Kevin Knauss: Health, History, Travel, Insurance
Posts related to health insurance for individuals, families, small groups, enrollment, eligibility in California, plans, coverage, benefits.
All of the categories of health insurance premium assistance – Individual and Family, Medicare, Employer Sponsored – can also help with out-of-pocket health care expenses. The programs will cover expenses that accrue to meeting the maximum out-of-pocket amount of the health plan. These costs include copayments, coinsurance, and deductibles, all of which add towards the maximum out-of-pocket amount.
Not all the below options may be available to you because some are contingent on your age, employment, or income. Those health insurance alternatives available to you are worth investigating and considering if they meet your budget or adequately address health care challenges you may be facing.
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.
The Paragon Health Institute report on fraud in the ACA enrollments is flawed and biased. The report does highlight the desperate need for affordable health insurance in many states that have not expanded Medicaid.
Jericho Share, a purported Health Care Sharing Ministry, fined and ordered to cease operations in California.
Covered California consumers who enrolled on or after February 18, 2024, should confirm they paid their initial payment online or contact Kaiser Permanente at 888-236-4490 to make a payment to effectuate their coverage.
Had you been near this family’s home, it would have sounded like an explosion as the Blue Shield member vented to me about the incompetent billing system of Blue Shield.
In March of 2021, Blue Shield approved the plan member to receive gender dysphoria health care services from an out-of-network provider. Unfortunately, Blue Shield, according to the press release, inappropriately adjusted several of claims submitted by the health care professional. The payment dispute led to the health care professional suspending continued treatment until the claims dispute was resolved.
IEHP appears to have very competitive rates for the Bronze and Silver metal tier health plans. They are less competitive at the Gold and Platinum levels. IEHP is the primary Medi-Cal managed care plan for the 2 counties. With the end of public health emergency, many Medi-Cal beneficiaries may no longer be eligible and will be transitioned to Covered California private health plans with the health insurance subsidies.
Silver 73, 87, and 94 health plans, available through Covered California based on household income, have no medical deductible. That does not mean you escape any patient responsibility for health care services subject to coinsurance. With the enhanced Silver plans, you go straight into the coinsurance percentage for inpatient hospitalization and skilled nursing facility stays because there is no medical deductible.
