health-insurance
29 stories related to this topic, newest first.
Nbc NewsMaryland family owes $1.3 million after specialized OCD program cut short by insurance limits
A 24-year-old Maryland woman received one year of residential psychiatric care at Sheppard Pratt before her family could no longer pay the daily rate. CareFirst BlueCross BlueShield covered only a portion of the cost, and the family now owes the hospital $1.3 million.
forbes.comHighmark Health Sues HaloMD Over No Surprises Act Arbitration Awards
Highmark Health filed suit June 1 seeking to overturn more than $3.9 million in arbitration awards. The insurer alleges HaloMD and a neuromonitoring provider submitted ineligible claims under the No Surprises Act.
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investopedia.comHealth Insurance Premiums Rise as Some Americans Consider Dropping Coverage
Premiums for employer-sponsored plans increased 6% to 7% while enhanced subsidies for some marketplace plans expired at the end of 2025. An emergency medicine physician described narrowing networks, prior authorization requirements, and longer wait times as factors prompting pati…
ForbesUnitedHealthcare to Cut Two-Thirds of Prior Approvals for Patients Under 18
UnitedHealthcare said it will remove two-thirds of authorization requirements for members under age 18 by the end of 2026. The change applies to commercial and Medicaid plans and covers many diagnostic services, routine procedures, and specialty care.
fortune.comU.S. Uninsured Rate Holds at 8.3 Percent in 2025
The share of Americans without health coverage remained near 8.3 percent last year. About 28 million people lacked insurance, according to new federal survey data.
FortuneCDC Reports U.S. Uninsured Rate Held at 8 Percent in 2025
New CDC survey data show the national uninsured rate remained near 8 percent for all of 2025. The figures mark the first full-year measurement during President Donald Trump's second term.
FortuneU.S. Uninsured Rate Held at 8 Percent in 2025
CDC survey data show the national uninsured rate remained near 8 percent throughout 2025. Congressional Budget Office and KFF projections indicate enrollment changes beginning in 2026.
BenzingaMark Cuban Questions Insurer Liability Standards for Coverage Denials
Mark Cuban asked why health insurers can deny care as medically unnecessary without carrying malpractice insurance. The post referenced cases where patients reported worsened conditions after denials.
flipboard.comJudge Orders Former Elevance Executive to Testify in Medicare Advantage Case
A federal judge ruled that Peter Haytaian must sit for a deposition in the Department of Justice case alleging Elevance Health overbilled Medicare Advantage plans. The decision allows the government to question the former executive under oath about the insurer's billing practices…
forbes.comHigh-Deductible Health Plans Now Cover Most U.S. Workers
A Netflix series scene highlights the financial impact of a $5,000 deductible. Data show deductibles have risen sharply since 2006. Surveys indicate many adults struggle to understand these costs.
business-fundas.comCongress Ends Enhanced ACA Tax Credits, Boosting Alternative Health Plans
Congress did not extend enhanced marketplace tax credits for 2026. Enrollment in lower-premium alternatives that do not meet ACA standards has increased.
zerohedge.comACA Enrollment Projected to Fall 17 to 26 Percent in 2026
The Wakely Consulting Group estimates that more than one million people have dropped Affordable Care Act coverage after Congress declined to extend subsidies. Premium increases ranging from 25 to 115 percent prompted the shift, with further declines expected through year-end.
forbes.comObamacare Deductibles Rise More Than $1,000 After Enhanced Tax Credits End
Average deductibles for individual health coverage under the Affordable Care Act increased by more than $1,000 this year. The change followed the expiration of enhanced premium tax credits at the start of 2026.
nypost.comHeart Transplant Recipient Describes Insurance Coverage That Does Not Provide Medication Access
A heart transplant patient reports that insurance approved everolimus but required repeated prior authorizations and peer reviews before denying the prescription. After public appeals, the insurer approved the drug at a cost of roughly $500 per month. The patient now receives the…
ncbi.nlm.nih.govStudy Evaluates Machine Learning Models for Health Insurance Risk Classification
Researchers tested three ensemble algorithms on a dataset of 59,381 insurance applicants to measure accuracy, fairness, and interpretability in underwriting decisions. The analysis compared performance across binary, three-class, and eight-class risk settings and examined dispari…
thenation.comMedicare Advantage brokers receive $10 billion in annual commissions
Medicare Advantage brokers collect about $10 billion yearly in commissions. The payments have drawn attention to the number of beneficiaries actually helped by the brokers.
