Capitol Hill Health Coverage

By Beacon Staff

Amid the debate to overhaul the U.S. health care system and after Rep. Denny Rehberg badly broke his ankle in a boat crash on Flathead Lake, Lee’s Mike Dennison has an interesting report out on the health insurance coverage enjoyed by Montana’s federal delegation. As you may have heard, it’s a pretty generous plan, and one shared by many federal employees. Sen. Max Baucus didn’t release details of his health coverage (though, at 67, he is eligible for Medicare), but it’s worth a look to see how Rehberg’s and Sen. Jon Tester’s coverage compares to your own – that is, if you’re lucky enough to have coverage.

From Dennison’s report:

The Blue Cross/Blue Shield plan chosen by Rehberg and Tester has a $300 deductible per person or $600 per family, after which the insurer covers 85 percent of the costs of most services. The maximum allowable out-of-pocket expense for a year is $5,000 – if they use physicians and hospitals in “preferred provider” network. If not, it’s $7,000.

They have a $20 co-payment for doctor visits, $200 for a hospital visit and $100 for an ambulance ride in an emergency. It’s more if you go outside the network. Also, hearing aids are covered up to $1,000 for adults, and prescription drugs are covered as well, with no co-pays for the first four generic drugs you buy and 80 percent covered after that.

It’s somewhat comparable to coverage available to state of Montana employees, who are in a self-insured pool managed by private insurance companies like Montana Blue Cross/Blue Shield or New West Health Services.

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