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BLUE CROSS AND BLUE SHIELD 'SPECIAL CARE' NOW AVAILABLE FOR PENNSYLVANIA'S WORKING UNINSURED

 BLUE CROSS AND BLUE SHIELD 'SPECIAL CARE' NOW
 AVAILABLE FOR PENNSYLVANIA'S WORKING UNINSURED
 HARRISBURG, Pa., May 1 /PRNewswire/ -- Pennsylvania's Blue Cross and Blue Shield Plans new low-cost health care coverage is now available.
 This new "Special Care" is specifically designed for thousands of low- and moderate-income Pennsylvanians who are 65 years or younger and currently have no health insurance.
 Blue Cross and Blue Shield will highlight Special Care throughout a 10-week promotional program that will feature 1-800-952-BLUE as the quickest access to Special Care.
 The low-cost program, averaging about half the price of standard coverage, is possible because participating hospitals throughout the state would accept discounted levels of reimbursement for those covered. Blue shield participating physicians also will accept discounted payments.
 Also contributing to the low cost will be a specially designed benefit package and a projected $8 million in annual subsidies from Blue Cross and Blue Shield.
 The State Insurance Department announced its approval of Special Care April 1, with the understanding that Blue Cross and Blue Shield could begin to accept enrollment applications May 1. Coverage under Special Care will begin June 1.
 Blue Cross and Blue Shield Special Care prices will range from approximately $62 to $75 per month for one person, depending on where an individual lives in the state. Family coverage also would be available, ranging from $122 to $198 per month for a family of four.
 Although low-priced, Special Care will provide full payment for covered hospitalization and professional health care services. The coverage also will include preventive services such as home and office visits for children and adults, according to Blue Cross and Blue Shield officials. Specific benefits include:
 Standard Blue Cross and Blue Shield Benefits:
 -- Surgery/anesthesia (inpatient/outpatient)
 -- Inpatient -- diagnostic services
 -- Emergency accident and medical treatment
 -- Maternity/newborn care
 -- Chemotherapy/radiation therapy
 Benefit Modifications:
 -- 21 days inpatient care (hospital/medical) -- renewable after 90
 consecutive days out of the hospital
 -- Outpatient diagnostic services ($1,000 annual maximum)
 -- Hospital and surgery review programs
 Primary Care/Wellness:
 -- 4 annual doctor visits per person ($10 copayment)
 -- Comprehensive preventive care for children (physician
 visits,immunizations,pathology)
 -- Routine annual mammogram and pap smear for women
 In developing the statewide Special Care program, Blue Cross and Blue Shield officials studied a Special Care program that has been offered by Blue Cross of Western Pennsylvania for the past year. That program insures 16,000 residents of western Pennsylvania. The new statewide program expands on the original program as another step in a series of initiatives undertaken by Blue Cross and Blue Shield to broaden access to health care coverage.
 Eligibility for Special Care. Pennsylvania's rate of uninsured is already among the lowest in the country, at an estimated eight to ten percent of the population. Blue Cross and Blue Shield Special Care is intended to further reduce that rate by making health insurance more affordable for the estimated 600,000 residents eligible for Special Care who currently do not have health insurance.
 Seventy percent of the state's uninsured are younger than 35. To reach that group, Blue Cross and Blue Shield designed the new program with single parents and young families in mind -- people who need both standard health care coverage and preventive services coverage. Pennsylvania's uninsured population is dominated by working single parents and young families.
 Those who are uninsured run the risk of financial devastation if they need extensive health care services. That cost either will go unpaid and be an unreimbursed burden for hospitals and doctors or will be shifted to those who are privately insured.
 Special Care is available to:
 -- One person earning $12,000 or less per year.
 -- Two-person families earning $16,000 or less.
 -- Three-person families earning $20,000 or less.
 -- Families of four or more earning $24,000 or less.
 Reasons for Low Cost. A number of factors would contribute to the low cost of Special Care:
 Health care providers -- hospitals, other institutions, doctors and other professionals providing care -- will accept lower-than-usual payments.
 Blue Cross and Blue Shield group customers contribute to a subsidy that will offset a portion of the cost of premiums for purchasers of Special Care.
 A managed care component of Special Care will require advance approval for 13 elective surgeries and all non-emergency hospital admissions.
 "Community-rating" of the new program will enable persons with Special Care to be part of one large group within each Blue Cross region, evenly spreading all premium expenses throughout the entire base of persons with Special Care coverage.
 Pennsylvania is one of nine states assuring the availability of "community-rated" health insurance. In Pennsylvania, community-rated coverage is available through Blue Cross and Blue Shield. States with community-rated health insurance tend to have lower rates of uninsured, according to the government's General Accounting Office (GAO), and other studies. Congress is considering greater use of community rating as federal policy.
 Currently, nearly 2 million Pennsylvanians are within community- rated Blue Cross and Blue Shield programs, including 225,000 individuals younger than 65; 1.1 million small-group employees and their families; and 650,000 senior citizens who purchase 65-Special coverage to supplement Medicare. Another 255,000 retirees have employer-paid 65- Special. Blue Cross and Blue Shield also provide health care coverage for 4.7 million Pennsylvanians through large group customers who purchase coverage for their employees.
 No Health or Age Restrictions. As with most coverage offered by Blue Cross and Blue Shield in this state, accessibility to community- rated Special Care would not be restricted by age (for those not covered by Medicare), health status or occupation. Those who are older or who have medical problems would not be charged a higher price.
 Special Care has been developed through a statewide task force involving blue Cross of Northeastern Pennsylvania, Blue Cross of Western Pennsylvania, Capital Blue Cross, Independence Blue Cross and Pennsylvania Blue Shield.
 /delval/
 -0- 5/1/92
 /CONTACT: Brian Herrmann of Pennsylvania Blue Shield, 717-763-3319, or Scott Dugan of Capital Blue Cross, 717-541-6134/ CO: Pennsylvania Blue Shield; Capital Blue Cross ST: Pennsylvania IN: INS SU: PDT


CC -- PH035 -- 5517 05/01/92 13:54 EDT
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Date:May 1, 1992
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