Category: Health Plans

Dealing with denial of cashless settlement and huge deductions in health insurance claims

October 14, 2020
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a group of people in a room: COVID-19 treatment: Dealing with denial of cashless settlement and huge deductions in health insurance claims

© Venkatasubramanian K
COVID-19 treatment: Dealing with denial of cashless settlement and huge deductions in health insurance claims

In the past few months, we’ve heard several stories of people with health insurance policies facing claim rejections, not getting cashless treatments, or having to pay hospital bills out of pocket for COVID-19 hospitalizations. There could be many reasons that insurers give for rejecting claims. Some situations are avoidable. You must ensure that a COVID diagnosis or treatment does not burn a hole into your hard-earned savings.

This article discusses some such key issues, along with actions you could take to avoid or reduce the financial burden of an already taxing health situation.

Claims declined for mild symptom cases: Health Insurance policies cover hospitalization treatments that are considered ‘necessary’ – where there is active treatment carried out in a hospital, under any local or international medical protocol. The claim could be declined

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What Do Americans Think Is Broken In Health Care? What Trump And Biden Would Do About It

October 14, 2020
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Our broken health care system has been a campaign talking point for generations, and 2020 is no exception. But what do people think is broken? What does your average worker, parent, student, or small business owner want fixed? My organization, the Foundation for Government Accountability wanted to know the answer to these questions.

When you ask more than 10,000 Americans in focus groups and polling what they want fixed in health care, you get some interesting and unexpected answers. The answers varied, but two themes were overwhelmingly represented: Health care remains top of mind for many Americans and they want more affordable coverage options.

President Trump’s Actions On Health Care

To his credit, President Trump has focused on how to address these concerns despite the Senate’s failure to pass health care reform early in his term. Without legislation to make broader health care changes Americans need,

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How we can help the unemployed keep their health insurance

October 13, 2020
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Keith Prisco is a stagehand at the United Center in Chicago and a proud union member of IATSE Local 2. Like tens of millions of Americans, he receives health insurance through his employer for himself and his family. The security of this coverage is even more important for Keith after he was diagnosed with leukemia four years ago. But when COVID-19 put a screeching halt on live events, that meant Keith was out of work — jeopardizing his health care coverage in the middle of a pandemic.

As COVID-19 continues to threaten the health and safety of Americans, millions of workers have found themselves under threat of losing their jobs, their health coverage, and their financial savings — all through no fault of their own.

It is unconscionable that unemployed or furloughed workers could also lose health coverage during a public health crisis, yet there are an estimated 10 to

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Health insurance changes leave many surprised with lack of cover

October 13, 2020
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As a paramedic, Natalie Glaser has a highly stressful job, with long hours and shift work.

She went to her GP, complaining of an upset stomach.

“I was really scared as well, and I still am scared,” she told PM.

But when the doctor advised her to get a colonoscopy straight away, her anxiety grew further.

“My GP asked me if I’d like to go to the private hospital system or the public, and I took out my HCF cover because I said I’m sure I’m covered for this procedure,” she recalled.

“When I pulled it out and it said I wasn’t covered for it, I was quite confused.”

Natalie Glaser said she lost the majority of her coverage when HCF reviewed her policy and moved her down to a lower-cost, more basic level of coverage.

“I lost 18 out of 25 procedures — that’s about 72 per cent of

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Local Health Plan Hosts Pink Stops in Breast Cancer Awareness Month Event

October 13, 2020
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Local Health Plan Hosts Pink Stops in Breast Cancer Awareness Month Event

PR Newswire

RANCHO CUCAMONGA, Calif., Oct. 13, 2020

RANCHO CUCAMONGA, Calif., Oct. 13, 2020 /PRNewswire/ — Even in the face of COVID-19, the Inland Empire will continue Making Strides Against Breast Cancer, thanks to the American Cancer Society-Inland Empire.  To raise funds for breast cancer research, the organization has reimagined their annual Making Strides Against Breast Cancer 5k event, transforming it into a socially safe Pink & Go Seek scavenger hunt. In support of this event, on October 17, Inland Empire Health Plan (IEHP) will provide a $2,500 sponsorship and will host three Scavenger “Pink Stops” in the Inland Empire.

IEHP was a proud sponsor and participant at last year's Making Strides Against Breast Cancer Event and is thrilled to continue participation at this year's reimagined and socially safe Pink & Go Seek scavenger hunt.
IEHP was a proud sponsor and participant at last year’s Making Strides Against Breast Cancer Event and is thrilled to continue participation at this year’s reimagined and socially safe Pink & Go Seek scavenger hunt.

