Tag: health insurance

4 Terms I Wish I Understood When I Signed up for Health Insurance

Posted on by Judith E. Ashton

Insider’s experts choose the best products and services to help make smart decisions with your money (here’s how). In some cases, we receive a commission from our our partners, however, our opinions are our own. Terms apply to offers listed on this page.

  • I chose a health insurance plan with the lowest monthly premium.
  • I would have chosen a different plan if I knew what the terms like deductible and co-insurance meant.
  • Next year, I’ll weigh the pros and cons of having a higher monthly payment vs. a higher deductible.

I was 30 years old when I started my first full-time, corporate job (which was here at Insider). Before that, I worked as a freelancer and dependent on California state’s health insurance, Medi-Cal, for two years. Back in New York, when I was working in the fashion industry, I worked at a startup that only offered one affordable health insurance option.

Working full-time at Insider is the first time I’ve had to choose between different tiers of health insurance plans. While I did my best to research my options, I still felt unprepared to make the decision. There are four terms I wish I’d known before choosing my current plan.

1. Out-of-network provider

Thanks to Medi-Cal, I was able to find a physical therapist just a 10-minute drive from my house to help me prepare for and recover from top surgery, and I didn’t have a copay. My new health insurance through work is accepted nationwide, but I noticed more providers on the east coast were in-network than providers on the west coast, where I live.

It turns out that my physical therapist didn’t

… Read the rest
Read more

Japan to integrate health insurance cards into My Number digital ID in digitization push

Posted on by Judith E. Ashton

The Japanese government has unveiled plans to discontinue its current health insurance card system and integrate its functionalities within the My Number digital ID infrastructure, phasing out the existing system by fall 2024, reports the Asahi Shimbun.

The intentions were revealed by Digital Minister Taro Kono earlier this month at Japan’s Digital Day events, alongside other plans for the country’s digitization, reports GovInsider Asia.

By integrating health insurance cards into My Number, Japanese citizens will be able to automate healthcare access at medical institutions via face biometrics checks and allow doctors and pharmacists to easily view information, including prescription records and medical checkups, after obtaining patients’ consent.

At the same time, according to the Asahi Shimbun, only around 30 percent of medical institutions and pharmacies currently have dedicated card readers for My Number installed, and only about 20 percent of the population have registered My Number cards for use as health insurance certificates so far.

To speed up the process, the Japanese government said it intends to require healthcare facilities to introduce the digital ID readers starting in April 2023.

Kono, who was the driving force behind the elimination of carved hanko ink seals in Japan and the overseer of COVID-19 vaccine rollout, clarified that the government will ensure all residents have time to register to use their health insurance cards with My Number before abolishing the current system.

As of September, the overall issuance rate of My Number IC chip-embedded plastic identity card and connected digital IDs stood at 49 percent. The government hopes almost all citizens can obtain My Number cards by March 2023.

Kono also confirmed plans to incorporate the driver’s license into the My Number digital ID by the end of March 2025, or potentially sooner. Unlike the health insurance cards, however, the

… Read the rest
Read more

Bright Health pulls out of Colorado insurance market

Posted on by Judith E. Ashton

Health insurance company Bright Health announced Tuesday that it won’t offer insurance plans in Colorado next year, meaning roughly 55,000 people in the state will need to find new coverage.

The decision is part of a move by Bright to pull out of every state in which it operates but two — Florida and California — as it struggles for profitability.

“The changes announced today give Bright Health a strong and stable platform for profitable growth at much lower risk,” Mike Mikan, the president and CEO of Bright Health Group, said in a statement.

Bright currently offers plans in Colorado on the individual and small group markets, where people buy coverage on their own or where small businesses buy coverage for their employees, respectively. In addition to Colorado, Bright will no longer offer coverage in Alabama, Arizona, Georgia, Nebraska, North Carolina, Texas and Tennessee, and it will drop coverage for certain types of plans in Florida.

