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HEALTH CARE Families not told about free insurance



Published: Tue, January 18, 2005 @ 12:00 a.m.



Some kids covered by Blue Cross and Blue Shield insurance are eligible for a free insurance program.

HARRISBURG (AP) -- Families of thousands of Pennsylvania children might be paying for health insurance they could get for free.

About 8,500 children are enrolled in low-cost insurance plans for lower-income families offered by the state's four Blue Cross and Blue Shield insurers. But most children who qualify for those plans also qualify for the state's free Children's Health Insurance Program, according to Community Legal Services, a group investigating the marketing practices of the state's four Blue plans.

There is no evidence, however, that the Blues -- which administer the CHIP plan for the state -- deliberately steered families into special care, for which they charge premiums, said Jonathan Stein, of the Philadelphia-based legal group.

But he said the situation shows that the Blues do a poor job of informing lower-income families of their options, and that the state shouldn't rely on them to run CHIP.

"I do think these families were grossly misinformed," he said. "I think that when the government relies on a monopolistic entity to be a provider of health insurance and a source of information, they cannot be an independent, reliable one."

CHIP coverage

CHIP is available to children up to age 19. In addition to being free, it offers better benefits than special care, including prescription, dental, vision and hearing coverage.

Representatives for each company said there are reasons a family might choose special care rather than CHIP. For instance, they said that unlike special care, CHIP has residency and proof of income requirements; they also said some families might prefer to keep their family under one plan.

"We have a long history of supporting the CHIP program," Capital Blue Cross spokesman Joe Butera said.

Enrollment outreach

Pat Stromberg, who directs CHIP, said the Pennsylvania Insurance Department has met with all four Blue plans and asked them to "reach out to special care families to make sure they fully understand CHIP and consider enrolling."

The department, however, hasn't received any complaints from people who felt they were steered into special care instead of CHIP, Stromberg said.

Stromberg added that she sees no motive to steer people away from the free plan, under which about 134,000 Pennsylvania children are enrolled. Insurers receive more money for children in CHIP than they do for children in special care, she said.




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