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Could There Be Medicare Savings In Prescriptions?

Several thoughts this morning arose as I was considering the cost of premiums versus the cost of doctors and prescriptions. What if there were regulations and guidelines that set parameters on all of the costs? Premiums increase due to the cost of care, and prescriptions remain high due to pricing set by pharmaceutical companies. It becomes an endless cycle of inflation year after year, but will there every be an end to the vicious increase? An article posted on the Wall Street Journal offers a solution with a savings bolstered at $16B. The government regulates both Medicaid and Veterans healthcare expenses and price negotiations …

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Did You Know, Not All Doctors are In Network?

You enroll in your health plan and choose an option that is affordable and seemingly everything you are looking for, but is it really? I come from personal experience when I discuss this as I was extremely naive to how health coverage works when I first started working in this industry. I received my health cards last year and noticed a doctor printed on my card but failed to look at the fine print. I thought nothing more of what was printed on my card.  A few months later I was sick and needed to see a doctor, so I called a …

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Open Enrollment Starts Today

Open Enrollment is here for 2016 health plans. According to an article on The Street, individuals spend less than 30 minutes researching their benefits. If you are someone that understands health insurance plans backwards and forwards this sounds like a decent amount of time to spend, but many Americans do not understand the other language that is “health insurance.” This kind of care less response to choosing something incredibly important could have a huge impact when you find yourself filing claims for a medical procedure that you weren’t expecting. Once you enroll in a health plan during Open Enrollment for …

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Insurance Premium Regulators Step In

This time of year health insurance carriers submit their insurance premium rates for 2016 to regulators for approval. With healthcare premiums already rising it was a surprise to see Florida regulators telling some carriers to raise their requested premium increase. Both Human and Blue Cross & Blue Shield of Florida were among those whose final rates were higher than they’d first filed, reports Bloomberg Business. Alex Kepnes, a Humana spokesman said the approved increase incorporated updated information from the U.S. Government on ACA programs designed to spread cost, known as reinsurance and risk adjustments. Regulators are able to push insurance to raise their …

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10 Essential Health Benefits

When the Affordable Care Act (ACA) was passed there were certain requirements placed on health plans guaranteeing health benefits. Going into the 2016 open enrollment all plans will be ACA compliant within this upcoming year. Currently there are still plans out there that are “pre-ACA” which an individual or family would have enrolled in before the ACA was passed and continued coverage through 2015. With ACA compliant plans there are 10 essential health benefits that are included under each plan that you may not know about. Here’s the list from HealthCare.gov: Outpatient care—the kind you get without being admitted to a …

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