Posted on: Saturday, January 22, 2005
Kaiser sets new fees
| • | Some example of what it'll cost |
By Deborah Adamson
Advertiser Staff Writer
Kaiser Permanente has raised its fees and will now charge 10 percent of the cost of diagnostic tests for members who used to get that service at no extra charge.
In a letter to members, the state's second largest health insurer said the higher rates took effect Jan. 1. By making it more expensive for consumers to use services, Kaiser hopes they will exercise more restraint.
"When you have to pay more, you become a smarter consumer," said Scott Nariyoshi, a Kaiser spokesman.
The increase in fees comes on top of an average 11 percent increase in Kaiser's rates this year for most members.
Joyce Edwards, a small-business owner in Kalihi, said the fee increases will be tough on the budget.
"That makes a big difference for all of us. People don't make that much money," she said. "The increase is going to be hard — to pay 10 percent of the tests."
Insurance Commissioner J.P. Schmidt said the state regulates health plan premiums but does not oversee fee increases, including the new Kaiser fees.
Kaiser also didn't need approval from the Prepaid Health Care Advisory Council, which determines whether health plans conform with the state's Prepaid Health Care Act.
Kaiser operates the most popular HMO, or health maintenance organization, plan in the state. That makes Kaiser the prevalent plan, a special status that allows Kaiser to set standards for other HMOs.
Since Kaiser chose to increase fees, other HMOs now could do the same.
Mark Elwell, owner of Bamboo Flooring in Honolulu and a Kaiser member, said rising healthcare costs are inevitable. But it's less than what he has seen in other areas as a traveling businessman.
"It's not a good thing, but at least it's not as high as other states," he said.
Reach Deborah Adamson at dadamson@honoluluadvertiser.com or 525-8088.
| Some examples of what it'll cost
The new fee increases will affect about half of Kaiser's 233,000 members and include: • Office visit co-payments go up by 20 percent to $12. • Patients will now pay 10 percent of outpatient lab, X-ray and diagnostic tests. Previously, Kaiser paid for the tests entirely. Certain preventive screenings such as screening mammograms and routine pap tests are exempt. • Members will now pay 50 percent of the cost of contraceptive drugs and devices. • The billing fee for not paying for services on the same day they are received will rise by 33 percent to $20. • Bills past due by 60 days or more will be assessed a 12 percent interest rate. Until the bill is paid or payment arrangements made, patients' non-urgent appointments will be rescheduled. Under the new rules, the co-pay for the 10 most common outpatient diagnostic tests ranges from zero for the mammogram and $6 to $10 for two types of chest X-rays to $150 for an abdomen and pelvis CT scan, according to Kaiser. |
