Health Insurance
Telehealth, and how it is covered
Coverage expanded substantially, then contracted in places, and the rules now differ by plan, by state and by type of service.
Health Insurance
Networks, deductibles, prior authorisation and appeals.
Health Insurance
Reading your health plan documents
Three documents describe your coverage, they say different things, and only one of them is the contract.
Health Insurance
Surprise billing protections and what they cover
Federal rules now limit balance billing in defined situations, and knowing which situations they are is the useful part.
Health Insurance
Dental and vision coverage, and whether it is worth buying
Two benefits sold as insurance that function more like prepaid discount arrangements, with low caps and a specific arithmetic.
Health Insurance
Preventive care, and why it sometimes generates a bill
A defined set of services must be covered without cost sharing, and the boundary between screening and diagnosis is where charges appear.
Health Insurance
Medicare basics for people who are not yet on it
Four parts, several enrollment deadlines, and penalties for missing them that last for life.
Health Insurance
Health savings accounts and flexible spending accounts
Two tax-advantaged accounts with similar names and very different rules, one of which you can keep forever.
Health Insurance
COBRA, marketplace coverage and the gaps between jobs
Losing employer coverage triggers several options with short deadlines, and the default option is frequently the most expensive one.
Health Insurance
Prescription drug coverage and the formulary
A list, maintained by the insurer, that determines what your medications cost and whether you can get them at all.
Health Insurance
The explanation of benefits, decoded
The document that says it is not a bill, arrives after every service, and contains the information you need to catch errors.
Health Insurance
Choosing a health plan during open enrollment
A decision made in twenty minutes once a year that determines several thousand dollars of exposure, usually made on premium alone.
Health Insurance
Prior authorization, and how to get one
The requirement that a service be approved before it happens, and the process that decides it — including what to do when the answer is no.
Health Insurance
Networks: HMO, PPO, EPO and POS
The network structure determines which doctors you can see and what happens when you see someone else, which is where most large bills originate.