[…] As David pointed out, there’s also likely to be frustration for patients as providers move in and out of networks. This can happen regardless of the size of a network, but if networks are purposely kept small, it’s more likely to happen. Patients tend to be wary of having to find new doctors, and having to do so simply because of network changes isn’t likely to make people happy. Hopefully the idea of narrow provider networks won’t become a widespread trend with employers, medical providers, or health insurance carriers.
Blog
Regulators And Insurers Still Working On Child-Only Coverage Issue
[…] So far, none of the carriers who had backed out of the child-only market have commented on whether the open enrollment periods might make them change their minds, but AHIP (America’s Health Insurance Plans) has said that they are continuing to work with regulators to try to find solutions that would make the child-only market feasible for insurers in the future.
Very Few Real Estate Transactions Will Be Impacted By New Medicare Tax
[…] One of the rumors that has been circulating via email lately proclaims that the PPACA includes a 3.8% tax on all real estate transactions. This is simply not true. […] Most houses do not sell for profits of anywhere near the capital gains threshold. And most families don’t qualify as high income households. So most real estate transactions will not be impacted in any way by the new Medicare tax.
CBS Story Leaves Out Important Options For Kids
[…] As I said, I have no knowledge of this particular family’s situation. But child-only policies have always been rare, and there is usually another option for those children to obtain coverage. They can be covered as a dependent on a parent’s policy (which can now include policies in the individual market), by Cover Colorado, or possibly by Medicaid or CHP+. Even situations like Thomas Wilkes, who was maxing out the lifetime caps, now has a solution because Healthcare Reform has removed lifetime maximums. There is a long way to go, and this situation is frustrating. But if you ever hear anybody say that they have no options to get their child covered in Colorado, please pass this information along. I hope that Mr. Serrano signs Maria up for some health insurance today, whether it is on a family policy with him, Cover Colorado, or CHP+. We should not be hearing anymore stories about uninsured children simply because their parents aren’t aware of the options available.
Colorado Division Of Insurance Still Reviewing Rates
We mentioned last week that the Colorado Division of Insurance had not yet approved rates past 9/23 for several carriers, and unfortunately, that is still the situation. For carriers that allow any effective date, quotes can still be generated for 9/22, but carriers that only allow 1st and 15th of the month effective dates are unable to quote new policies now (and have been since 9/15) if their rates have not been approved. This is causing a bit of a traffic jam for people who are searching for a new individual health insurance policy right now. […]
Doctors Contracting Directly With Patients
[…] Personally, I would be open to the idea of seeing a family practice doctor who doesn’t contract with health insurance carriers, and paying for routine care out of pocket, if there were some way to combine that with a discount on our health insurance premiums… If the DocTalker Family Medicine idea were to become more widespread and if insurers could account for this type of care when setting premiums, I can see it making a lot of sense for healthy families who want to use health insurance for large medical bills and budget for smaller bills themselves.
Healthcare.gov A Good Resource For Brokers
I spent some time on the Healthcare.gov website this morning, and found some great resources that could be particularly helpful for people with pre-existing conditions who are unable to obtain coverage in the individual market. The website was set up in conjunction with the PPACA and was designed to help people navigate the myriad of health insurance options available, along with the changes that will happen over the next few years as the provisions of the PPACA go into effect. […]
Quoting Blackout On Most Plans and Effective Dates
Many plans with most carriers still haven’t gotten the rates approved past 9/23. These plans with carriers like Anthem BCBS can still be quoted with effective dates of 9/22 and before.
Carriers like Cigna only have 1st and 15th of the month effective date options. Therefore, rates and plans are not being quoted at all until the DOI approves their rates. Hopefully any moment.
Make sure to subscribe via email or follow us on Facebook for rate approval updates.
Health Wonk Review – Politics, Money and Health
Welcome to the Health Wonk Review. Health care costs, politics, and the economics of health care seemed to be the prevailing themes in the submissions this time, and there are some great ideas floating around here. Enjoy! […]
UnitedHealthOne Erroneous Email
Yesterday, September 13th, UnitedHealthOne (Golden Rule) sent out an erroneous email to individual/family clients:
“Thank you for choosing a UnitedHealthOne Insurance plan. Payment is currently past due and your plan may be at risk of lapsing. In order to make a payment over the phone, please contact Client Services at 1-800-657-8205 or your broker […]”
If you call the client services number given, an automated message will play before the list of options:
“Please note, if you received an email on Monday about your premium, please disregard this as it is an error and we apologize for any inconvenience.”
Access To Primary Care Is Only One Piece Of The Puzzle
[…] We need to make sure everyone has health insurance (first step in expanding access). We need to make sure there are enough primary care physicians (and other care providers) to go around. And then we need a systematic, coordinated effort between health care providers, hospitals, and health insurance carriers to make sure that everyone is on the same page. Expanding access to primary care is part of the solution, but it will only work in tandem with the other parts.
