There was tremendous confusion over which doctors were in-network for the new individual and family plans offered through Covered California in early 2014. While the major health insurance plans offering PPO and EPO plans maintained the provider networks were the same regardless of whether they were purchased on or off the exchange, doubts persisted fueled […]
Health Care Insurane Coverage
Posts related to coverage, prescription medications, benefits and providers under health insurance plans.
Comparing hospital outpatient, labs, and imaging costs
For years we have been told that the way to put the brakes to sky rocketing health insurance premiums was to let consumers shop and compare costs. While this pricing mechanism certainly works in markets where consumers have access to good comparative information, when it comes to shopping for health care services based on priced, your […]
What counts as income for MAGI?
A key service agents provide to ACA health insurance eligible clients is assisting them to determine their Modified Adjusted Gross Income, MAGI. This unfortunately puts agents in the role of being income and tax experts. One of the biggest questions agents get is what qualifies as household income for the purpose of receiving the Advance […]
Robin Williams would still be alive if he had been homeless
We see them across the United States. Homeless men and women, filthy, pushing shopping carts, diving in dumpsters, sleeping in tents and suffering from mental illness and substance abuse. Short of becoming a mercenary, they have sunk almost as low as any human being can and still be considered somewhat civilized. Yet, through all the […]
Review of IRS draft ACA tax credit reconciliation forms
With the release of the draft IRS forms for reporting advance premium tax credits and reconciliation with the household MAGI, health insurance agents might be called upon to know another part of the ACA, the dreaded tax forms. The variety of reporting statements individuals and families may receive from employers and the exchanges will require […]
IRS mid-year ACA tax credit check up
The IRS issued a mid-year ACA tax credit check up advisory to remind individuals and families to report household changes if they are receiving Advance Premium Tax Credits to lower their monthly health insurance premiums. Most notable is the admonition that if the household income exceeds 400% of the federal poverty lineas reported on their […]
Anthem Blue Cross to experiment with online doctor visits
The Anthem Blue Cross of California provider network just got larger as of July 1st when Blue Cross members can enroll in LiveHealth Online to consult with a doctor through the Internet using a regular computer, tablet or smart phone. The cost for the doctor visit or online consultation, in lieu of actually visiting a […]
What’s wrong with jumping off the Golden Gate Bridge?
On Friday, June 27, the Golden Gate Transportation District (GGTD) voted to spend $76 million to install a “Physical Suicide Deterrent System”. The deterrent system will be comprised of a wire net extending approximately twenty feet on either side of the Golden Gate Bridge to catch people who jump. My question is, “What’s so bad […]
Quiet Pride Parade for Sacramento Intactivists
In a moment of exuberant passion for the cause of educating people about the stupidity of routine infant circumcision, I signed up the nascent Sacramento Intactivist group to march in the Sacramento Pride Parade. I walked in last year’s San Francisco Pride Parade with over 50 committed Intactivists and figured we could muster at least […]
California health plans cover newborn circumcision
Thanks to the Affordable Care Act all individual and family plans now include coverage for maternity care. These new health services, many of which are provided at no cost to the patient, also extend to the new born. Prominent in many private health plans is coverage for routine infant circumcision.