AARP being questioned on health care plans they offer that lack catastrophic coverage
03 11 08 - 12:32
AARP questioned on health plans
By Julie Appleby, USA TODAY
Some health plans offered by AARP, the older Americans advocacy group, mislead consumers into thinking they're protected from catastrophic health costs but leave them vulnerable to paying tens of thousands of dollars, Sen. Chuck Grassley, R-Iowa, says.
Grassley, the top Republican on the Senate Finance Committee, is sending more than a dozen questions to AARP CEO William Novelli today about AARP plans that cover about 1 million people. The actions are part of Grassley's broader health coverage and cost inquiry.
"Insurance is supposed to limit your exposure to the potentially high cost of a serious illness, and these plans do the opposite," Grassley says. "It's especially alarming when the marketer is a big-time advocate for health security and the target market is under- and uninsured Americans."
The AARP plans, backed by UnitedHealth Group, one of the largest insurers, cap what the insurer pays but not what policyholders might owe. Such policies, often called "limited benefit plans," are a small but growing segment of the market offered by many insurers. They generally cost less than traditional coverage.
David Sloane, an AARP senior vice president, says the group offers a wide variety of policies. Until the USA "reforms the system and gives everyone access to coverage," he says, plans such as those being scrutinized by Grassley provide one alternative. "For people who … need at least some protection, this is better than nothing," Sloane says.
The AARP plans cost about $133 to $466 a month and target people ages 50 to 64. Grassley initially focused on two: Essential Plus Health Insurance and Medical Advantage Plan. AARP says about 44,000 people are enrolled in those plans — out of 1 million in all its limited benefit plans that Grassley will examine.
One plan pays $3,928 for a coronary artery bypass. Yet that surgery averaged $33,000 in hospital costs in 2006, reports the Agency for Healthcare Research and Quality. The plans don't cover the first day of hospital care.
Karen Pollitz, director of the Health Policy Institute at Georgetown University, says AARP's and other similar plans don't protect people from high costs, noting they pay little for hospital care.
AARP's other types of insurance plans — such as Medicare supplement and prescription drug policies — are not part of the inquiry.
Grassley's letter cites concerns about AARP's marketing materials, which say the plans offer the "essential benefits you deserve."
Dave Mathis, senior vice president of health products, says of the materials, "These are not comprehensive plans, and it's not our intent to market them as such."