Health First Health Plans Has Emphasis On Wellness
By Space Coast Medicine & Active Living // May 17, 2013
HEALTH FIRST INDIVIDUAL
Previously Only Available In the Workplace – Beginning May 1 Includes Option For Individuals and Families
CENTRAL FLORIDA, USA – As Devita Rodrigues sees it, her membership in Health First Health Plans is more than health insurance. It is also her ticket to wellness.
Rodrigues, owner of Corinthian Kitchen and Bath in Rockledge, joined the plan last year, but it was not the first time she had enjoyed the extensive coverage it provides.
“The company I used to work for had Health First and I always liked the plan,” she said. “They’re always very attentive to what I need and very easy to work with and I never had to wait very long for anything. The doctors make me feel very comfortable and I’ve never had any problems with claims. The program had always earned an A+ with me.”
The plan’s emphasis on wellness appeals to Rodrigues, who was looking for incentive to get exercising.
“After having my daughter, I wanted to get back into fitness, and the fact that the plan includes membership in Pro-Health served to motivate me to get moving,” she said.
Rodrigues appreciates unlimited free access to the state-of-the-art fitness center, Pro-Health & Fitness, in Viera, where she can be found as many as five times a week.
“I’m now taking a spin class and I absolutely love it,” she said.
“Their scheduling is very convenient. I’m also looking into their nutrition classes, because I want to change my family’s eating habits.
Her daughter, Symone, often joins her mom at Pro-Health, where she can enjoy KidFit classes or other child-friendly activities and programs.
INTEGRATED DELIVERY SYSTEM
With more than 60,000 members in Brevard and Indian River Counties, Health First Health Plans is nationally recognized for its customer service. Beginning May 1, the plan, which was previously only available through the workplace, now includes the option for individuals and families to join directly.
“As an integrated delivery system, Health First is ideally positioned to coordinate care for the individual market,” said Jason Alford, director of individual and marketplace sales at Health First.
“Health First Health Plans has designed a comprehensive suite of individual plans to cover people interested in benefits similar to those provided by large employers, in addition to those simply wanting protection in case of a major health event. The individual and family plans will include major medical insurance policies offering a full range of preventive care, office visit co-pays and hospital coverage to those under the age of 65.
“Operating in a community with such a large population of self-employed, early retirees and college students, Health First Health Plans recognizes the significant market demand for individual products,” said Alford.
“These plans also provide members with pre-negotiated discounted rates with Health First’s networks of hospitals, physicians and pharmacies. Our individual and family plans are contracts directly between our members and us. This dynamic makes the policy truly individual and not dependent upon where a person works or the plan chosen by an employer.”
The new individual and family option was created to address the specific needs of area residents.
“Operating in a community with such a large population of self-employed, early retirees and college students, Health First Health Plans recognizes the significant market demand for individual products,” said Alford.
“Although many residents of our community are covered by employer-sponsored or Medicare plans, thousands find themselves needing or wanting individual policies.”
AIMED AT THE CURRENTLY UNINSURED
The individual and family plan option is aimed at the currently uninsured, early retirees, the self-employed, persons who are between jobs, college students, recent graduates, small business owners without group benefits and individuals who have experienced high rate increases from other individual plans.
Because Health First is Central Florida’s only fully integrated health system, it is well positioned to provide a comprehensive package of healthcare services for the new individual and family plan members. The system operates four hospitals, several outpatient and wellness services, four fitness centers, the largest multi-specialty physician group in Brevard, the First Flight air ambulance program, and the area’s only trauma center.
“The new Preferred Provider Organization known as the ‘PPO’ network gives members the choice to maximize their benefits within a home network or to use benefits outside the home network with a higher cost-share.”
The new individual and family plans will expand provider access for members and offer coverage inside and outside the local network with a Preferred Provider Organization network arrangement,” said Alford.
“The new Preferred Provider Organization known as the ‘PPO’ network gives members the choice to maximize their benefits within a home network or to use benefits outside the home network with a higher cost-share.”
Individual and family plan members enjoy a first full-year deductible that does not reset on January 1, but rather on the anniversary of the policy.
OUTSTANDING SERVICE DELIVERY
Health First Health Plans has repeatedly earned national recognition for service delivery. For example, the Centers for Medicare and Medicaid Services (CMS) awarded the plan 4.5 stars in a five-star rating, placing the plan among the top in the nation.
The ratings – based on clinical quality, customer service, wellness programs, screenings, responsiveness and management of chronic long-term conditions – were created to help consumers compare individual plans’ performances in order to make informed decisions.
The National Committee for Quality Assurance, an independent organization that reports on the quality of managed care plans, ranked Health First Health Plans #20 among more than 300 health plans reviewed across the nation. The rankings placed the plan among the top in the nation.
Health First Health Plans also earned kudos from J.D. Power, the global market research company, which annually performs an exhaustive audit of customer satisfaction. J.D. Power recognized the plan’s call center for its outstanding customer service experience based on survey data that evaluated courtesy, knowledge, concern, convenience and issue resolution.
EMPHASIS ON WELLNESS
One of the health plan’s greatest assets is its emphasis on wellness.
“We’re known for our health and wellness aspects,” said Dr. Jennifer Brady, vice president and medical director for Health First Health Plans. “We strongly encourage our members to take advantage of these benefits.”
From its inception, the plan’s philosophy has encompassed a comprehensive wellness component. Individual and family plan members will be able to access without cost the programs of the Pro-Health & Fitness facilities located in Viera, Palm Bay, Melbourne and Merritt Island.
These facilities offer indoor heated pools, strength, training and cardio equipment, group fitness classes, indoor jogging trail, basketball courts, wellness classes and – for an additional fee – customized services such as massage therapy, weight loss classes and personal training. For the convenience of North Brevard residents, the plan also offers free membership to the Parrish Health & Fitness Center in Titusville.
KEEPING PEOPLE HEALTHY
To further enhance wellness, the plans provide online tools that include a health assessment to identify potential health risks. If the member so desires, he or she can be connected with a “health coach,” a nurse that through phone or e-mail conversations can help the individual with issues such as weight loss, diabetes and high blood pressure. “Our goal is to keep people healthy as long as possible,” said Brady.
Patients with chronic health issues such as cancer or congestive heart failure can depend on the plan’s case manager to help navigate through coordination of care.
“They try to take some of the burden off the patient’s shoulders,” said Brady.
With the launch of the Affordable Care Act in 2014, the healthcare field will experience a multitude of changes.
“Thousands of Space Coast residents will qualify for premium subsidies from the federal government to purchase individual insurance,” said Alford.
“Thousands of Space Coast residents will qualify for premium subsidies from the federal government to purchase individual insurance,” said Alford.
“Entering the market in 2013 with individual products allows the plan to establish its focus. Many people are purchasing individual insurance this year to maintain maximum control over the decision-making process.”
Health First Health Plans will make individual and family plans available with a May 1 effective date. Thereafter, effective dates will be available on the 1st and 15th of each month. For more information call 321-434-5665 or visit Health-First.org/Health_Plans
