Kevin Knauss: Health, History, Travel, Insurance
Posts related to coverage, prescription medications, benefits and providers under health insurance plans.
It took me a long time to realize that the old adage of “It’s not what you know, but who you know” with respect to success was a crock of crap. Regardless of what or who you know, if you can’t produce something that people will consume, you will never be successful. The connections help get in you in the door. But if you can’t produce results, service, or products, you will be of little value to your associates.
Both the health plans and the doctors practice subtle and overt forms of discrimination against people with Covered California health insurance. Some of the discrimination is legally built into the health plans. Other discrimination takes place in the form of denying health care services because the prospective patient has a Covered California health plan.
Covered California is cancelling the Advance Premium Tax Credit subsidy that lowers a household’s monthly health insurance premium for 2016 for some consumers. Through Covered California’s automatic renewal process I’ve seen several families’ tax credits disappear for 2016. Without intervention or explanation, many families who had their health insurance automatically renewed may receive a bill for the full premium amount because the tax credit subsidy was eliminated by Covered California.
Covered California has finally been able to include family dental plan enrollment to consumers who have purchased a health plan through the exchange. The dental plans overall are pretty good but they come with some conditions that limit suitability for all families.
Individual and family plans offered through Covered California in 2016 will include new pharmacy prescription drug benefits. The benefit, also mirrored in many off-exchange health plans, caps the amount a consumer must pay every month for a particular prescription. While that sounds straight forward, the rules surrounding any pharmacy deductible and tiered drug formulary can be complicated and confusing.
Every family is unique in their health care needs. There are situations when each family member may require a different health plan to meet their particular health challenges. Unfortunately, many families who enroll in a health plan through Covered California are unaware that not all the family must be on the same health plan.
At the August 2015 Covered California Board meeting James DeBeneditti, Deputy Director of Plan Management, reviewed the options and challenges for offering vision insurance on the Covered California online enrollment website. The only viable option reported was to put a simple link on the Covered California website to vision insurance providers. For the inclusion of the hyperlink Covered California would charge $10,000 and take a 10% commission. The $10,000 implementation fee is essentially an advertising cost for the vision plan while Covered California acts like an unlicensed insurance agent collecting a 10% commission for selling vision insurance.
I thought it was so sweet that a fellow car wash patron was taking time out from washing her own car to help other people figure out how to get tokens or work the wash selector switch. But when she asked me how my car washing experience was, I figured she was one excellent employee. Wrong again! […]
There is nothing worse than being lied to by a customer service representative. This routinely happens to any Consolidated Communications (formerly Surewest) customer when they call and request assistance with configuring a new wireless ADSL modem router that the consumer purchased. The customer service representative will inform the caller that Consolidated’s Internet service only works […]
At the end of June 2015 the Centers for Medicare and Medicaid Services (CMS) announced that they had boosted the reimbursement for high cost health care claims to health insurance companies participating in the ACA reinsurance program from 80% to 100% for 2014. The increase in coverage resulted from fewer requests for coverage of high […]
