Good news for women: Recent changes to the Affordable Care Act will expand access to essential services. This is especially important considering that women are more likely to need preventive health services, yet are less likely to be able to pay for those services because they have a lower average …
What are the Differences between an HMO and a PPO?
Choosing between an HMO and PPO can be confusing. There are several major differences you should know about in order to make an informed decision. A Health Maintenance Organization, or HMO, is a managed care provider for health insurance that coordinates with health care providers on a prepaid basis. HMO …
Does the Healthcare Mandate Mean I Will Have to Buy Health Insurance?
The Patient Protection and Affordable Care Act has resulted in many changes to healthcare, including removing exclusions for pre-existing conditions and requiring plans to cover certain preventive services, such as colonoscopies and mammograms. The aim of the Affordable Care Act is to reduce costs and fraud, and ensure every American …
What is the Difference between Formulary and Non-Formulary Drugs?
A formulary is a list of drugs and supplies covered by a health insurance plan, and each plan has its own specific formulary. Non-formulary drugs are those that are not covered or that are covered a higher rate than formulary drugs. A plan with an “open formulary” may allow coverage …
Changes to Women’s Healthcare under the Affordable Care Act
The Affordable Care Act (frequently referred to as “Obamacare”) has resulted in the addition of many no-cost services in women’s health care. In August health insurance plans were required to add eight new benefits in addition to 14 other benefits that had already been added. The new benefits come at …
A Brief History of Medicare
Medicare is a life saver—quite literally—for millions of retired Americans. In place since 1965, Medicare guarantees healthcare insurance to Americans age 65 and older who have worked a minimum of 40 quarters (10 years) as well as individuals with end stage renal disease and disabled individuals under age 65. Medicare …
Improvements to Medicare under the Affordable Care Act
The passage of the Affordable Care Act in 2009 resulted in some improvements to Medicare coverage, including preventive care coverage and drug coverage. Here are the changes in more detail: Drug Coverage– Beginning January 1, 2011, individuals who reach the gap of Part D prescription drug coverage automatically get a …
What is Blue Shield of California?
Blue Shield of California is a non profit organization offering affordable health insurance and Medicare plans for individuals, families, seniors, and employers. In addition to medical coverage and Medicare supplement plans, Blue Shield also offers dental and vision plans to meet every customer’s needs in terms of pricing and quality …
Understanding HIPAA’s Privacy Rule
The Health Insurance Portability and Accountability Act (HIPAA), pronounced “Hip-Uh,” is a law that was introduced in 1996 to protect patient privacy as well as limit exclusions for pre-existing condition, provide patients with guaranteed renewal of health insurance policies, and require that patients be given the right to continue group …
Understanding Lumenos Coverage and Plans
Selecting the right healthcare coverage is not exactly easy. There are so many different providers and so much to understand – and it is not necessarily written for the average person. The Lumenos plans from Blue Cross of California seek to make the healthcare coverage process a little bit easier …