Explore insurance coverage from National Health Underwriters: Plans, coverage, underwriting logic, employer benefits, open enrollment — service journalism.
Plans, coverage, underwriting logic, employer benefits, open enrollment — service journalism
Guaranteed issue ended medical rejection for ACA-compliant plans, but rating still moves on age, geography, tobacco and plan type — and outside the ACA, old rules persist.
Written by Renata Silva
Forty states and the District of Columbia have expanded Medicaid to most adults under 138 percent of poverty; in the remaining holdout states, adults too poor for subsidies still have no option.
Written by Renata Silva
The explanation of benefits is not a bill — it is the insurer's account of what happened to a claim, and three of its fields decide whether you pay the right amount.
Written by Renata Silva
A denial letter starts a clock, not a conversation: the appeal route, the deadlines and the outside reviewer who can overrule your insurer are all written into federal rules.
Written by Renata Silva
Insurers require advance approval for expensive drugs, imaging and procedures; knowing who files the request, the clocks that apply and how denials get overturned can save weeks.
Written by Renata Silva
One path bundles everything into a private managed-care plan with low premiums and networks; the other keeps Original Medicare and buys predictable cost sharing.
Written by Renata Silva
Most employees default to last year's choice; a one-hour structured review of premiums, networks and accounts usually finds money the default leaves on the table.
Written by Renata Silva
Both accounts let you pay medical bills with pretax money, but eligibility rules, rollover treatment and investment options split them sharply.
Written by Renata Silva
One number is what you pay before insurance starts paying; the other is the ceiling on what you can ever pay in a plan year — and confusing them is expensive.
Written by Renata Silva
The metal names on marketplace plans describe one specific number — actuarial value — and knowing that number changes how you compare plans.
Written by Renata Silva