Provider networks and prescription drug coverage are important consideration for consumers when choosing a plan. As part of CHIR’s weekly series highlighting FAQs from our updated Navigator Resource Guide, this week we discuss how to make sure your plan provides access to the doctors, prescription drugs, and culturally competent care that you need.
In Congress and state legislatures across the country, policymakers are debating fixes to surprise medical bills. The federal government has yet to enact comprehensive reforms, but a number of states have taken steps to protect consumers. One such state is Texas, which last year enacted a new law holding consumers harmless in situations that commonly lead to surprise medical bills. However, the state’s new protections were almost gutted due to an implementation loophole, a cautionary tale for federal and state policymakers. CHIR’s Rachel Schwab takes a look at what happened in Texas.
Open Enrollment has ended in the majority of states, and almost 8.5 million people signed up for coverage through HealthCare.gov. As consumers begin to use their 2019 plans, a host of questions about covered services, cost sharing, provider networks and more are sure to crop up. Luckily, CHIR has answers to frequently asked post-enrollment questions in our recently updated Navigator Resource Guide.
In CHIRblog’s February installment of What We’re Reading, CHIR’s Olivia Hoppe digs into new research that highlights the consequences of the recent short-term limited-duration health plan rule, the effects of expanded private insurance on access to primary and specialty care, the impact of the ACA’s dependent coverage provision on birth and prenatal outcomes, and an assessment of state-level efforts to expand access, affordability, and quality of coverage.
Balance billing occurs when a consumer who is treated by an out-of-network provider is subsequently billed by that provider for the difference between what their health plan paid and what the provider charges. In their latest issue brief published by the Commonwealth Fund, Kevin Lucia, Jack Hoadley, and Ashley Williams analyzed laws in all fifty states and the District of Columbia to understand the current scope of state laws that protect consumers from balance billing.
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 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.