But the shockwaves will echo especially loudly in Colorado because Bright is intertwined with a major health reform initiative backed by the administration of Gov. Jared Police. Bright is the carrier that offers plans for the Peak Health Alliance, a pioneering “health care purchasing alliance” that unites members of a community to directly negotiate lower prices with local hospitals. As Peak’s selected insurance carrier, Bright then bundles those prices into insurance plans for Peak members. Peak started in Summit County and currently operates in eight western Colorado counties.

Anne Ladd, the CEO of the Peak Health Alliance, said she learned of Bright’s decision to leave Colorado at 5 am Tuesday via a company news release. She said the move means that Peak will not be able to offer plans in 2023 because there is not enough time to team up with a

… Read the rest
Read more

In major retreat, Bright Health halts individual health insurance coverage

Posted on by Judith E. Ashton
medical insurance

Credit: Pixabay/CC0 Public Domain

Bright Health Group will end individual and family health insurance coverage and reduce its Medicare Advantage coverage to just two states, steps that will cut its revenue in half.

The moves, announced Tuesday, represent a dramatic retreat for the Bloomington, Minnesota-based company that built a national presence in just five years.

After attracting billions of dollars in investment capital, Bright Health’s fast growth created the need to meet greater regulatory reserve requirements. Coupled with pandemic-related payouts, the company reported huge financial losses. Executives said the restructuring would ease those pressures and bring stability.

“We would expect to see much greater predictability in our revenue and growth margins,” Mike Mikan, the company’s chief executive, told investors in a conference call.

Bright Health currently sells coverage on government-run exchanges in 15 states. But it said it will no longer offer coverage in any of them beginning in January, effectively mothballing that line of business.

Bright also announced it will withdraw Medicare Advantage plan offerings in four states, leaving only California and Florida.

The company will decamp in January from individual health insurance markets in Alabama, Arizona, Colorado, Florida, Georgia, Nebraska, North Carolina, Texas and Tennessee—extending the previously announced withdrawal from Illinois, New Mexico, Oklahoma, South Carolina, Utah and Virginia . In a document footnote, Bright said there is a chance it may continue some individual plan coverage in California.

It is unclear how the downsizing will affect its employee base. The company did not respond to a request for comment.

Bright Health said it will now focus on its non-insurance business. The company operates medical clinics that will be a part of its “fully aligned care model,” which integrates data and analytics. This model aims to deliver better value for aging and underserved patients in the

… Read the rest
Read more

Many Americans can’t afford health costs even with insurance

Posted on by Judith E. Ashton

By Michael Ollove | Stateline.org (TNS)

BALTIMORE — The number of Americans with health insurance has climbed to historic highs during the COVID-19 pandemic, but within that silver lining is a darker hue.

Many Americans have policies that only provide limited financial protection, to the point that many patients report forgoing needed medical care or prescriptions to avoid being hit with punishing out-of-pocket costs.

Those are some of the findings from a new health insurance survey conducted by the Commonwealth Fund, a private research foundation that promotes high-quality, equitable health care.

The survey comes on the heels of other health insurance data, including some released by the US Census Bureau from its annual American Community Survey, attesting that certain pandemic measures, particularly those Congress passed, have ushered more people into health insurance than ever before.

People are also reading…

In 2021, nearly 299 million Americans had health insurance, the most ever, and the number of Americans without health insurance — just over 28 million in 2021 — had dropped by 1.4 million people from 2019, according to the American Community Survey.

During the pandemic, Congress has prevented states from disenrolling anyone from Medicaid, the health plan for lower-income Americans. It also increased subsidies to help pay for individual health plans bought on the Affordable Care Act markets.

Yet the increased insurance hasn’t necessarily provided sufficient financial protection and by extension, necessary medical care.

The Affordable Care Act requires insurance plans to provide specified benefits, but it doesn’t eliminate the copays and deductibles that patients must pay.

