Insurance

Pregnant patients are being asked to make large payments months before they deliver, a change from decades of standard practice. Advocates worry that it allows providers to hold "treatment hostage."

Treatments that don’t help patients, and may even harm them, are difficult to eliminate because they can be big sources of revenue.

Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and predicts what kind of care an individual will need. New rules will ensure humans are part of the process.

Prior authorization is a common tool used by health insurers for many tests, procedures and prescriptions. Frustrated by the process some patients and doctors want to elevate their denials for further review.

Insurers selling coverage in North Carolina, Pennsylvania and New York, among other states, say they won’t cover Leqembi with insurance offered on the individual market and through employers because they see the $26,000-a-year drug as experimental.

A federal appeals court Thursday cleared the way for eight South Florida hospitals to pursue a lawsuit against a health insurer over payments for emergency-room care.

More than half of the largest employers in the U.S. cover fertility care, which includes IVF. Researchers say a divide is growing between people who receive help paying for care and those left out.

People now have at their disposal more medicines that are effective at reducing weight, but none can counter obesity alone. One big problem: Insurance coverage remains spotty, and the costly drugs may be needed long term.

The body mass index — a simple mathematical equation — is tied to a measure of obesity invented almost 200 years ago. On the downside, it can stand between patients and treatment for weight issues. It particularly mismeasures Black women and Asians.

This guide from Life Kit includes podcast episodes on how to select the right health care plan, a glossary of common insurance jargon and why you should give your summary of benefits a close read.