medpagetoday.comFederal Agencies Hold 20 Stakeholder Meetings on No Surprises Act Arbitration Rule Changes
Federal agencies have held 20 meetings with industry groups this year on updates to the No Surprises Act's Independent Dispute Resolution process. Health care providers and their trade groups accounted for 13 meetings while insurers had four. The final rule, first proposed in Nov…
ForbesHealth Insurers Report Lower Medical Loss Ratios in First Quarter
Major health insurance companies including UnitedHealthcare, CVS Health’s Aetna, Centene and Elevance Health reported lower medical loss ratios in the first quarter of 2026 as patient claim costs declined. Enrollment in Affordable Care Act marketplace plans fell sharply at United…
ksl.comCigna to Exit ACA Marketplace in 2027 After Enhanced Subsidies Expire
Cigna announced it will leave the Affordable Care Act exchanges in 2027 following the expiration of enhanced federal subsidies. CVS's Aetna has also stopped offering plans on the marketplace while enrollment has declined. Nearly 23 million Americans obtain coverage through the AC…
CNBCCompany Beats First-Quarter Estimates and Raises Outlook
The company reported adjusted earnings per share of $2.57 and revenue of $100.43 billion in the first quarter, exceeding Wall Street forecasts. All three business segments, including its insurance unit, retail pharmacy and health services division, surpassed expectations. The com…
investopedia.comCigna Group to Exit Affordable Care Act Marketplaces After 2026
Cigna Group announced it will stop offering health plans in the Affordable Care Act marketplaces at the end of 2026. The decision follows a similar withdrawal by CVS Health's Aetna unit last year. Executives cited a focus on other business lines amid shrinking enrollment in the A…
FortuneJohn Hancock CEO Unveils Longevity Preparedness Index at Annual Symposium
John Hancock CEO Brooks Tingle introduced a new Longevity Preparedness Index at the company's third annual symposium, highlighting strategies for extended lifespans. The index, developed with MIT AgeLab, assesses readiness across eight domains amid rising U.S. median age and agin…
medpagetoday.comArchelle Georgiou Previously Reduced Prior Authorizations at Major Health Insurer
Archelle Georgiou, who has experience addressing prior authorization practices, helped reduce them years ago at a large health insurance company. The company is now the largest in the United States. This background informs her understanding of public frustrations with the process…
BenzingaMark Cuban Proposes Monthly Deposit Healthcare Model, Calls Insurers 'Non-Insurers'
Billionaire Mark Cuban criticized health insurers on X, describing them as holding companies exploiting oversight gaps. He proposed a healthcare model using monthly deposits similar to ACA silver plan premiums, with funds allocated to stop-loss coverage, primary care and savings…
medpagetoday.com50 Health Insurers Commit to Standardizing Prior Authorization for Key Services
Major health insurance companies, including UnitedHealthcare, Aetna and Cigna, committed to standardizing electronic prior authorization requests for services like orthopedic surgeries and imaging. The move spans commercial, Medicare Advantage and Medicaid managed care plans.
Substrate placeholder — needs reviewSheer Health Company Assists Patients with Insurance Claim Denials
A company named Sheer Health helps patients navigate denials of health insurance claims. Seventy-three percent of Americans view delays and denials in medical treatment by insurers as a major problem. The service reviews policies and appeals decisions on behalf of clients for a f…
NewsweekOptions for Obtaining Uncovered Prescription Medications Under Health Insurance
Health insurance plans may not cover certain prescription medications, leaving individuals responsible for full costs. Options include discussing alternatives with health care professionals, requesting exceptions from insurers, and applying for assistance programs. These steps ca…
Substrate placeholder — needs reviewChanges in Health Coverage Expose Stable Patients to Renewed Risks
Patients with chronic conditions who have maintained stability for years face renewed health risks due to alterations in their insurance coverage. According to STAT News, these changes occur independently of disease progression. The situation highlights vulnerabilities in the hea…
Substrate placeholder — needs reviewUS Health Insurers Simplify Prior Authorization for Certain Medical Treatments
Major US health insurers have implemented changes to streamline the prior authorization process for specific treatments, according to industry groups. These adjustments aim to reduce administrative burdens on physicians. The changes follow federal recommendations issued earlier t…