Medicare Advantage (MA) plans received more than 2 million prior authorization requests in 2021, of which about 6% were denied. This statistic, sourced from the Kaiser Family Foundation (KFF), illustrates the challenges MA users face in receiving the necessary treatments and medications. Prior authorization is a practice used by health insurance companies to control costs […]
We’re on a mission to make sure your clients, get the most out of their Oscar plan. That’s why we’re shining the spotlight on the Oscar Essentials this month. And, first up is account creation! With an Oscar account, your clients can take control of their healthcare experience like never before. Imagine being able to […]
Exciting news for healthcare consumers in Texas! Blue Cross Blue Shield of Texas has announced that Ascension, one of the largest non-profit healthcare systems in the country, will remain in their network. This means that patients who have health insurance through Blue Cross Blue Shield will continue to have access to Ascension’s vast network of […]
By: Michelle M. Saavedra On December 31st, millions of people around the world were eagerly counting down the hours to welcome the new year. But for insurance agents, the real countdown began when the ball dropped on Time Square. This action alone symbolized the impending end of the Open Enrollment Season for the year 2023. […]
The 2022-2023 Open Enrollment Season saw more than 16.3 million people sign up for healthcare coverage, a new record that signaled the continuing need for access to quality healthcare and the Affordable Care Act’s (ACA) continued success in providing that access. The enrollment period ran from November 1, 2022 to January 15, 2023, and […]
Dual eligible special needs plans (DSNP) are a type of Medicare and Medicaid coverage that are tailored to meet the specific needs of certain individuals. DSNPs provides access to a wide range of services and benefits designed to help individuals with long-term care needs and help them maintain their independence in the home or in […]
The 1095 forms are tax documents used to report health insurance information to the Internal Revenue Service (IRS). They are part of the Affordable Care Act (ACA) and are used to determine eligibility for government subsidies and tax credits. 1095 forms are typically issued by employers, health insurance providers, and the Health Insurance Marketplace. What […]
During a CMS National Stakeholder call, the omnibus spending plans were discussed as it relates to the recent spending plan proposed by Congress that would allow states to resume Medicaid continuous enrollment unwinding after the end of the first quarter of 2023. This post outlines a few key points about the unwinding of the Medicaid continuous […]
The IRS just made a final ruling regarding the ACA “Family Glitch”. Here’s everything you need to know about it as a health insurance agent, and what this will mean for your customers. The Final Rule addresses the “family glitch” in the Affordable Care Act by basing the affordability of employer-sponsored coverage for a family […]
Ambetter plans to expand access to their value network in Florida. Starting January 1, 2023, Ambetter Value plan members can access providers in the below list for all medical needs. Cano Health Medical Centers Centrum Medical Center Fox Medical Center IMC Health Medical Centers MedFlorida Medical Center UniVida Medical Center Community Medical Group is currently […]