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In the past, many patients who opted for experimental treatments for cancer and other life-threatening illnesses found that their insurance companies stop covering all routine care for their illness. The health overhaul mandates that insurers continue to pay for doctor visits, hospital stays, test and other routine treatments.
Congress is betting more than $3 billion over the next decade that "comparative effectiveness" research can transform medical care by helping determine the best approach to a particular illness.
The 'Insurance Capital' bucks the nationwide trend of states turning to private managed care plans.
States will be given wide latitude to decide what "essential benefits" insurers must offer in policies offered on new health exchanges come 2014, the Obama administration said Friday in a move that pushes off final federal rules on those benefits until sometime next year.
When Gary Diego's wife, Ellen, had bleeding in her brain, she ended up in an out-of-network emergency room. And he ended up with a huge bill. In a practice known as balance billing, insurers pay a portion of the out-of-network charges, and the rest is dumped on patients.
Crowded emergency rooms and a lack of primary care doctors have fueled recent expansions. But the drive to lower costs is also a factor and could bring more customers under the overhaul.
He's done with mandates, but Newt Gingrich likes John Goodman's idea for helping people who buy insurance and paying for care for those who don't.
Both Perry and Obama can claim political victories with the Medicaid waiver the feds granted to the Lone Star state. But public hospitals have the most to gain from the new system.
A loophole in the health law could allow employers to game the system by dumping their sicker employees onto health insurance exchanges.
Marilyn Ringstaff's clinic fills a void for low-income uninsured women in Rome, Georgia.
Here are some questions SHIP officials recommend asking.
It's a mixed verdict, however. Medicaid will be spared, and the Medicare hit will be limited to providers. But other programs, from disease prevention to public health surveillance, face big automatic cuts in 2013.
As they shoulder more health care expenses, workers in some plans can reduce their costs by participating in company wellness programs.
The new health law mandates that insurers cannot pay less for emergency care in "out-of-network" hospitals and eases consumer worries about having to pre-authorize an emergency room visit.
Although the GOP presidential candidate is offering to let beneficiaries stay in the traditional fee-for-service program, critics say his plan could shift more cost to individuals.
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