“The big ‘but’ is that while it’s great that more people have insurance coverage, it’s also half the battle,” said Gideon Lukens, director of research and data analysis for health policy at the left-leaning research institute, the Center on Budget

… Read the rest
Read more

Bright Health Pulling Insurance Plans Including Obamacare From Nine States

Posted on by Judith E. Ashton

Bright Health Group is pulling individual Obamacare and family health insurance plans from nine states, which will force hundreds of thousands of Americans to choose new healthcare coverage for next year.

Thehealth insurance company Tuesday”health insurance company Tuesday said it will “no longer offer Individual and Family Plan products through Bright HealthCare in 2023, or Medicare Advantage products outside of California and Florida.” The announcement came on a day Bright Health said raised $175 million “that is expected to close in the coming weeks and take the business through profitability.”

It’s unclear exactly how many enrollees will be impacted by the decision and faced with choosing new health plans for 2023. Bright Health, which became a publicly traded company just last year, had about 1 million total health plan enrollees projected for 2022, the company has said.

Bright Health couldn’t be reached this morning for comment on how many health plan subscribers would be impacted, but the move impacts customers in at least nine states, according to its press release on the exits.

“With this announcement, in addition to the previously announced market exits, Bright HealthCare will not offer Individual and Family health plans in Alabama, Arizona, Colorado, Florida, Georgia, Nebraska, North Carolina, Texas, and Tennessee after 2022,” the company said.

By scaling back to its largest healthcare markets, Bright Health said the company will be “profitable on an Adjusted EBITDA basis in 2023 and will serve underserved populations through its risk-bearing care delivery business, Medicare Advantage products, and the ACO REACH Program in states that covers 26% of the aging US population.”

“We have demonstrated the power of the Fully Aligned Care Model in serving aging

… Read the rest
Read more

Health Insurance Whistleblower: Medicare Advantage Is “Heist” by Private Firms to Defraud the Public

Posted on by Judith E. Ashton

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now! I’m Amy Goodman, with Juan Gonzalez.

A major investigation by The New York Times this weekend has found many of the nation’s largest health insurance companies have made billions of dollars in profits by exploiting the government’s Medicare Advantage program. Eight of the 10 largest Medicare Advantage providers have overbilled the government. Six of the 10 have been accused of fraud by the government or company whistleblowers.

This comes as the number of people enrolled in the privatized system continue to grow. Projections show that by next year more than half of all Medicare beneficiaries will be enrolled in a private plan.

Under the system, health insurers get more government funding for sicker patients, which has given the companies an incentive to make patients appear more ill than they actually are. UnitedHealth, Humana, Kaiser and other health insurance companies have been sued for fraud for overdiagnosing patients to bump up profits. The cost to taxpayers is staggering. Overbilling by health insurance costs the government an estimated $12 billion to $25 billion in 2020. The New York Times reports doctors at Kaiser were offered bottles of Champagne and bonuses if they added additional illnesses to the medical records of their patients so the company could make more money.

Joining us now is Wendell Potter, former executive for the health insurance companies CIGNA and Humana. Potter is now the president of the Center for Health and Democracy and the president of Business Leaders for Health Care Transformation. He’s author of the book Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.

Welcome back to Democracy Now!, Wendell, joining us from

… Read the rest
Read more

Twitter Solved My Health Insurance Woes When Common Sense Got in My Way

Posted on by Judith E. Ashton

The power of social media and its role regarding health insurance has blown my mind.

What emails and countless hours on the phone with multiple people could not accomplish has been fixed by Twitter. One tweet calling out Covered California and Blue Shield of California about a problem with the termination date of my policy and my issue has been resolved.

On Sept. 1, my health insurance officially changed to Medicare from Covered California Blue Shield, my state’s marketplace insurance. I have been stressing over this switch for a few months now and I have done everything in my power to ensure a smooth transition: making sure I have enough of my Lynparza (olaparib) on hand until I can get a refill, canceling the old plan and updating my new insurance information.

Alas, nothing is ever simple when it comes to health care and insurance. More specifically, nothing about living with metastatic breast cancer for over eight years has been simple.

