health insurance

Health insurers have filed their requests for rate increases (or, in one case, decreases!) for the coming year (effective January 2015). The Office of the Health Insurance Commissioner reviews those requests to make sure they're fair, and then issues a ruling, probably by mid-July. Before then, you have an opportunity to weigh in.

Here are the details on those opportunities, plus OHIC's summary of what insurers have requested.

RIPR FILE

State lawmakers have plenty of competing priorities to consider as they wrap up the legislative session. One of those is what to do with the state’s health insurance exchange, HealthSource RI. Health care reporter Kristin Gourlay joins host Dave Fallon to talk about the lively debate that's developed around this question of whether to keep HealthSource going or scrap it and default to the federal health insurance exchange, healthcare.gov.

Lawmakers are being asked to decide the fate of HealthSource RI, the state’s online health insurance exchange. At issue is how to pay for it, or whether to scrap it. And plenty of voices are weighing in on the conversation. The latest claims state officials were told years ago that building an exchange wasn’t viable but did it anyway.

As you may know, there's a debate in the Rhode Island Statehouse over how to fund the state's online health insurance marketplace, HealthSource RI, after the Obamacare money runs out. Some say the $17 - $23 million dollar price tag to fund the site, customer service reps and centers, and infrastructure needed to negotiate for health insurance plans for sale on the site is just too much for a state with anemic coffers.

A statewide effort to link more Rhode Islanders with primary care is expanding.

The effort is called the Chronic Care Sustainability Initiative, or CSI.CSI promotes the patient-centered medical home model of health care. In a patient centered medical home, a team of health care professionals coordinates a patient’s care. It’s especially helpful for patients with chronic illnesses, although anyone can join.

As you may know, far more Rhode Islanders signed up for Medicaid than expected recently. And the state is on the hook for millions more dollars than anticipated to care for them. The federal government is picking up the tab for now for people who became newly eligible for the program under the Obamacare Medicaid expansion, which Rhode Island opted to accept (unlike some other states). That allowed childless adults, men and women, earning less than a certain amount a year, to get health insurance, some perhaps for the first time.

Aaron Read / RIPR

A state senate committee has recommended passage of two bills aimed at curbing prescription drug and heroin abuse.

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.

Kristin Gourlay / RIPR

The public comment period has ended and now the Rhode Island health department must decide whether United Healthcare can cut Landmark Medical Center from its insurance network. The decision could affect thousands of patients.

Aaron Read / RIPR

You may have gotten a letter in the mail recently from your health insurance company asking whether you wanted to opt out of something called an “all payer claims database.”

It's pretty basic: in order to save a little money, most people have to stick to a budget. But before you can sketch out that spending plan, you need to know where your money's been going and how much you've been spending on everything. Then you can look for places to trim and skimp.

So too goes the theory with health care spending. Or at least, that's the idea behind several new efforts:

Aaron Read / RIPR

New rules for Medicare Advantage plan members give seniors more flexibility to opt out of plans that drop their doctors from the network.

The Centers for Medicare and Medicaid Services has announced that Medicare Advantage plan members will be able to switch plans if those plans drop doctors mid-year without cause. These are Medicare plans offered by private insurance companies and often operate like HMOs.

As you may know, today is the deadline for individuals and families to sign up for health insurance coverage through HealthSource RI, if you don't already have coverage. But what happens tomorrow?

Well, if you're an individual or a family without coverage now, and you can't get it through your employer or via Medicaid, you'll have to wait until the next open enrollment period, November 15, 2014. Also, you might face a tax penalty.

Monday is the deadline to enroll in a health insurance plan through HealthSource RI, the state’s online insurance marketplace. That’s the last chance to enroll until November.

The push is on to attract as many eligible Rhode Islanders to HealthSource RI to sign up for a health insurance plan. March 31st is the deadline to enroll in coverage in order to avoid a tax penalty for the year. And the next open enrollment period doesn’t start until mid-November for coverage that begins the following January. So if you were waiting until the last minute, now’s the time.

Another study seems to suggest that, contrary to previous assumptions, it does.

Researchers from Beth Israel Deaconess Medical Center in Boston have just published the results of a study in the Annals of Emergency Medicine that looked at all emergency department visits at 69 hospitals between the fall of 2006 and the fall of 2009. In 2006, Massachusetts expanded access to health insurance to nearly everyone in the state.

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