By BOB ANEZ/Associated Press Writer
HELENA - A handful of the estimated 165,000 Montanans without health insurance will be offered bargain-priced coverage through a new program a Helena company is offering.
The New West Health Plan, developed by New West Health Services, is a pilot project the 2003 Legislature authorized. The intent is to measure interest in a basic insurance plan for those unable to afford broader coverage or whose employers don't provide health benefits.
Patrick Aberle, chief executive officer for New West, said Tuesday the program will be offered initially only to 1,000 people and will be limited to Billings and Helena. It could be expanded after five years with approval of the Legislature and the state insurance commissioner, he said.
The insurance covers basic services: preventive care such as immunizations, unlimited visits to a primary physician participating in the program, lab tests, X-rays, mammograms and generic prescription drugs. The policy does not cover more costly types of care such as emergency services and hospitalization.
To be eligible for the coverage, a person must be under 65, ineligible for either Medicare or Medicaid, uninsured for the past six months or seven of the past 12 months, and a resident within 30 miles of either Helena or Billings.
Coverage will become available Jan. 1.
The program is similar to one offered by Blue Cross Blue Shield of Montana for the past two years. Called Blue Care, it covers 250 people and offers a complimentary and slightly higher-priced alternative to the New West program, said Tanya Ask, spokeswoman for Blue Cross Blue Shield.
For example, she said Blue Care offers hospitalization but limited doctor office visits and that can be a valuable combination for someone needing coverage for inpatient care. The premiums range from $53 to $136 a month, Ask said.
Aberle said the New West program is another step toward dealing with the one in five Montanans without insurance. ''While this is not a solution to the entire problem, it will address the greatest needs of the uninsured,'' he said.
Aberle noted that the services included in the policy are those intended to help people manage an existing illness and seek the care needed to avoid more expensive medical services later.
Monthly premiums will range from $20 to $100, depending on age, and the average rate is expected to be $45 to $50, he said. The rate is about a fourth of what a full-coverage policy would cost, Aberle added.
Premiums will be subsidized by $300,000 that will be paid by the plan's sponsors, which include 29 hospitals and about 1,300 other care providers. All see the program as an advantage because it will mean fewer people with unpaid medical bills, he said.
Enrollment will be on a first-come, first-served basis. Forms can be obtained by calling New West at 1-800-290-3657.