Now that open enrollment is over, consumers are starting to raise questions about their coverage. One such question from Georgia illustrates one of the challenges consumers may face – a network that changes mid-year. JoAnn Volk takes a look at some options.
While we’re struggling with Affordable Care Act (ACA) issues, there’s value in taking the time to look back and appreciate the impact of the ACA and other healthcare reforms implemented over the past few decades. To that end, CHIR faculty member and former Indiana Insurance Commissioner Sally McCarty is posting a series called “Back in the Day – Lessons from Pre-reform Days.” This installment looks at policies in a “death spiral.”
Navigators have been fielding a range of questions. One that comes up repeatedly is whether an individual who falls into the so-called Medicaid coverage gap and later gets a job with income that would qualify them for premium tax credits can get a special enrollment period. JoAnn Volk takes a look at the options for these individuals.
CHIR faculty Sally McCarty, David Cusano, and Max Farris serve as technical assistance professionals (TAPS) in the Robert Wood Johnson Foundation State Health Reform Assistance Network. In that capacity, they have developed the Consumer Services Toolkit to help assure that consumer service representatives in state insurance departments have critical information about the Affordable Care Act at their fingertips. Sally McCarty introduces the toolkit and its components.
Blue Cross Blue Shield of Mississippi has included a new provision in its plan description that could mean huge costs for plan participants. The new policy does not cover prescription drugs prescribed by out-of-network providers. How does this policy square with the ACA? And what does it mean for consumers? Elissa Dines discusses.
The ACA established new appeal rights for consumers facing a denial of a benefit or service from their health plan. As consumers start to use their new Marketplace coverage, JoAnn Volk takes a look at the health plan appeals process required of all new plans, and what these new rights mean for patients.
High risk pool enrollees face particular challenges transitioning to new coverage when their coverage ends. But announcements in the past week provide relief to both PCIP enrollees as well as those in state-based high risk pools. JoAnn Volk takes a look at what those announcements mean for consumers.
The Kaiser Family Foundation—in collaboration with CHIR experts Kevin Lucia and Katie Keith—has released a new report exploring factors leading to medical debt among people with insurance. Kevin Lucia has this preview.
Almost two months into open enrollment, Navigators and other consumer assisters must field a multitude of questions about plan options inside the marketplace and out, how individual and employer-sponsored coverage may change as a result of the ACA, and whether consumers have the coverage they need to satisfy the individual mandate. Today, CHIR released a Navigator Resource Guide that helps Navigators explain key insurance and marketplace concepts and accurately answer a wide range of questions.
As ACA implementation unfolds, one group that will be transitioning to new coverage is individuals enrolled in state-run high risk pools. Because these individuals have such significant health care needs, their transition to new coverage raises potential concerns, especially for those who use their high risk pool plan to supplement their Medicare coverage. In this blog, JoAnn Volk takes a look at those transition issues and how some states are responding.
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.