My first mistake was waiting until the day my new Medicare policy took effect to call and cancel my old policy. Apparently, my commonsense approach in waiting until the new coverage began to cancel my previous policy is not how it’s done. Silly me. But in my mind, I can’t risk any lapse in coverage when living with cancer.

I started with a call to Blue Shield to cancel the policy only to be told I needed to cancel through the marketplace. So my next call was to Covered California. The person who I spoke with at Covered California informed me I was supposed to give them two weeks’ notice prior to canceling; I had waited too long and now they couldn’t terminate my plan until Sept. 30.

That seemed fine until I received a bill from Blue Shield

… Read the rest
Read more

Buying Your Own Health Insurance? Here’s the Company Slashing Your Bill.

Posted on by Judith E. Ashton

Being your own boss can be a dream come true. However, professional independence comes with its own harsh realities. One aspect many people don’t immediately consider is health insurance. Without a corporate job managing coverage for you, finding the right plan at the best price can be complicated and expensive.



Courtesy of Catch

But it doesn’t have to be — not even for time-crunched solopreneurs. one company, Catchis trying to simplify health insurance and other benefits for the self-employed, making it easy to navigate and save money.

Founded in 2018, Catch is a personal payroll and benefits platform that helps you take care of your taxes, retirement, and health insurance. Freelancers and the self-employed can use Catch’s app to automatically track, trace, and manage their income as well as get the lowest price on a current or new health insurance plan.

Focus on what you do best.

Better still, Catch has a new tool called Premium Slasher, designed specifically to get savings for people who buy their own insurance. Catch will analyze your current plan and search the billions of dollars of available government tax credits to lower your monthly premiums. The process takes about two minutes, according to the company. All you need to do is make sure your income estimates, location, and family size are up-to-date. Catch does the rest for you.

Best of all, it’s free. How is that possible? “Catch makes money as an insurance broker, earning commissions from insurance carriers,” explains Catch’s CEO and co-founder, Kristen Anderson. “This means Catch can offer its customers Personal Payroll and Premium Slasher for free.”

Anderson adds, “Most of us don’t want to spend our time figuring out benefits. Freelancers and solopreneurs often have a vision that’s centered around improving their craft and increasing their

… Read the rest
Read more

5 Reasons Supplemental Medicare Insurance Can Benefit the Standard Medicare Plan

Posted on by Judith E. Ashton

With one out of every 10 Americans carrying some kind of medical debt, you aren’t alone if you think you could use some extra help. A standard Medicare plan pays for a lot, but there are some necessary costs that it just won’t cover.

If you find yourself struggling with medical payments even though you have Medicare, supplemental Medicare insurance might be for you.

Supplemental Medicare insurance—also known as Medigap—can pay for medical costs that Medicare won’t cover. Keep reading to find out more about Medigap insurance and discover its benefits.

What Is a Medicare Supplement (Medigap) Plan?

A Medigap plan is a private health insurance plan that fills in the “gaps” in Original Medicare.

A regular Medicare plan will cover around 80% of approved medical costs. A Medigap plan can help with that remaining 20%. It’s similar to a Medicare Advantage plan but with some important differences.

Medicare Advantage typically has lower premiums and sometimes includes services like gym memberships.

However, Advantage plans won’t offer coverage for every healthcare provider who accepts Medicare. They also don’t provide coverage while traveling, and you risk having higher out-of-pocket expenses and emergency costs with one.

Meanwhile, Medigap plans offer some handy benefits that Medicare Advantage plans don’t. In this next section, we’ll discuss five ways that Medigap can benefit your standard Medicare plan. Keep in mind that benefits vary from one plan to another.

1. Get Out-of-Pocket Expenses Paid For

Medicare is great, but it doesn’t pay for everything. Even when you’re on Medicare, you’ll likely have many out-of-pocket expenses that are up to you to pay for.

These out-of-pocket costs include coinsurance, copayments, and deductibles. This can be particularly helpful if you have costly deductibles on multiple medications.

Some Medigap plans will even help pay for additional medical benefits, such

… Read the rest
Read more