Tag: healthcare coverage

Health insurance companies can’t use AI for Medicare

Logan B.
Health insurance - Medicare and AI

Newly released federal guidelines say that artificial intelligence can’t make all the choices. The Centers for Medicare and Medicaid Services (CMS) have released new guidance for health insurance companies to protect Medicare Advantage (MA) against bias from artificial intelligence (AI). The CMS is the federal agency overseeing Medicaid, Medicare and other programs CMS oversees the Children’s Health Insurance Program (CHIP), the Health Insurance Marketplace, Medicare and Medicaid. It recently issued a policy memo to insurers in which it banned them from using algorithmic systems or AI exclusively to decide on…

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Many health insurance denials in Pennsylvania to undergo fresh review

G. Turner
Health insurance - Denied - Pennsylvania

A new program in the state will focus on cases in which individuals have failed to obtain payments. The new Independent External Review program in Pennsylvania will be taking another look at health insurance claims in which policyholders felt they were incorrectly denied. Many people feel that the current appeal process hasn’t worked for them due to its limitations. There is already an appeal process available to health insurance customers whose claims have been denied for the cost of a medication or medical procedure. They have been able to appeal…

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Many lapsed Medicaid recipients will enroll in ACA health insurance plans

Logan B.
Health insurance - Affordable Care Act Form

Experts and insurers have predicted that after losing old coverage, there will be an influx of policy shopping. Health insurance companies and advisors alike are preparing for a notable surge of consumers looking for assistance in navigating Affordable Care Act enrollment after having lost Medicaid coverage in 2023. As of April, this year, the extensions for coverage that were put into place during the pandemic ended. Beginning April 1, 2023, the Medicaid and Children’s Health Insurance Program (CHIP) coverage extensions that were put into place throughout the worst of the…

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More than half of US adults with health insurance struggle with their plan

G. Turner
Your Health Insurance Plan Form

People with poor of fair mental health faced the highest challenges with their coverage. Over half of insured adults in the United States are facing struggles with their health insurance, according to a recent Kaiser Family Foundation survey. The survey results showed struggles in everything from payment discrepancies to limited mental healthcare coverage. The online survey was conducted this year between February 21 and March 14. It involved the participation of 3,605 adults who are covered by employer-sponsored health insurance plans, Medicaid, Medicare, a Military plan, or Affordable Care Act…

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Health insurance plan enrollment has shifted due to the pandemic

Marc
Health insurance plan enrollment - pandemic - American flag on face mask

As is the case with everything else, signing up for coverage has been impacted by COVID-19. As has been the trend with virtually everything in 2020, health insurance plan enrollment has been impacted by the presence of the pandemic. The coverage and benefits have altered due to the impact of the pandemic on health care. As insurers, employers, and even Medicare have seen the needs of policyholders change throughout the pandemic, they have made changes to coverage in an effort to better respond COVID-19. Consumers are also taking a closer…

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