Colorado Hospitals Expanding
[…] I understand that each hospital needs to bring in enough money to pay staff, maintain the facilities, and – in the case of for-profit hospitals – make a profit for shareholders. But overall healthcare costs aren’t helped by duplication of facilities and high-tech medical gadgets. There has to be a balance between providing the excellent medical care, keeping things at least somewhat convenient for patients, and keeping medical costs under control. […]
Nothing Is Free
[…] For people with chronic health conditions who meet their deductibles every year, the savings with a high deductible health plan might be small or non-existent, and in those cases, more comprehensive coverage might make sense. But for people who are healthy, and insuring against potential future medical costs, it typically makes sense to minimize the amount that you’re guaranteed to pay (premiums) and accept a little bit higher exposure to amounts that you might have to pay (medical expenses that fall below the deductible). […]
Guaranteed Issue Policies For Children Happened Too Quickly
[…] Regardless of the practicalities involved, there’s no doubt that the headlines about insurers ceasing to issue child-only policies is generating some ill will and bad PR for insurance carriers. Either lawmakers knew that would happen, or else they put very little thought into considering the details of how insurers would go about making children’s coverage guaranteed issue a mere six months after the bill was signed into law, and just added the provision as a feel-good part of the bill.
More Americans Skipping Medical Care
[…] Copays and deductibles have risen for most families over the last few years, even those who don’t have policies that qualify as high deductible. And at the same time, economic stability has decreased for most families. This isn’t a good combination, and Joe’s right about the fact that when people skip necessary routine medical care, it will likely lead to increased medical costs (and declining health) in the future.
Money For Health Insurance Premium Increase Reviews
[…] Colorado will get $1 million to use for more extensive review of future rate increases, and the Division of Insurance has proposed hiring more analysts and actuaries to examine the data that is filed each year by the insurance carriers. The rate proposals will get more scrutiny, which is a good protective measure for consumers. But insureds could still see hefty rate increases thanks to the ever-increasing cost of health care. […]
Early Retiree Reinsurance Program Proving Very Popular
Earlier this summer, HHS announced that businesses could begin submitting applications to the newly-created Early Retiree Reinsurance Program in order to receive federal funding to help pay for retirees’ health insurance until they become eligible for Medicare. To date, 2000 businesses have been approved for the program, and HHS Secretary Kathleen Sebelius says that this is just the beginning. Businesses have shown great interest in the reinsurance program… […]
Amendment 63 On The Ballot In Colorado
Throughout this year, the Independence Institute has been working to get a measure on the ballot in Colorado to block the health care reform legislation that would require everyone to have health insurance starting in 2014. Yesterday, the Colorado Secretary of State confirmed that the amendment supporters have gathered enough signatures to get the measure on the ballot, so it will be up for a vote in November. […]
Deciphering Medical Loss Ratio Rules
Jaan Sidorov of the Disease Management Care Blog has started deciphering the specifics of the Medical Loss Ratio requirements, and it looks like the National Association of Insurance Commissioners (NAIC) is taking a rather inclusive view of medicine in their interpretation of the law. Ever since the MLR minimums were laid out in the PPACA, there has been much debate over what would be considered administrative costs. It’s heartening to see the NAIC giving so much leeway in terms of what will be considered medical expenses. […]
Why Medicare For All Might Not Be So Great
[…] most non-elderly Americans still get their health insurance through their employers. And in general, as long as people are somewhat satisfied with the status quo, most of us tend to be a bit resistant to change. Obviously, people who are currently uninsured are likely to support sweeping changes in the health care system. But most Americans do have health insurance, and those who have generous policies – that are at least partially funded by their employers – might find themselves with less coverage if we moved to a single payer plan.
Grandfathered Plans Will Be Rare By 2014
Several provisions in the new health care reform law will begin to take effect next month. More changes will take place over the next three years, leading up the biggest changes in 2014, when all individual policies will have to be guaranteed issue, and everyone will be required to have health insurance.
The only way an insurance policy will be able to avoid some of the changes implemented by the new law is to retain grandfathered status, basically by keeping the policy mostly unchanged from the way it was on March 23, 2010, when the law was passed. But it turns out that the benefits […]
Prescription Veggies
Colorado is the only state in the US with an adult obesity rate below 20%, but we’re just barely below that threshold. And according to the Colorado Health Report Card, our rate of obesity is rising faster than the rate for the whole country. I came across a NY Times article about a program that has been implemented in Mass recently, and I would love to see Colorado do the same thing. Maybe we could see our obesity percentage start to fall instead of continuing it’s upward climb. […]
Not Many Details Yet On Maternity Coverage In Colorado
[…] We still have several months left in 2009 for regulators and insurance companies to work out the details, and I’m sure we’ll know more by the end of the year. When you combine this with the new Colorado law banning gender rating on health insurance policies, and the myriad of reforms coming from the federal government, I’d say that health insurance regulators in Denver are going to have their hands full for a while.
Avoiding Adverse Selection
[…] Hopefully the fact that insurers can designate an open enrollment period for children to be accepted on a guaranteed issue basis will make it more likely that parents will keep their children continuously insured. The spirit of the law regarding coverage for children is good: It isn’t right that sick kids should be unable to get health insurance at any price. But with no requirement that all kids be insured, and without a designated open enrollment period, the new law would absolutely have encouraged adverse selection.
Eligible Does Not Mean Enrolled
[…] With budget cuts all over the county, now is probably not a good time for state agencies to add staff who focus on helping parents enroll their kids in public health insurance programs. But existing community based organizations could be a great resource for parents with uninsured kids. And this might also be an excellent position to fill with volunteers who are willing to work with parents in their own communities. […]