Miami-Dade, Blue Cross Announce Low-Cost PPO Aimed At County's Uninsured

Main Category: Health Insurance / Medical Insurance
Article Date: 29 May 2009 - 4:00 PDT

Florida's Miami-Dade County and BlueCross BlueShield of Florida on Tuesday announced a new low-cost health plan, called Miami-Dade Blue, aimed at helping the estimated 600,000 uninsured county residents, the Miami Herald reports. The plan -- which costs taxpayers nothing -- is a traditional PPO, with no pre-approvals or referrals and will cost a healthy 35-year-old male about $100 per month. Miami-Dade Blue has a $250 deductible and will cover 90% of in-network hospital costs and 100% of fees for in-network lab tests after the deductible is met. The copayment for generic drugs is $10 per prescription; the plan will not offer coverage for brand-name prescriptions.

The plan is being offered to individuals younger than age 65 and to small employers with up to 50 workers. Businesses will be guaranteed coverage if 70% of employees take part in the plan and the owner pays at least 50% of the premiums; however, individuals with costly pre-existing health conditions likely will be denied coverage. The plan has an annual out-of-pocket limit of $2,500 and a lifetime benefit of $5 million. About 1,500 physicians agreed to be part of the Miami-Dade Blue network, while 20 clinics and seven hospitals are in the plan's network (Dorschner, Miami Herald, 5/27).