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Medicare more expensive than new ACA plans

Individuals who recently acquired Parts A and Part B of Original Medicare may find they have to pay more per month than their existing ACA health plans. Under the ACA rules, once someone accepts Medicare, they must exit any ACA health plan they purchased through the exchange and the tax credits that make it affordable. […]


Acupuncture for all, my trip to the acupuncturist

All new ACA health plans include acupuncture as a covered health care service in California. So what is it like to receive acupuncture and can it potentially help relieve medical challenges that some of us face? I decided to try out this traditional Chinese medicine to see if it would alleviate the pain in my neck.


A visit to Blue Shield to fix the billing issues

To be honest, I was fully prepared to be dragged kicking and screaming out of the Blue Shield of California corporate offices in El Dorado Hills. Numerous phone calls and emails on behalf of a client who had made his monthly premiums like clockwork, only to have his health insurance cancel, resulted in hollow promises and no action by Blue Shield to resolve the billing and cancellation nightmare. My last hope to help restore the health insurance for my long distance truck driving client was to rattle the corporate cage of the carrier.


The hidden costs of dental, vision and supplement plans

When searching for supplemental health benefits like dental and vision insurance, be cautious of paying additional fees or joining membership associations tied to the insurance. VSP vision insurance, Delta Dental and AARP all have marketing agreements that mandate the purchase of an association membership or one-time fee. These associations may offer little value to the member and only serve as another revenue stream for the issuing company.


Greedy doctors kick patients out of their practices

California doctors, upon finding that the new Covered California health plans may not reimburse them enough to maintain their vaunted lifestyle, are kicking existing patients with the new health insurance out of their practices. These doctors are the epitome of the maxim “Putting profits before people.” Most of these greedy doctors haven’t exercised the common decency to notify their current patients before their appointments that unless they have the right color of health insurance, they won’t be served.


Transgender health benefits remain elusive in California

While the Insurance Gender Nondiscrimination Act (IGNA), also known as AB 1586, prohibits health plans from denying medically necessary health care to transgender individuals, the exact treatment options covered for individuals with gender dysphoria remain unclear in California. The determination of whether a health plan will cover a certain medical procedure to facilitate the transition to the opposite and identified sex of the health plan member hinges on the medical necessity of the procedure.


Are Certified Enrollment Counselors prepared to answer health insurance questions?

One of the strategies for enrolling hundreds of thousands of California residents in new Covered California health plans was to have an army of in-person Certified Enrollment Counselors. While these folks are trained on how to fill out the Covered California application, they don’t necessarily have any background in health insurance or how it works. Are the Certified Enrollment Counselors (CEC) qualified to answer simple to complex questions about health insurance and will they be there next month when their client has issue?


Covered California releases worthless health plan rating report

In an attempt to help consumers decide on the right health plan, Covered California has compiled a star rating system for the health insurance carriers based on outdated information. Even worse than basing a report on old data is the disastrous customer service that many Californians have experienced from many of these health insurance companies, including Covered California, in the last two months. The horrible customer service and nightmare enrollment process is not reflected in the new quality rating results.


Insurance companies deny health care with restricted networks

When the insurance companies are having their risk for unexpectedly high health care expenses subsidized they should not have the luxury of creating tight doctor and hospital networks. The restrictions on network providers for cost containment purposes is exceptionally irritating when it is the plan members that are helping fund part of the risk reduction provisions by having to pay for the reinsurance fee on qualified health plans. Restricted networks and new EPOs are just a “work around” solution to allow health insurance companies to selectively limit health care like they have done in the past.


Covered California creates confusion with extended payment deadline

Families that didn’t have their insurance cancelled by the ill-fated Covered California forced policy cancellation of December 31 are now wrestling if they should make their current health plan premium for January. The utter lack of communication between Covered California and the health plans has left many families without knowing if they do or don’t have health insurance.


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