Kevin Knauss: Health, History, Travel, Insurance
Posts related to coverage, prescription medications, benefits and providers under health insurance plans.
With a peek at the enrollment statistics released by Covered California after the end of the ACA open enrollment we are able to visualize just how large the health insurance industry is in the state. While the enrollment data is only for individual and family plans (IFP) purchased through Covered California, the 1.3 million individuals […]
The first challenges individuals and families faced with the smaller provider networks offered in California was keeping their current physician or finding doctors that would accept the new health plans for health care treatment. The next hurdle has been doctors referring or using out of network physicians for patient care. Patients are now getting slapped […]
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.
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.
As the ACA open enrollment winds down, attention now turns to helping individuals and families in the new health plans actually get health care from their insurance. While there have been significant challenges just getting people signed up for health insurance, there will surely be additional hurdles as households now try to use the new health plans. For most people, they have no advocate to help them maneuver through the maze set up by health care professionals and insurance plans. Who will be the health insurance advocates for these families?
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.
One of the first options a Medicare beneficiary faces when they are reviewing Part D Prescription Drug plans (PDP) is whether they want a plan with a deductible. The deductible amount, set by Medicare, is the dollar amount a plan member must pay before he or she is eligible for the reduced copayment for the drugs. The big decision for the Medicare beneficiary is if they should select a PDP with a lower premium and $310 deductible or pay a higher monthly premium for a no deductible plan.
When Covered California decided to force health insurance companies to cancel their policies on December 31, 2013, they set in motion a cascading effect that have left many new plan members without access to prescription drug coverage. At least two pharmacies have recognized the problem and are offering help to cover vital prescription medications to new Affordable Care Act health plan members that have yet to received neither member ID numbers nor an invoice.
As a novice WordPress user I have been relatively happy with the traffic my blog posts have generated. But as a commerce site the other measurement that my site is really connecting with my audience is the number of people who email or call with questions. I was able to generate more “person to person” interaction after I added some simple invitations to my website.
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
