Sutter Health Plus is expanding its service area to include 15 new ZIP codes in Santa Clara County effective Jan. 1, 2020. access to care for members in the South Bay who live or work in Santa Clara County, primarily around San Jose
Health Insurance
Posts related to health insurance for individuals, families, small groups, enrollment, eligibility in California, plans, coverage, benefits.
Covered California Wants To Intimidate Agents From Selling Legal Products
I share Covered California’s concern that health care sharing ministry programs are a mine field waiting for someone running from ridiculously high health insurance premiums to step on and have the bomb explode. However, I disagree with Covered California’s proposed use of certified agents to be their foil to limit the enrollment in these products. Agents are not the jailers charged with keeping the citizens within the health insurance pool.
Oscar Cuts UCLA, Hoag from Covered California Health Plans
If you want to keep either UCLA or Hoag in your Oscar health plan, you will have to enroll in an off-exchange Oscar plan that is designated with the Circle network. The Circle network that includes UCLA and Hoag will only be available in the metal tier plans of Bronze and Silver.
Sutter Health Plus Estimated Cost Schedule and Plans for 2020
Sutter Health Plus has added a schedule of estimated costs for many routine health care services similar to the Kaiser Permanente fee schedule. They have also released their individual and family health plans that are available in parts of the Bay Area and Sacramento region. For individuals and families with High Deductible Health Plans, it […]
Kaiser Top Distributor of Opioids in Sacramento County
Kaiser is unique in that because they manage their own pharmacies, we can get a look at the ordering habits of opioids, and by extension, the prescribing of those opioids by Kaiser doctors. With a pharmacy like Costco, that has a higher ordering rate for higher strength doses of hydrocodone, it is hard to pinpoint which doctors or medical groups are prescribing the stronger drugs. It may not even be a doctor in Sacramento County.
Kaiser Ear Cleaning Cost Jumps 33% For 2019
If you take a nasty spill on your skate board in San Francisco, and have to have your ankle X-rayed at Kaiser, it will cost $102. But if you break your finger poking your political opponent in the chest, that finger X-ray will cost $111. These costs are lower in Southern California where they have more skate boards and finger poking. An ankle X-ray in Southern California will be $71 and the finger at $78. They don’t mention if there is a discount X-ray cost for both if you poked someone and then fell off your skate board.
Blue Shield Implements Non-Binary Gender Option
Blue Shield has added a gender identity category to align with the new state law even though health insurance companies are not required to do so. As an organization, Blue Shield recognizes our members whose gender identity is female, male or nonbinary. We want to honor any employee, and member their wish to be recorded as the gender they identify with.
Anthem Blue Cross Fined $2.8 million over Grievance and Appeals Process Failures
In addition to paying a $2.8 million fine, Anthem Blue Cross has agreed to a Corrective Action Plan (CAP) that represents a fundamental shift in how the plan handles enrollee grievances.
Medi-Cal May Pay For Your Private Health Insurance
The HIPP program pays the medical insurance premiums, coinsurance, deductibles, and other cost-sharing obligations for the individual. The annual cost of the premiums and member cost-sharing is compared to the estimated cost of an equivalent set of Medi-Cal services. Outlined in in an ACWD Letter 09-02, DHCS uses a specific formula to determine the cost-effective nature of the private insurance over Medi-Cal FFS.
Lost Health Insurance? Maybe Health Care Sharing Option Will Work
If you think regular health insurance is filled with loop-holes and caveats to avoid paying health care claims, read the fine print on the HCSM. It can be difficult to know if the HCSM will pay on certain claims under certain conditions. Then there is the wild card of denial because of how the injury or illness occurred that is not explicitly included or excluded in the plan. For example, if you are at a gay bar and are dancing, then trip and break your ankle, will it be covered if the HCSM does not approve of activities involving the gay community?
