[…] And finally, if the Supreme Court is going to hand down a ruling like the one we got from the Appeals Court last week, we need to know that as soon as possible too. If the individual mandate does indeed end up being tossed out, the health care reform law will need an awful lot of compromises and revisions in order to make it tenable. Perhaps I’m being overly pessimistic, but given the level of compromise we’ve seen from the political system over the last decade or so, I have a hard time seeing how the PPACA could go on with one of its major provisions deleted. […]
[…] But the shortage of doctors who will accept new Medicaid patients could definitely be seen as a significant obstacle to receiving care for people who rely on Medicaid to cover their healthcare costs. It’s likely that there is a long list of reasons why people on Medicaid have poorer health outcomes (and we have to be careful to not mistake correlation with causation). But it’s reasonable to assume that the difficulty Medicaid patients experience in finding a doctor isn’t doing anything to improve their health outcomes.
[…] Over the last several years, most of the major health insurance carriers in Colorado have increased the out of pocket portion that an insured has to pay for prescriptions. Most individual policies now have prescription deductibles, and a lot of carriers have designated very expensive drugs as a separate tier that requires a percentage copay from the insured, rather than a flat amount. And of course, premiums continue to climb. The Makena story is an example of why this happens, and it has nothing to do with health insurance carrier profits. When insureds see their health insurance premiums skyrocket again, where do you think they will point their finger?
Since January 1, 2011, all new individual health insurance policies issued in Colorado have included maternity coverage as required by a new state law. The text of the bill was quite clear in stating that its provisions would apply to all “policies issued or renewed on or after the applicable effective date of this act.” (see the top of page 3 of the text). But until now, there was still some confusion around maternity coverage and policy renewals, and inconsistencies in how the law was being applied. […]
[…] We seem to be caught up in a wave of screening test excitement lately, with new advanced testing available for every disease under the sun. Rather than focusing on things that can truly prevent health problems (the old, and decidedly low-tech diet and exercise ideas…), we are fixated on developing newer and better screening tests. This exacerbates the problem of over-consumption of health care and rising health care costs.
[…] If you sign up for automated payments, there’s nothing to remember. You don’t have to worry about your health insurance lapsing because a bill didn’t arrive, or because you forgot to send in a check. You don’t have to worry about making a typo or accidentally sending an underpayment. And in a lot of cases it’s less expensive to have automated payments set up too – some carriers charge an additional fee if you opt to receive a bill and mail a check for your premium.
[…] You can still get quotes for child-only plans, but the only options that will appear on quote engines that work with major health insurance carriers are Rocky Mountain Health Plans, and Kaiser Permanente for people in the Denver/Boulder area. We wanted to clarify this point in case there is confusion surrounding the open enrollment period. It’s unknown whether the other major carriers will be able to find a way to make child-only coverage a profitable venture as time goes by, but for now, the options are still quite limited in the child-only market in Colorado, regardless of the open enrollment window.
Clients in Colorado can now get quotes and apply for HumanaOne with effective dates of 1/1/2011 or later. Remember, these will include maternity coverage as a base benefit. Existing members with an Enhanced, Copay, HSA, or Value plan will receive these benefit changes at the time of their renewal. For clients who have an Autograph,… Read more about Humana 2011 Rates Are Official
Anyone looking to compare plans with 2011 rates can start with Anthem BCBS, Assurant, and Rocky Mountain Health Plans (get quotes here). These will include maternity coverage. More coming this week….
[…] Even when policies are free or very low cost (such as Medicaid or Child Health Plan Plus), a significant number of eligible individuals continue to go without coverage, for a myriad of reasons. So it stands to reason that plenty of uninsured people who are eligible for GettingUsCovered won’t apply. Some likely aren’t aware of the availability, and many others simply can’t afford to pay the premiums. But apparently Colorado is enrolling people at a fairly fast pace – as of November 1, there were 20 states that had fewer than 50 people enrolled in their newly-created high risk pools.
