Centers for Disease Control and Prevention

Laurie Cook went shopping recently for a mammogram near her home in New Hampshire. Using an online tool provided through her insurer, she plugged in her ZIP code. Up popped facilities in her network, each with an incentive amount she would be paid if she chose it.

That didn’t take long.

Court Rules Against Insurer In 'PIP' Payment Dispute

Feb 12, 2018

Pointing to “numerous conflicting decisions” by lower courts, a divided state appeals court ruled Friday against Progressive Select Insurance Co. in a dispute about how much should be paid to a hospital for treating a man injured in an auto accident.

Senate Ready To Pass 'Prior Authorization' Measure

Jan 25, 2018

The Senate on Wednesday prepared to pass a bill that would place new requirements on how health insurers handle prior-authorization requests and appeals from denials of care.

Florida lawmakers are looking to ensure genetic tests won’t affect eligibility for insurance coverage. The House Health and Human Services Committee unanimously passed a measure preventing insurance companies from using genetic information when making policy decisions.

Wikimedia Commons

The Trump administration’s watershed decision Thursday to allow states to test a work requirement for adult Medicaid enrollees sparked widespread criticism from doctors, advocates for the poor, and minority and disability rights groups.


Some Americans who froze their credit reports following the big data breach this year at the credit-rating firm Equifax may be in for a surprise if they try to purchase insurance on the federal health law’s marketplaces. That freeze could trigger a delay in the application process.

As a lifelong racket-sports fanatic, I've dealt with shoulder pain for decades, treating it with bags of frozen peas, physical therapy, cortisone shots and even experimental treatments like platelet-rich plasma. Eventually, however, the soreness prevented me from handling daily-living tasks like pulling a bottle of olive oil off the top shelf of my kitchen or reaching to the back seat of my car to grab my purse. Even low-impact activities such as swimming freestyle hurt a lot. Sleeping also got tougher. After MRI showed two full-thickness rotator-cuff tears, I finally called a surgeon.


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

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.

Copyright 2017 NPR. To see more, visit


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.