."
The Star reports that hospitals seek profits on "surgical procedures such as joint replacements -- the very surgeries targeted in medical tourism -- and then use those proceeds to help fund money-losing areas of care" (Lee, Indianapolis Star, 11/12). 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.