…the deductible is met. Note that not all plans must comply with the ACA’s preventive services requirement. See the alternative coverage section to learn more. (45 CFR § 147.130(a)(2)). I was denied coverage for a service my doctor said I need. How can I appeal the decision? If your plan complies with the Affordable Care Act and denied you coverage…
…A Note on Our Methodology This blog is intended to provide a summary of comments submitted by SBMs and state DOIs. This is not intended to be a comprehensive report of all comments on every element in the Notice of Benefit and Payment Parameters proposed rule, nor does it capture every component of the reviewed comments. For more stakeholder comments,…
…The Commonwealth Fund, December 15, 2020 This report estimates the potential effects of a proposed strategy to improve health plan affordability by allowing more people to enroll in subsidized health plans through the ACA marketplaces, removing the current “firewall” between employer plans and marketplace subsidies. What it Finds Researchers examined the potential effects of allowing nonelderly people with employer coverage…
…reasons. A Note on Our Methodology This blog is intended to provide a summary of comments submitted by insurers. This is not intended to be a comprehensive report of all comments on every element in the Notice of Benefit and Payment Parameters proposed rule, nor does it capture every component of the reviewed comments. For more stakeholder comments, visit http://regulations.gov….
By JoAnn Volk and Sabrina Corlette In the waning days of 2020, Congress enacted a $900 billion COVID-19 relief package and government funding bill (H.R. 133). Included in the measure is the “No Surprises Act,” which contains new protections for consumers from surprise medical bills from out-of-network providers. The new law establishes, for the first time, comprehensive protections in the…
…abused. This compromise helped secure the support of bipartisan leadership from four key congressional committees: the Senate HELP Committee and the House Committees on Energy and Commerce, Education and Labor, and Ways and Means. House Speaker Nancy Pelosi (D-CA) has voiced her support, as has Senate Minority Leader Chuck Schumer (D-NY). The White House has confirmed that President Trump would…
Open Enrollment has ended in most states, and many consumers have signed up for a health insurance plan offered on the marketplace. For those who haven’t, there may still be an opportunity to enroll in an ACA-compliant health insurance plan during a Special Enrollment Period (SEP), which are available in some states and to some consumers, depending on their eligibility….
By Jack Hoadley, Kevin Lucia, and Beth Fuchs On December 22, Congress enacted a $900 billion COVID-19 relief and government spending bill that included comprehensive bipartisan, bicameral legislation to protect consumers from surprise medical bills, called the No Surprises Act. Federal legislation has been under consideration for more than a year, but prior efforts were stymied, in part because of…
We at Georgetown CHIR are thankful that our team has remained safe as we work from home, but we keep at the center of our vision those who have had to face the brutal effects of the COVID-19 pandemic. When the world went on lock down in early March, our team quickly pivoted to researching and writing about the government…
…Step 1: Pay your first premium I’ve picked the plan I want. Now do I send my premium to the marketplace? No, you will make your premium payments directly to the health insurance company. Once you’ve selected your plan, the marketplace will direct you to your insurance company’s website to make the initial premium payment. Insurance companies must accept different…
The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.