In

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We Like Our Health Insurance And Working From Home

October 13, 2020
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Jan Dubauskas is the Vice President of Healthinsurance.com.

We have experienced a lot of change throughout the course of the pandemic that has required us to reconsider our priorities and become nimble in the way we work and how we reach out to our clients. Many were skeptical that these changes would lead to similar productivity. However, as we prioritize our health during the pandemic, working from home has become important, and many (24%, according to CNBC) have adapted so well that they want to keep doing it.

When we first started working from home, the primary concern for many was to set up an office, retain camaraderie, and continue meeting with clients. During the spring, as I watched as annual springtime conferences got canceled or sent to an online format, I keenly felt the void previously filled by those intense social interactions. It seemed that with a bit

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Trump expects voters to fall for the same health care trick twice

October 13, 2020
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As a presidential candidate four years ago, Donald Trump not only railed against the Affordable Care Act; he also made bold promises about the magnificence of his alternative plan. The Republican’s alternative to “Obamacare” would offer everything Americans they could dream of, including better coverage at a lower price. All voters had to do was elect him.

In reality, of course, Trump didn’t know and didn’t care about how to deliver on these promises. He was peddling post-policy nonsense, counting on the electorate to not know the difference.

As a president, when it came time to follow through, Trump was lost without a map, amazed to discover the complexities of an issue he never he even tried to understand. The Republican endorsed plans that did the opposite of what he told voters he’d do, and when it came time to engage in actual negotiations, Trump struggled to keep up —

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Are you wasting money on Medicare supplement plans?

October 13, 2020
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By Paul Davis | Contributing Writer

You may think this as a devious come-on from an unscrupulous insurance agent. But really, my intent is to try to connect with people who are truly overpaying on their present plans without realizing it.

If you watch TV, it’s difficult to avoid commercials for Medicare Advantage HMO plans that have zero monthly premium. Those plans are great for people who have doctors contracted with those plans and comfortable with the HMO concept. FYI, some of those plans include providers contracted with UCLA and Cedars-Sinai Medical Center. Many people find that surprising.

But this article is more for those people who want to have freedom of choice and do not mind paying a monthly premium for a Medicare Supplement (also known as a Medi-gap) plan.

If you’re on a Plan J, which has not been sold since 2010, you are on the richest standardized

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China’s public health insurance agency says it can’t afford to provide Covid-19 vaccine for free

October 13, 2020
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a person holding a wine glass: A man works in a Sinovac Biotech laboratory in Beijing. An experimental Covid-19 vaccine developed by the company is one of four Chinese candidates in the final stage of human trials. Photo: Reuters

A man works in a Sinovac Biotech laboratory in Beijing. An experimental Covid-19 vaccine developed by the company is one of four Chinese candidates in the final stage of human trials. Photo: Reuters

With four Chinese vaccine candidates in the final stage of human trials, it is still not clear whether Beijing plans to provide Covid-19 shots for free after the public health insurance agency said it would not pay for them.

Some advanced economies, including the United States, Australia and Japan, have said any Covid-19 vaccines they buy – provided they have been proven safe and effective – will be made available to their citizens for free.

But China’s National Healthcare Security Administration on Friday said the medical insurance system could not afford the “high cost” of vaccinating the population. It made the remarks in a public reply to a request for free vaccinations from an unidentified deputy of

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AM Best Assigns Stable Outlook to Indonesia’s Non-Life Insurance Market

October 13, 2020
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Despite a bleak macroeconomic picture, Indonesia’s non-life insurance market is well-diversified and underpinned by solid capitalisation, supporting a stable outlook assigned to the segment, according to a new AM Best report.

A new Best’s Market Segment Report, titled, “Market Segment Outlook: Indonesia Non-Life Insurance,” states that the non-life insurance market’s overall robust return on equity, supported by stable historical underwriting performance and strong balance sheet fundamentals, along with good government support including infrastructure plans and economic stimulus, are factors in the stable outlook.

The Indonesia non-life insurance market expanded by 14% year over year, to IDR 79.7 trillion (USD 5.4 billion) in 2019 from IDR 69.9 trillion (USD 4.9 billion) in the previous year, supported mainly by strong growth in credit insurance. Gross premium written (GPW) for credit insurance, the market’s third largest business line, increased by 86.2% to IDR 14.6 trillion in 2019. Property insurance, the largest business

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