Health insurance news covering payers, premiums, Medicare Advantage, ACA markets, and benefit design.
The article argues that the US healthcare system's fee-for-insurance model forces rushed primary care visits, prompting a shift toward direct primary care. This alternative model charges patients monthly membership fees to enable longer, more comprehensive doctor-patient relationships.
Disney announced it will stop offering medical insurance to US employees' spouses who have access to coverage through their own jobs, starting next year. The policy change does not affect other dependents or spouses without access to employer-sponsored coverage.
Customer satisfaction with Medicare Advantage plans has declined for the second consecutive year, according to a JD Power study. The survey of over 14,000 members found that only 34% felt prepared for unexpected events, prompting advisors to review client coverage.
The article advises a laid-off worker in Wisconsin on securing affordable health coverage after employer insurance ends. It suggests exploring Affordable Care Act Marketplace special enrollment periods as a viable alternative to prohibitively expensive COBRA options.
Customers who filled prescriptions using insurance at Kroger pharmacies between December 2018 and August 2026 may receive payouts from a proposed $17 million class-action settlement. The lawsuit alleges the retailer charged higher out-of-pocket costs by ignoring lower Savings Club prices when reporting to insurers, though Kroger denies the claims.
The article advises seniors relocating within the United States on maintaining Medicare coverage. It explains that Original Medicare remains portable nationwide, while Part D and Advantage plans require address updates or plan switches during a special enrollment window to avoid penalties.
The article argues that Medicare Part A's 100-day skilled nursing coverage is a ceiling, not a guarantee, ending when daily skilled care is no longer deemed necessary. It explains that patients may face bills if they plateau before day 100 and outlines the appeal process for non-coverage notices.
Aon projects US employer healthcare costs will rise by 9.5% in 2027, exceeding $19,000 per employee. This marks the fourth consecutive year of near-double digit increases, with finance, technology, and public sectors facing the highest spikes due to service utilization and GLP-1 drug use. The projected surge is expected to be passed on to workers through higher premiums.
Oregon regulators have approved significant health insurance premium increases, raising individual rates by nearly 22% and small business rates by 15.5% for 2027. Officials cite the expiration of federal subsidy enhancements and rising medical costs as primary drivers. To address affordability, state leaders are considering policy interventions such as enrollment caps and a new state reinsurance program.