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New: Oscar Health Small Group for Los Angeles & Orange Counties Available 5/1

Oscar Health, known for low premium individual health plans with high tech features, has expanded their product offerings in California.

Small businesses in Los Angeles and Orange Counties will now have access to Oscar group health plans.  These plans will have the same features enjoyed on individual plans including 24/7 telemedicine & concierge services and fully functional smart app.

I am hoping that Oscar Health will expand their offerings to larger portions of California.

If you are interested in a free, no obligation quote for the new Oscar Health plans, send and e-mail or give me a call (1-800-509-0659).  

Dave
www.davefluker.com





Recent posts

Beware Medicare ID Card Scams

As with anything new, there are those who will find a way to take advantage of people to line their own pockets.  Such is the case with the new Medicare ID cards.  New cards are scheduled to be sent in waves with California beginning in May, 2018.

As reported by The Motley Fool earlier this month, scammers are using two techniques to obtain personal and private information from vulnerable seniors.  Two basic techniques that are being used are - 

1.  Telephone calls claiming to be from Medicare requesting seniors pay a fee for their new ID card (claim it's not free which is not true) and,

2.  Telephone calls claiming to be from Medicare requesting personal and banking information for verification in order to get your new ID card from Medicare.

No doubt there will be more attempts and techniques employed in these phishing schemes.  

It is important to remember that Medicare will never call you to obtain any personal, financial or private information (just like the IRS).  Medicare does no…

California Senate Bill Would Outlaw Short-Term Health Insurance

California Senate Bill 910 (Hernandez), which was re-referred to Health Committee on March 14th, would prohibit any insurer from selling short-term health insurance in California.

"This bill, commencing January 1, 2019, would prohibit a health insurer from issuing, selling, renewing, or offering a short-term limited duration health insurance policy, as defined, for health care coverage in this state."


"10123.61. (a) Commencing January 1, 2019, a health insurer shall not issue, amend, sell, renew, or offer a policy of short-term limited duration health insurance policy for health care coverage in this state."

Some California residents use short-term health insurance in lieu of compliant but more expensive Obamacare coverage or as an interim coverage between compliant health plans.  

Within the last year or so we have seen two carriers terminate their short-term health offering in California.  HCC Tokio Marine dropped their plans in 2017, and Petersen International Under…

California Sues Sutter Health Alleging Excessive Pricing

California Attorney General Xavier Becerra has sued Sutter Health, accusing them of illegally quashing competition and overcharging customers and employers.

"A 2016 study found that hospital prices at Sutter and Dignity Health, the two biggest hospital chains in California, were 25 percent higher than at other hospitals around the state. Researchers at the University of Southern California said the giant health systems used their market power to drive up prices — making the average patient admission at both chains nearly $4,000 more expensive."

Of the lawsuit, "it said Sutter employs a variety of improper tactics, such as gag clauses on prices, “punitively high” out-of-network charges and “all-or-nothing” contract terms that require all of its facilities to be included in insurance networks."

I'll be keeping an eye for updates on this as many in my area of California use Sutter Health services.  This limits the choice of health insurance plans significantly.

Read t…

California MRMIP Alive & Well For 2018

California's MRMIP (Major Risk Medical Insurance Program) has apparently survived the proposed budget cut last year.

In 2017, the proposed 2018 budget would have eliminated the MRMIP and the MRMIF (Fund) and transferred the fund balance to the newly established Health Care Services Plans Fines and Penalties Fund.  See my blog post from 2017

MRMIP is qualifying health coverage for mandate/penalty issues.  It is available year round for enrollment (assuming no waiting list) to California residents who are denied enrollment in a qualifying health insurance plan (Obamacare).  

Online 2018 MRMIP Brochure with benefits, rates and application form


Dave
www.davefluker.com





Idaho "Freedom Blue" Health Plans Coming Soon?

Vox.com has released some details about Idaho Blue Cross' plans for new, non-ACA health insurance plans.  As mentioned in my blog post of February 1, Blue Cross received legislative approval to offer skinnier and less expensive health insurance plans to individuals & families.

http://davefluker.blogspot.com/2018/02/the-idaho-experiment-exit-obamacare.html

Apparently the five new plans will be dubbed "Freedom Blue" and will come in between 25%-50% cheaper than Obamacare plans.  From what I am reading, it appears that the plans will have some new provisions as well...


Up to 50% rate up for applicants with health conditionsPre-existing conditions exclusions for those who fail to maintain prior coverageLifetime maximum benefits $1,000,000There will likely be issues between Idaho and the federal government.  
Read the full article on Vox

Dave www.davefluker.com


Aetna Under Investigation by California Insurance Regulators

Aetna is currently being investigated by the California Dept of Managed Healthcare (DMHC) and the California Dept of Insurance (DOI) in relation to recent testimony in a lawsuit.

"The Department of Managed Health Care, which regulates the vast majority of health plans in California, said Monday it will investigate Aetna after CNN first reported Sunday that one of the Hartford, Conn., company's medical directors had testified in a deposition related to the lawsuit that he did not examine patients' records before deciding whether to deny or approve care. Rather, he relied on information provided by nurses who reviewed the records — and that was how he was trained by the company, he said."


"In an emailed statement Monday, Aetna did not directly address the question of case reviews by non-physicians. It said its "medical directors review all necessary available medical information for cases that they are asked to evaluate. That is how they are trained, as physici…