MNsure adds Rochester health plans
Nearly three weeks after state officials announced Medica would begin offering additional plans for Rochester residents, consumers can start buying those plans on the state's health insurance exchange today.
Jenni Bowring-McDonough, a spokeswoman for the state's exchange MNsure, said the delay getting the plans online was due to testing. MNsure did not want them online until they were confident that consumers could access the plans without encountering problems.
"MNsure is thrilled to be able to offer more choices to consumers in southeastern Minnesota," she said.
Before these plans were added to the exchange, only one health insurance plan was available to Rochester residents — a Blue Cross Blue Shield Minnesota plan with a $3,000 deductible. In an interview Monday, Sen. Carla Nelson, R-Rochester, said she was frustrated the Medica plans had not become available yet.
The lack of choice for Olmsted and Dodge county residents in certain ZIP codes prompted state officials and local lawmakers to work on a deal enabling Medica to offer insurance plans in those areas. On Oct. 1, the Minnesota Department of Commerce and Minnesota Department of Health touted those efforts, noting Medica soon would be offering seven plans in Rochester.
When it comes to provider choice, Rochester residents shopping on the exchange are still in a tough position. Under the Medica plans, Mayo Clinic Rochester is not in the network. That's the reason Medica plans had not been offered in those ZIP codes originally because they did not meet a state requirement that certain numbers and types of providers be covered within a certain radius, said Medica spokesman Greg Bury.
The only exception to this is if a patient is referred to Mayo Clinic Rochester by a physician at a Mayo Health System facility. Bury said Mayo Clinic Rochester was not included in Medica's network because "the two organizations have not been able to agree on financial terms that are acceptable."
Mayo Clinic spokesman Bryan Anderson said Mayo is open to discussions that would broaden the number of people with access to the clinic, adding that "Mayo Clinic has agreements with most major insurers."
Even with the additional Medica plans in place, southeast Minnesota continues to have the highest average insurance premium rates of any other region in the state. That, coupled with the lack of choice of providers, frustrates Rochester insurance broker Michael Pagelkopf.
"What has happened here has certainly given new meaning to the word affordable and to the word choice because if a person wants to or needs to be able to doctor at Mayo Clinic in Rochester, there is only one choice and that's the plan with Blue Cross Blue Shield," said Pagelkopf, owner of John W. Pagelkopf Agency.
He is also frustrated that it took nearly three weeks to make the Medica plans available on MNSure's website. In addition, he continues to have problems accessing the website. On Monday morning, the website was down while he was trying to assist two different customers.
House Health and Human Services Policy Committee Chairwoman Tina Liebling, DFL-Rochester, said it is important for people to realize there is no need to rush to sign up on MNsure.
"There's still time, and if people know that they are coming, I think it's a situation where people know they don't have to buy yet," she said.
With the Medica plans, a 40-year-old nonsmoker in Rochester can get a bronze plan with a $6,350 individual deductible for $257.17 per month. Similar plans start at $115.32 in the Twin Cities metro.
So why the higher costs in southeast Minnesota? Some point to what's been dubbed the "Mayo effect," pinning the blame on more expensive care on Mayo Clinic and a lack of competition in the region. Others argue the region has a sicker population. Ultimately, Liebling said it's likely a number of factors. She said Minnesota's loss ratio regulations mean insurance companies can't charge exorbitant prices for coverage.
"It can't be that the companies are just gouging everybody," she said. "It's pretty clear that the costs are higher. Why they are higher and what we can do about it still needs to be resolved."
Anderson said Mayo Clinic is continuing to do what it can to be an affordable option for care. He said that some insurers are reluctant to offer plans that include academic medical centers like Mayo Clinic.
"As an academic medical center, Mayo Clinic cares for patients with more complex medical conditions that have higher costs to insurers," he said. "And, as we've seen across the country, the higher costs for these complex patients create a reluctance for insurers to offer plans that include academic medical centers."
MNsure is Minnesota's new online health insurance marketplace, sometimes called an exchange. Minnesota consumers and small businesses with up to 50 full-time employees can obtain health insurance through MNsure with options that range from free or low-cost policies for government health insurance such as Medicaid and MinnesotaCare to commercial health plans.
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