When it comes to health insurance, "in-network" means a provider or facility that's contracted with your insurer to provide services at an agreed-upon rate. "Out-of-network" means a provider or facility that doesn't have an agreement with your insurer. Whether in-network or out-of-network providers and facilities are covered, and to what extent, depends on your particular health insurance plan.
Thousands of Rhode Islanders have signed up for health insurance in recent weeks, some for the first time. I'm thinking that means some might not be so familiar with our health care system, or they might not know how to keep costs down with plans that carry higher deductibles or out-of-pocket costs.
So... here are a few tools to help you navigate, from finding the highest quality, to keeping costs down, to managing your own health. It's not an exhaustive list, but a start...if you're starting from scratch!
For the first time, Rhode Island’s insurance commissioner has directed health insurers to disclose what they pay for health care services. But that information won’t necessarily be directly available to patients.
You may have heard news yesterday that the federal government has released a greater level of detail on the prices hospitals charge for a list of common procedures and how widely those prices vary - not only from state to state but within states, and even within the same city. The data comes from the Centers for Medicare and Medicaid Services (or CMS), from 3000 hospitals nationwide.
Rhode Island is beginning a public effort to develop a statewide plan to improve the way we pay for health care. Lt. Governor Elizabeth Roberts is leading the effort.
With a $1.6 million dollar grant from the federal Center for Medicare and Medicaid Innovation, Roberts launched the six-month planning initiative. A series of public meetings will gather input from experts and community members. Roberts says she wants a plan to help health care providers and insurers move away from payments for a particular treatment or service toward paying for improved health.
News from the New England Journal of Medicine today finds that the cost of caring for people with dementia (including Alzheimer's) will more than double in the next couple of decades. That's because the nation's population is aging, and because the care can be expensive. Most of the estimated $215 billion dollars these diseases cost the economy can be chalked up to long term care.
RI lawmakers are considering changing the Voter ID law. RI artists can get some help managing their money. These stories and more on the RIPR Morning News Podcast. Plus Political Commentator Scott MacKay analyzes what the current sequestration means to RI.
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