Tag: summary of benefits and coverage

From Acne to EcZema: The Return of Medical Underwriting Puts Millions at Risk for Losing Coverage or Higher Premiums

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Medical underwriting, outlawed by the Affordable Care Act (ACA), is a practice used by insurance companies to assess a consumer’s health status. In the event of an ACA repeal, millions of people could lose coverage, pay higher premiums, or receive inadequate benefits that exclude essential health services, all based on a pre-existing condition. While many of us don’t see ourselves as falling under that category, the list of health conditions that qualify you for the chopping block may surprise you.

Accessing Provider Directories and Formularies: CHIR Goes Sleuthing

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We’re counting down again to Open Enrollment 3 and this year, all health plans must make accessing provider directories and formularies, or the list of covered prescription drugs, easy for consumers. This means consumers should be able to find this information on insurer website sites without creating an account or entering a policy number. CHIR’s Sandy Ahn flexes her investigative skills and looks to see how accessible this information really is.

The NAIC’s Summer Meeting: Updating Network adequacy and ACA Transparency Requirements

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The National Association of Insurance Commissioners (NAIC) has been hard at work updating a model state law governing the adequacy of health plan provider networks and revising the ACA-mandated summary of benefits of coverage for consumers. JoAnn Volk serves as a consumer representative to the NAIC and shares details from their recent national meeting as well as upcoming activities.

Shifting into Post-Enrollment Issues: Fielding New Questions from Consumers

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As we approach the end of open enrollment into new coverage options under the Affordable Care Act, many consumers have questions about their new health plans – what benefits are covered, what doctors are included in their networks, and what to do if there’s a problem. JoAnn Volk has them covered, with a series of frequently asked questions about post-enrollment issues, excerpted from our Navigator Resource Guide.

Shining a Light on Health Insurance: Senate Commerce Committee Examines Progress, Challenges

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Health insurance is a complicated product that consumers have difficulty understanding, a common theme throughout Wednesday’s Senate Commerce Committee hearing on “The Power of Transparency: Giving Consumers the Information They Need to Make Smart Choices in the Health Insurance Market.” Fortunately, new tools are already available to help consumers shop for and compare coverage, and more will become available as Affordable Care Act implementation continues to roll out.

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.