I had a phone call this week from my health insurance company. Actually, two calls.
The first was a ‘robocall’ letting me know that flu season is just around the corner, so it’s not too late to get a flu shot. And I was reminded, my plan pays for immunizations at 100%.
The second was a live caller. “Checking our records,” they said, “it’s been just over a year since your last physical. Will you be scheduling one soon?”
The Affordable Care Act requires health insurers to accept virtually all individual and small group applicants. No medical questions. No pre-existing conditions. In short, at the time of enrollment, they can’t assess risk.
But that doesn’t mean after enrollment, they can’t try and manage risk. Keeping me well reduces claims.
And remember, insurers are now governed by medical loss ratio rules. Lower claims must be passed on in the form of lower premiums or rebates (or both).
In that context, “managed care” works for me.