Insurance

WMFE

Let’s say you have health insurance through your employer and live in one of 21 states with laws protecting consumers against surprise medical bills from out-of-network providers.

Should one of those unwanted bills land in your mailbox, you can turn to your state law and regulators for help, right?

Not necessarily.

Some States Roll Back ‘Retroactive Medicaid’

Nov 14, 2017

If you’re poor, uninsured and fall seriously ill, in most states if you qualify for Medicaid — but weren’t enrolled at the time — the program will pay your medical bills going back three months. It protects hospitals, too, from having to absorb the costs of caring for these patients.

The 2018 annual open-enrollment period for coverage on the health insurance marketplaces starts Wednesday. But if you don’t take care of lingering issues from your past coverage, they may come back to haunt you when you try to sign up this fall.

Unpaid Premiums

New rules will allow some insurers to require you to pay any back premiums you owe for the 12 months prior to the effective date of your new coverage.

Joe Raedle/Getty Images

Latinos, who just a year ago were highly sought customers for the Affordable Care Act’s marketplace plans may not get the same hard sell this year.

The open enrollment period begins in one week for 2018 marketplace coverage, but many consumers are confused about what to expect. No wonder!

Cheap Health Insurance / Flickr

Older or disabled Americans with Medicare coverage have probably noticed an uptick in mail solicitations from health insurance companies, which can mean only one thing: It’s time for the annual Medicare open enrollment.

Telehealth Panel Eyes Insurance, Licensing

Oct 4, 2017
Cheap Health Insurance / Flickr

To increase the use of telehealth in Florida, a panel is recommending that insurance companies be required to reimburse health-care providers for telehealth services and that the Legislature authorize participation in interstate “compacts” that make it easier for doctors and other providers to be licensed in a variety of states.

Insurance Chief Pushes Patient Billing Change

Oct 2, 2017
WMFE

Nothing is going to slow down Insurance Commissioner David Altmaier from asking the Florida Legislature to prevent insured patients from being hit with high out-of-pocket costs for emergency medical transportation.

Uninsured Rate Falls To Record Low Of 8.8%

Sep 13, 2017
Cheap Health Insurance / Flickr

Three years after the Affordable Care Act’s coverage expansion took effect, the number of Americans without health insurance fell to 28.1 million in 2016, down from 29 million in 2015, according to a federal report released Tuesday.

Too Few Patients Follow The Adage: Shop Around

Aug 21, 2017

Despite having more financial “skin in the game” than ever, many consumers don’t make any attempt to compare prices for health care services, a newly released study found.

Nursing Homes Move Into The Insurance Business

Jul 13, 2017

Around the country, a handful of nursing home companies have begun selling their own private Medicare insurance policies, pledging close coordination and promising to give clinicians more authority to decide what treatments they will cover for each patient.

The number of U.S. adults without health insurance has grown by some 2 million this year, according to a major new survey that finds recent coverage gains beginning to erode.

The new numbers highlight what's at stake as Congress returns to an unresolved debate over Republican proposals to roll back much of former President Barack Obama's health care law.

Florida Blue

Florida Blue will file its proposed rates for the Affordable Care Act marketplace this week and officials warn they could increase by 20 percent if the federal government stops funding the cost sharing measures that are included in Obamacare.

Florida’s insurance officials are considering moves to rein in assignments after the Legislature again failed to take action.  The procedure allows service providers to work directly with an insurer, but some say they’re taking advantage of the system.

For more than two decades, Celeste Thompson, 57, a home care worker in Missoula, Mont., had not had regular contact with a doctor — no annual physicals and limited sick visits. She also needed new glasses.

Like many others who work in the lower rungs of the health care system, a category that includes nursing aides as well as direct care and personal care assistants, she has worked hard to keep her clients healthy by feeding them, dressing them and helping them navigate chronic conditions.

Justices Refuse To Reconsider ‘PIP’ Fees Ruling

Mar 30, 2017
wp paarz / Flickr

The Florida Supreme Court this week rejected a request from medical providers that it plunge again into a dispute about payments by Allstate Insurance Company to care for auto-accident victims.

Lawmakers Seeking Changes In Claim Bills

Mar 28, 2017

Two House members are seeking to make far-reaching changes to the process by which the state and local governments pay out claims for deaths, injuries, and wrongful imprisonment.

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AUDIE CORNISH, HOST:

We've been looking this week at what we know of plans to replace Obamacare, and one of them aims to spread the burden of caring for the very sick. Here's Speaker Paul Ryan on public TV's "Charlie Rose" show.

Agreements Reached On Long-Term Care Insurance

Jan 13, 2017
Florida Office of Insurance Regulation

State regulators and insurers have reached agreement on 10-year plans that include rate increases on long-term care insurance policies, the Florida Office of Insurance Regulation said Thursday.

Marketplace Enrollment Still Important

Dec 13, 2016

Since Republicans have plans to repeal the federal health law, should consumers still sign up for next year’s coverage? And if the health law marketplaces disappear, might Medicare eligibility be expanded? Here are answers to some recent questions from readers.

Doctors, Hospitals Want Cash Before Treating Patients

Dec 6, 2016

Tai Boxley needs a hysterectomy. The 34-year-old single mother has uterine prolapse, a condition that occurs when the muscles and ligaments supporting the uterus weaken, causing severe pain, bleeding and urine leakage.

The Affordable Care Act prohibits insurers from discriminating against people with serious illnesses, but some marketplace plans sidestep that taboo by making the drugs that people with HIV need unavailable or unaffordable, complaints filed recently with the Department of Health and Human Services' Office for Civil Rights allege.

Accident victims with private insurance are getting surprised by sky-high ambulance bills and Florida Insurance Consumer Advocate Sha 'Ron James wants to do something about it.

Three doctors who have led a task force that evaluates preventive medical services say the group's recommendations shouldn't be tied by law to insurance coverage.

The former chairmen of the U.S. Preventive Services Task Force say the link between medical recommendations and insurance coverage leads to financial incentives that can corrupt the process and distort people's health care decisions.

Workers’ Comp Rates Set To Rise Starting Dec. 1

Oct 5, 2016
Nick Evans

Workers' compensation insurance rates will jump 14.5 percent starting Dec. 1, after a filing Tuesday that carried out a decision by state regulators.

Cheap Health Insurance / Flickr

There are many recommendations for preventive care in the health law. Services recommended by the U.S. Preventive Services Task Force have to be provided without charging anything out of pocket.

Republican Leaders Expect Action on Workers’ Comp

Sep 30, 2016
Gage Skidmore / Flickr

With Florida businesses facing a 14.5 percent increase in workers' compensation insurance rates, state Chief Financial Officer Jeff Atwater and a key Republican senator said they expect lawmakers to take action during the 2017 legislative session.

Panel Recommends More Services With No Cost Sharing For Women

Sep 27, 2016
iStock

The list of preventive services that women can receive without paying anything out of pocket under the health law could grow if proposed recommendations by a group of mostly medical providers are adopted by federal officials later this year.

Decision On Workers’ Comp Rate Could Come Soon

Sep 21, 2016
Florida Office of Insurance Regulation

State regulators may be close to deciding on a proposed 19.6 percent increase in workers’ compensation insurance rates.

Privately insured people with cancer were diagnosed earlier and lived longer than those who were uninsured or were covered by Medicaid, according to two recent studies.

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