Kevin Knauss: Health, History, Travel, Insurance
Posts related to coverage, prescription medications, benefits and providers under health insurance plans.
The impacts of so many Medicare plans not paying an agent commission will suppress the number agents who are willing to assist enrollments for no compensation. In other words, some Medicare beneficiaries may have a tough time finding local agent help to evaluate their Medicare plan options.
The summary of benefits of the health plans indicates 100 days of skilled nursing facility residency per member per benefit period. The benefit period begins when you enter the facility and ends when you leave or 60 days after you are discharged. This is where the descriptions get a little hazy. One interpretation is that you can have multiple 100-day stays during the year as long as there is a 60-day span between admissions.
The goal of the program is not to have parents or legal guardians have to pay out-of-pocket for covered services and hearing aids. However, if the family has other insurance, the provider must bill that health plan first, which may require some initial costs by the family. After the private health plan has paid their share, HACCP will supplement the remaining costs.
The Stanford Health Care hospitals and facilities contract with Blue Shield ended on June 28, 2024. Despite many months of good faith negotiations with Stanford Health, we have not been able to reach a reasonable agreement on reimbursement rates and contractual terms that are beneficial for both parties and keep care sustainably affordable for our members.
Whether you purchase your health insurance through Covered California or off-exchange direct from the carrier, you can use the Covered California Shop and Compare tool to search for doctors and hospitals. The Covered California provider search tool will display the network status of the doctors and hospital you select for all the different plans offered.
Of all the Medicare plans, the Part D Prescription (PDP) plans are the most confusing. The confusion arises because Medicare allows the Part D plans to offer alternate plans that differ from the standard plan. The alternate plans must be as good as the standard plan for the average Medicare beneficiary. Cost Sharing of the […]
The common complaint from my clients in 2023 is that they can’t find a doctor. I am in the crowd who couldn’t find a Primary Care Provider to figuratively save my life. I changed my focus from certain preferences to reviewing low star rated doctors. With the switch, I found a good, competent Primary Care Provider.
Basic human rights and equal access to health care services is nonnegotiable. There can be no compromise. State’s rights do not supersede human rights. The goal of health care is to keep people healthy, productive, and sustainable. No state law should prevent a person from receiving care to remain healthy, productive, and sustainable.
Blue Shield PPO members can schedule a visit by calling the Blue Shield Nurse Hotline or contacting Dispatchealth directly via website or telephone. Blue Shield HMO members must call their Primary Care Physician for a referral for an in-home visit to treat a medical condition. In-home visits are grouped into 5-hour windows corresponding to morning, afternoon or evening. Appointments can be as early as 7 AM or as late as 10 PM, sometimes on the same day as the request. Care is available in English and Spanish.
Does my Medi-Cal insurance cover my abortion? Yes. Is my private insurer required to cover my abortion? Yes for most people. California law is clear that abortion care is basic health care, and most insurance plans must cover basic health care services. This requirement does not apply to employers that provide “self-funded” health care coverage or grandfathered plans.
