united healthcare

Health insurance rates in Rhode Island will go up once again for most consumers in 2016. The state’s health insurance commissioner has made a final decision about those rates for individuals and businesses.

Rates for all United Health plans are going up –large employers, will pay about four and a half percent more, and small business plans will rise just over seven percent. Individuals with a Neighborhood Health Plan of Rhode Island policy will pay an average of $312 dollars a month, up nearly six percent.

Or... they could be. Insurers have just filed their requests for premium rate increases with the state’s health insurance commissioner. They’re only preliminary. And in years past the health insurance commissioner has denied some increases. But if experience is any guide, the average monthly premium for most plans will probably go up - in some cases by two-digit percentages.                                                         

It all depends on how you buy your insurance - on your own, through a small business, or through a large business.

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.

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

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.

Connecticut doctors sued United Healthcare for dropping them from their Medicare Advantage network. Will Rhode Island follow suit?

Probably not, says Steven DeToy with the Rhode Island Medical Society. He told me he thinks it's unlikely the doctors will have any luck in court because United had the right to drop doctors - it's in their contract. And if they did, it could get expensive and messy: doctors could be responsible for half the cost of mediation if it comes to that.

A federal judge in Connecticut is blocking United Healthcare’s move to drop hundreds of doctors from its Medicare Advantage network.

The Hartford Courant reports that the Fairfield and Hartford County Medical Associations convinced the court that removing the more than 2-thousand doctors in Connecticut from the health insurance network would be too damaging. And that the insurer plans to appeal the decision.

RIPR health care reporter Kristin Gourlay joined host Dave Fallon in the studio to talk about what United Healthcare's recent decision to drop several hundred doctors from its Medicare Advantage plan means for the 36,0000 or so Rhode Islanders in that plan. Following is a transcript of their conversation, and a link to listen.

The Rhode Island Medical Society said United Healthcare has cut hundreds of doctors from its Medicare Advantage network. The plan covers some 36,000 Rhode Island seniors.

Rhode Island Attorney General Peter Kilmartin and Health Department director Michael Fine have sent a letter to the CEO of United Healthcare New England expressing their concern over the insurer’s dropping of dozens of doctors from its managed Medicare plan in the state. They want United to reinstate doctors until they submit a plan to handle the transition.

Wikimedia Commons

United Healthcare has notified an unknown number of Rhode Island doctors that they’re being cut from its Medicare Advantage plan network. The news comes during Medicare’s open enrollment period and could affect thousands of senior citizens in the Ocean State.

You may have heard about United Healthcare's decision to cut a number of doctors from its Medicare Advantage plan in Rhode Island and some surrounding states. That means that, for some seniors, their doctor may no longer be considered "in network" - and, therefore, no longer affordable for some, since "out of network" doctor visits cost more.

Rhode Islanders who buy health insurance individually or through a small employer now have an idea how much their monthly premiums will be in 2014. The state’s outgoing commissioner of health insurance approved rates lower than insurance companies requested, although just about everyone’s health insurance bill will be going up.