Health Insurance

Michael Righl / Flickr

 

Faculty and staff members at the University of Pittsburgh now receive transgender benefits, including behavioral health support, medications and surgery.

The Pittsburgh Post-Gazette reports officials say the change, which was sent to employees last week, is meant to bring the university into compliance with federal rules on sex discrimination in employment.

Insurance giant Aetna will stop selling health insurance through most of the exchanges created by the Affordable Care Act in 2017 because the company said it is losing money in many of those markets.

On Monday, Aetna said it will sell individual insurance policies in only 242 counties in four states, down almost 70 percent from the 778 counties in 15 states where the company markets Obamacare plans this year.

The battle continues to rage between drug companies that are trying to make as much money as possible and insurers trying to drive down drug prices. And consumers are squarely in the middle.

That's because, increasingly, prescription insurers are threatening to kick drugs off their lists of approved medications if the manufacturers won't give them big discounts.

Megan Harris / 90.5 WESA

The needle is in and out in a second. I let my breath return to its normal pace, and I’m given a Tweety Bird bandage as a reward for my maturity.

Twice a day, Angela and Nate Turner of Greenwood, Ind., put tiny strips that look like tinted tape under their tongues.

"They taste disgusting," Angela says.

But the taste is worth it to her. The dissolvable strips are actually a drug called Suboxone, which helps control an opioid user's cravings for the drug. The married couple both got addicted to prescription painkillers following injuries several years ago, and they decided to go into recovery this year. With Suboxone, they don't have to worry about how they'll get drugs, or how sick they'll feel if they don't.

The Justice Department is suing to block two proposed mergers between major health insurance companies, saying the deals violate antitrust laws and would lead to higher health care costs for Americans.

U.S. Attorney General Loretta Lynch explained the decision at a press conference:

Vermont Insurers Must Now Cover Vasectomies

Jun 18, 2016

Vermont has become one of several states working to make sure vasectomies are among the birth control options couples can afford.

Gov. Peter Shumlin last month signed into law a bill that adds vasectomies to the list of procedures that most health insurance coverage in Vermont must pay for.

Charles Williams / Flickr

While much of the testimony at a state Senate hearing in Pittsburgh on Thursday focused on the need for the state to fund opioid addiction treatment regimens, one expert recommended the state take legal action against insurers who illegally deny coverage of long-term rehabilitation programs for those addicted to heroin or prescription painkillers.

Uninsured Pennsylvanians Feeling Impact Of Health Care Deadline

Dec 15, 2015
Jasleen Kaur / flickr

Tuesday is the deadline for consumers to choose a health insurance plan under the Affordable Care Act in order to receive coverage by January 1, 2016.

While the Pennsylvania Insurance Department ramps up efforts to make sure resources are available and accessible to families and individuals, Gov. Tom Wolf has commended the coverage expansion, which he says has dropped from 14 percent uninsured to 8 percent uninsured in two years. 

New Health Care Company Helps You Choose The Right Plan

Nov 24, 2015
Fotos GOVBA / flickr

Open enrollment regarding the selection of a health care plan offers a lot of options. How you do sort through what’s  available and choose the best option for you or your family? We’ll pose that question to Dan Harding, co-founder of Health Sage a Pittsburgh company helping to empower consumers when it comes to health insurance options.

Upupa4me / flickr

A problem that has cost thousands of Pennsylvanians hundreds, if not thousands, of dollar has the state investigating.

Insurance holders think they have found an in-network provider for a specific procedure, but a physician, specialist or contractor who is out-of-network is actually helping to provide the care. The result is a bill that the patient thought would be $50 dollars, turns into a bill for much more.

It’s called surprise balance billing.

An event on Wednesday night at Veterans Place of Washington Boulevard will have assistors on hand to help veterans sign up for health insurance options available under the Affordable Care Act.

The event is co-hosted by Get Covered America.

If veterans earn less than 138 percent of the Federal Poverty Level — which is $16,243 for a single person or $33,465 for a family of four — they may be eligible to enroll in Health Choices, Pennsylvania’s Medicaid program, as well as keep their VA benefits.

Gov. Wolf Seeks State Authority Over Health Insurance Marketplace

Jun 2, 2015
AP Photo/Keith Srakocic, File

Gov. Tom Wolf's administration said Tuesday it has formally applied to take over the operation of Pennsylvania's health insurance marketplace as the Democrat seeks a bulwark against the potential loss of health insurance subsidies for hundreds of thousands of state residents.

The health insurance marketplace open enrollment period starts Saturday. It ends Feb. 15.

Neil Deegan, Pennsylvania State Director of Enroll America said during the last open enrollment period, 28,000 Allegheny County residents signed up for health coverage. But there are still residents without it.

“The uninsured rate here in Allegheny County is at about 12 percent. So while great work was done last year, there’s much to be done,” Deegan said at an event held Friday in Garfield.  

Women’s health advocates in Pennsylvania are calling on the Corbett administration to extend a low-income women’s health insurance program set to expire at the end of the year.

The Women’s Health Caucus sent a letter Thursday to state Human Services Secretary Beverly Mackereth asking for a one-year extension of the SelectPlan for Women program, which provides coverage for gynecological exams, emergency contraception and breast and cervical cancer screenings for an estimated 90,000 women in the commonwealth.

More than 12,600 Pennsylvanians are at risk of losing their federal exchange health insurance this September if they do not resolve inconsistencies in their enrollment information, according to the Pennsylvania Health Access Network.

In May, more than 970,000 people were identified by the Department of Health and Human Services as missing information or having contradictory information about their citizenship or immigration status in their data.

Pittsburgh was awarded $200,000 to insure children in the city through Healthy Together.

The money was granted from the National League of Cities and was given to eight cities that showed a quality and feasible business plan to increase access to healthcare. Cities could receive up to $260,000 for their efforts.  

Liz Reid / 90.5 WESA

With just two weeks left to sign up for health insurance through state and federal online exchanges, Allegheny County Executive Rich Fitzgerald has declared March 17-23, 2014 to be Affordable Care Act Week in Allegheny County.

Fitzgerald said county officials are working with nearly three dozen partner organizations on “one last push to encourage residents to get all the information and be able to enroll in the marketplace.”

A new report from Georgetown University finds that nationwide, the rate for uninsured children continues to decline, even as most Americans perceive that the rate is on the rise.

“As of 2012 it was just over 7 percent nationwide without coverage,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “That is certainly still too many, but in fact that’s a historically low number.”

More than twenty years after the Children’s Health Insurance Program (CHIP) became law, a new report finds that about 1 in 20 Pennsylvania children is still uninsured.

According to the second annual State of Children’s Healthcare in Pennsylvania report by the Pennsylvania Partnerships for Children, or PPC, nearly 148,000 children in the state lack health insurance.

With less than two weeks until Pennsylvania's online health insurance marketplace opens to the public, advocates are trying to spread the word about its offerings.

For people who feel the slightest pecuniary pinch and don't have significant health coverage, the soon-to-launch state exchange offers a chance to shop at a discount.

Financial assistance will be available to some purchasing health care plans through the marketplace opening Oct. 1, allowing those individuals to greatly reduce the percentage of their income spent on coverage.

A new insurance plan from Highmark allows employers to nudge their employees toward particular hospitals when they need risky surgeries.

Employers using the "Blue Distinction" program can give incentives, such as waived deductibles and co-pays, to employees who choose hospitals that have proven track records for certain surgeries.

The company can also choose to increase co-pays or even “carve out” coverage for any other hospital when the specialty surgery is needed, according to Highmark Vice President of Regional Sales Eric Hays.