For nearly two decades, Cover Colorado has been providing health insurance to people in Colorado who don’t have access to group health insurance coverage and have pre-existing conditions the make them uninsurable (or unable to get coverage without exclusion riders or rate increases that put their premium above that offered by Cover Colorado) in the individual health insurance market. While we’re lucky to have such a resource, it doesn’t come cheap […]
[…] The Division of Insurance has recently released an extensive FAQ page detailing how the review process works. The page includes data about health insurance premiums in Colorado, how they compare with the rest of the country, and specifics about how the Division of Insurance reviews rate increase proposals from carriers. […]
A west coast legal firm has launched an investigation into the market conduct of Mega Life and Health Insurance Company and Mid-West National Life Insurance Company. Their parent company, HealthMarkets, Inc., is also being investigated, along with the two shareholders (Blackstone Group, L.P. and Goldman Sachs Group, Inc.) who purchased HealthMarkets in 2006 for $850 million. […]
The National Association of Insurance Commissioners is meeting this week to figure out the specifics of how the new medical loss ratio (MLR) rules should be implemented, and they’ll be voting on the issue tomorrow. Basically, health reform law calls for health insurance carriers to be spending 80 – 85% of premium dollars on medical care as of January 1, 2011. But the insurance industry would prefer to see the increased MLRs phased in gradually. They say that they can meet the new MLR requirements over the next few years, but that trying to do so all at once by the first of the year will only serve to drive some carriers out of business entirely. […]
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. […]
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.
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[…] In general, I’m a fan of as much transparency as possible in health care. I think that patients, doctors, and payers (both public and private health insurance) should have access to information related to treatment, diagnoses, and cost – as quickly as possible and as clearly as possible. Open source medical records is one step towards transparency, and I like that. […]
We’re in the midst of a beautiful Colorado summer, and the words to John Denver’s Rocky Mountain High (one of our official state songs) were running through my head over the weekend. So this week’s Cavalcade is a tribute to all the beauty that Colorado has to offer. I’m including a few photos we’ve taken over the years, so not only will you learn all sorts of new stuff about risk and risk management, but you’ll get a virtual tour of Colorado at the same time […]
[…] Private health insurance companies tend to take some of their cues from Medicare in terms of what they cover, so if Medicare eventually makes home visits more available, it stands to reason that people with private health insurance might also have access to house calls from doctors, even if they can’t afford to pay full price to a non-network provider.
[…] We definitely needed a solution to make health insurance available for everyone, and there’s no way to do that without taking away some of the freedoms from both sides (including the ability for insurance companies to decline applicants, and the ability for people to choose to not have health insurance). The legislation isn’t perfect, and it won’t please everyone, but hopefully a decade from now, the problem of millions of Americans living without health insurance will be a memory.
[…] It would be nice to see more options available for our clients who are looking for maternity coverage. My preference would be if clients could select their health insurance policy based on all of the other features of the plan, and then add maternity benefits after they had settled on a policy, rather than choosing a policy by default simply because it is one of a very few options that offer maternity benefits.
[…] What if our health insurance ID cards came with barcodes that could be scanned in the doctor’s office or hospital, immediately allowing the office staff to see our benefits, how much of our deductible still needs to be met, and any exclusions on our policy? Then admission and treatment data could be transmitted directly to the health insurance carrier, without the need for phone calls or extra staff. […]
[…] But setting a flat dollar amount above which a plan will be taxed seems ill-advised. It doesn’t really do a good job of weeding out health insurance plans that truly have too many bells and whistles, and it wrongly penalizes people who live in areas where health care costs are higher than average, or companies with a disproportionate number of older workers.
[…] Even if the cost of the test is only counted towards a patient’s deductible (as might be the case if the patient has an HSA qualified plan, for example), just knowing that it will be billed to the health insurance company might make a patient more likely to get the test. In addition, billing the test to a health insurance company is likely to result in a lowered final price for the patient based on network negotiated rates. All around, it makes sense for dental offices that provide HIV screening to be able to bill a patient’s health insurance company for the test.
[…] I’m not opposed to the idea of health insurance companies that could operate on a national basis, allowing people to keep their health insurance if they move to another state. But such a plan would have to be overseen by federal guidelines. Simply opening things up to allowing health insurance companies to base themselves in any state they choose, operate under that state’s laws, and sell health insurance in all states, would take us to the lowest common denominator in terms of consumer protections.