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A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan

Most people get their health care through some form of managed care plan – a health maintenance organization, preferred provider organization, or point-of-service option. Most of the time, people receive the care they need, but the potential exists for disagreements over the services that will be provided or paid for…

State Health Insurance Marketplace Profiles

Up-to-date state profiles give an in-depth look at each state’s progress in setting up marketplaces, formally known as exchanges, including the legislative process and the next steps.

A Profile of Health Insurance Exchange Enrollees

The Patient Protection and Affordable Care Act calls for the creation of Health Insurance Exchanges in all states by January 1, 2014. The exchanges are a critical element of the health reform law, aimed at helping individuals and families shop for and purchase health insurance on their own with additional…

The Flip Side of Higher Premiums: Better Coverage

Time Magazine’s recent cover story on health care – “Bitter Pill” by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing…

Obamacare y Usted: Si compra seguro médico en el mercado individual

Si usted compra su plan de salud por su cuenta (en vez de tener cobertura a través de su empleador), usted tendrá nuevas opciones para tener su cobertura, pero la Ley del Cuidado de Salud a Bajo Precio requiere que usted esté asegurado o será multado. Qué está cubierto Bajo…

Obamacare y Usted: Si tiene seguro médico a través de un empleador

Si usted tiene cobertura de beneficios de salud a través de su empleador o del empleador de un miembro de su familia, usted probablemente pueda mantener esa cobertura y no tener que hacer ningún cambio. En la mayoría de los casos, la cobertura de su empleador satisface los requerimientos de…

State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the Affordable Care Act

Key provisions of the 2010 Affordable Care Act (ACA) create new Marketplaces for people who purchase insurance directly and provide new premium tax credits to help people with low or moderate incomes afford that coverage. This analysis estimates that about 17 million people who are now uninsured or who buy insurance on their own (“nongroup purchasers”) will be eligible for premium tax credits in 2014. This issue brief provides national and state estimates for tax credit eligibility for people in these groups.

Medicare Advantage 2014 Spotlight: Plan Availability and Premiums

This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2014, premium levels and other plan features. Medicare beneficiaries, on average, will have 18 private Medicare Advantage plans available to them in 2014, reflecting both new plans entering the market and old plans exiting it. If Medicare Advantage enrollees remain in their current plans, average monthly premiums will rise by almost $5 per month, or 14 percent, to $39 per month. The analysis also examines some benefits provided by Medicare Advantage plans including drug coverage and caps on out-of-pocket spending, and finds that average out-of-pocket limits across all plans will climb 11 percent to $4,797 in 2014. Additionally, this analysis examines changes in the types of plans available (HMOs, PPOs, etc.), including special needs plans in 2014.

California’s Uninsured on the Eve of ACA Open Enrollment

This report presents the findings of a baseline survey of California’s uninsured adult population just before the start of the first open enrollment period under the Affordable Care Act (ACA). It will be followed by three other surveys over the course of the next two years that will capture the…