Business

WellPoint subsidiary drops coverage in Illinois, Texas

UniCare says it couldn't get enough market share. Members can opt for comparable insurance with Blues plans in both states.

By Emily Berry — Posted Nov. 13, 2009

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Indianapolis-based WellPoint is sending about 400,000 of its non-Blue membership to BlueCross BlueShield-affiliated plans owned by another company, citing an inability to win enough market share to serve those members efficiently.

The members belong to WellPoint's national UniCare subsidiary but are not in one of the 14 states in which it owns Blues plans. The company reported 33.9 million members before the announcement.

"In markets where we are Blue, we see the advantage of our scale; we see the advantage of our market depth. And that was a challenge for us in Illinois and Texas," said WellPoint President and CEO Angela Braly.

Affected UniCare members can opt to move to Blues plans, which in both states are owned by Health Care Service Corp.

HCSC, based in Chicago, has about 4.4 million members in Illinois and 7.2 million in Texas, said company spokesman Ross Blackstone. HCSC also owns the Blues plans in Oklahoma and New Mexico. Members who move are guaranteed comparable coverage without consideration of preexisting conditions.

The move will include only commercial membership in the two states; customers with Medicare plans and other products sold by UniCare will not be affected.

Physicians in Illinois and Texas who serve UniCare members should send claims to UniCare through the end of the year, then to the Blues after members switch at the beginning of 2010, Blackstone said.

After the switch, reimbursement rates will be under the Blues' fee schedule. Any doctors who are in UniCare's network but not the Blues' will be considered out-of-network and reimbursed accordingly, Blackstone said.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn