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Health Care Insurane Coverage

Posts related to coverage, prescription medications, benefits and providers under health insurance plans.

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Blue Shield In-Home Healthcare For HMO and PPO Members In Southern California

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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.

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Most California Health Plans Include Abortion as A Covered Health Care Benefit

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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.

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How To Select A Health Insurance Plan

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Health insurance, at a basic level, is asset protection similar to car, life, and home insurance. Most health plans have an annual maximum out-of-pocket amount that limits your liability to outrageous health care bills in the event of an accident or sudden illness. Once the maximum out-of-pocket amount is met, the health plan covers all in-network health care expenses for the rest of the year.

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The Health Care Hole: Patient Support and Advocacy. Can a mobile app help?

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A single application that can be shared between different caregivers, perhaps several children take turns caring for an elderly parent, will keep the current care giver abreast of the latest conditions and medications. HeyRenee would not become a patient advocate, but a program to support the patient, doctors, and caregivers. The app can be interactive prompting medication alerts and accepting a reply that the drug was taken. In addition, a telemedicine appointment could be included in the app for a quick diagnosis or update if conditions worsen.

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Do The Star Ratings for Covered Health Plans Have Any Relevance?

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Most consumers would be surprised to learn that their health plans are being rated on how well their doctors treat them. Consumers don’t want their health plan involved in their health care decisions or interactions with their doctors. Consequently, some health plans are paying for the sins of some providers by being labeled with a low star rating.

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Dignity Health Excommunicates Anthem Blue Cross

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The calendar of events on the Keep Dignity Health website states that by October 17, 2021, all Dignity providers and hospitals will be out-of-network with Anthem Blue Cross. The contract termination would include Medicare Advantage plans and other HMO groups. The complete termination with Blue Cross assumes that there will be no resolution to the contract dispute. Dignity Hospitals will still be in-network for life-threatening emergency care.

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Medicare Part D Prescription Drug Comparison Confusion

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In California there are 32 different Part D plans offered by 11 different insurance companies. One plan sponsor offers six different plans. The only thing that differentiates these plans at first glance are the marketing names like Basic, Choice, Classic, Enhanced, Plus, Saver, Secure, and Value. These monikers are marketing gimmicks and tell the Medicare beneficiary nothing about the benefits of the plan.

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FDA Warning on Shingrix Shingles Vaccine Mirrors My Experience

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May 15, 2019: Tuesday night, Wednesday morning experiencing horrible pain in left shoulder, the worst in days, could not sleep. Left arm shoulder very weak in terms of raising it above my chest, usually need the right hand to help it. Turning my neck does not increase the pain. Moving my arm in different positions is what really hurts. Just resting at night, the shoulder throbs and I get some sharp pains when I try to move it into another position. Sitting upright seems to help the most. Spent hours sleeping in a chair for relief.

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Anxiety Over the Covid-19 Vaccine

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In 2019 I decided to get the shingles vaccine. I figured that since I had never had a reaction to the flu vaccine, nothing would happen other than a hoped for suppression of another bout with shingles. Two weeks after the first vaccine injection I had a raging sinus headache for days. My doctor said it was allergies and prescribed Flonase. Then my shoulders started to get weak. Within a couple days my whole body was itching, head to toe.

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New Mental Health Benefits For 2021 California Health Plans

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Requiring health insurance policies to cover medically necessary prevention, diagnosis, and treatment of all mental health conditions, as well as substance use disorders, that are listed in the most recent version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the mental and behavioral disorders chapter of the most recent edition of the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (ICD-10).

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