It can pay to compare health plans Nov 1, 2009
During open enrollment time, it can really pay off to learn the nuances of HMOs, PPOs, and other common health insurance plans ... HMOs appeal to people who prefer premiums that may be a little lower and who like a plan that makes many choices for them when it comes to specialists or hospitals ... Most HMOs do not set a deductible amount that consumers must pay before coverage kicks in, but there may be deductibles for some services in an HMO plan, such as hospital stays, day surgery,... (Boston Globe)
Some terms used by health plans to describe their costs and services Nov 1, 2009
Health maintenance organization (HMO): A system that provides comprehensive medical services usually in return for a fixed, prepaid fee. Health savings account (HSA): Like a flexible spending account, it allows you to save pretax dollars for health care expenses. (Boston Globe)
Medicare Advantage may lose luster Nov 1, 2009
HMO plans offer more in terms of health management, but only within a preselected "network" of physicians, while fee-for-service plans provide comprehensive acute care. The federal government funded the private plans at 95 percent, on average, of what it was paying for Medicare. (Pittsburgh Post-Gazette, PA)
Column: Will you need me when Im 65? Oct 31, 2009
For example, while municipalities avoid adding employees to their health insurance plan like the plague, Medicare Advantage HMOs such as Harvard Pilgrim, Tufts and Blue Cross/Blue Shield compete to win the business of these same people when they turn 65 ... The HMO continues to receive the pmpm every month, even if the plan member never gets sick ... For every 1,000 plan members, then, the Medicare Advantage HMO receives about $900,000 from CMS plus any modifiers for existing conditions, plus... (Arlington Advocate, MA)
Chronic Fatigue Patients No Longer Fakes? Oct 31, 2009
"Once my HMO even asked me to take a truth serum to see if I was lying," said Toussaint, now 48 and founder of , an organization that advocates for women in pain. "I was so ashamed.". (ABC News)
Study: State's Medicaid patients dying from painkillers Oct 30, 2009
t6 wrote on Oct 29, 2009 6:17 PM:" Don'tMakeMeComeInThereIs exactly right. Getting approved for surgery to repair the actual problem is next to impossible in some medical programs. I for one am a Kaiser victim. I've been told for years now that there is nothing wrong or that they can't figure out whats causing the problem however, they have no problem prescribing anti-inflamatory and pain killing drugs. Let me get this straight Doc? I don't have a problem but you think I should take... (Longview Daily News, WA)
Lockton: 12 percent rise in coverage cost Oct 30, 2009
The percentage of employers offering an HMO plan dropped from 44 percent in 2008 to 32 percent in 2009. Most employers (91 percent) offer PPO plans with higher deductibles and higher out-of-pocket expenses. (Denver Business Journal, CO)
HMO expects near double-digit rate hike Oct 29, 2009
for free extra services. Subscribe to Business First. (Buffalo Business First, NY)
Suit challenges state's autism practices Oct 28, 2009
The dispute hinges, in part, on definitions of health care providers in the state HMO and mental health parity laws. The lawsuit also alleges consumers were able to appeal treatment denials to an independent medical review system until March with some success but a department memo ordered subsequent complaints to be handled as coverage issues through the agency s internal grievance system. (Sacramento Business Journal, CA)
Capital Hill Oct 28, 2009
IBDs HMO group fell 2. 4% on Monday, but i by early Tuesday afternoon, despite a generally weak market. (Investors Business Daily)
Harris County reveals pilot insurance program for uninsured employees of small businesses Oct 21, 2009
Two benefit plans are administered by either health benefit plan giant , a business of (NYSE: UNH), or Community Health Choice, a nonprofit HMO affiliated with the. Both plans cover inpatient and outpatient services and, depending on which plan is chosen, preventive dental, vision exams and other services may be covered. (Houston Business Journal, TX)
Too many health care monopolies Oct 20, 2009
Here in New York, radical insurance industry consolidations have led to a monopoly-like situation in many parts of the state, where one or two large corporations control the entire HMO market. For example, in Ithaca, just one company -- Excellus -- controls 100 percent of the HMO market ... A single corporation controls 87 percent of Buffalo's HMO market, 80 percent of the Binghamton market, 79 percent of the Albany market and 62 percent of the Rochester market. (Albany Times Union)
Hidden Costs of Medicare Advantage Perks Oct 16, 2009
Nancy Smyth, 68, wants to keep the free gym membership that comes with the Medicare Advantage policy she bought from Health Net, a private HMO. And John Kizer, 72, hopes his plan will continue to offer free prescription eyeglasses and free hearing aids ... The program blossomed in the late 1990s when Congress bolstered it with millions in additional federal subsidies to for-profit HMOs ... "The promise of Medicare Advantage and Medicare HMOs was to save the government money, to save consumers... (CBS News)
Guest column: Does anyone know whats what? Oct 16, 2009
Another contradiction lies in the Town of Arlington s own struggle with the cost of health insurance: How is it that while the town tries to avoid having employees on its health insurance plan, when those same employees turn 65, companies like BlueCross BlueShield, Tufts and Harvard Pilgrim compete to get them to join their Medicare HMO ... Fischer s next piece will discuss Medicare s capitated payment system, and explore why town employees suddenly become desirable customers for Medicare HMOs. (Arlington Advocate, MA)
Insurance mandate to cost millions Oct 16, 2009
An independent review of MPS finances released in April shows MPS employees and retirees have the choice of two health care packages: a preferred provider organization (PPO) plan that costs $18,500 per employee per year and a health maintenance organization (HMO) plan that costs $11,400 per employee. The district s PPO costs are 78 percent higher than the average PPO, while the district s HMO costs are 11 percent higher than average, according to the review by , a New York City-based management... (Milwaukee Business Journal, WI)
Preparing for two flu seasons Oct 15, 2009
Those age 65 years and older must provide a health insurance card from Medicare or a participating Medicare HMO Plan. One hundred volunteers with the Burlington Volunteer Reserve Corps (MRC), which includes nurses and medical professionals such as BOH member Dr. Wayne Saltsman, will staff the flu clinic. (Burlington Union, MA)
N.H. workers ax furloughs, layoffs on way Oct 13, 2009
"The union called on Lynch to reopen negotiations on a new contract.Lynch said he was disappointed by the vote."Over the last few weeks, agencies have been developing plans for layoffs in the event the union rejected the contract," the governor said in a statement. "I will be meeting with department heads (Tuesday) morning to begin implementing those plans, which include notifying impacted employees this week and completing most layoffs by the end of October. "As votes were being counted earlier... (Seacoast New Hampshire)
Readers Write 10/12 Oct 13, 2009
I recently received information regarding my 2010 HMO coverage, and sure enough, my monthly premium has again increased by about 10 percent. Frankly, I feel that if there were more choice for consumers, insurance companies would be more responsive to consumer needs. (Atlanta Journal-Constitution -- Opinion)
Click to read:Poll: Congress Gets Low Health Care Grade Oct 10, 2009
What makes it worse is the people are forced to line the pockets of the phony baloney HMO markets. Going to be some weeding coming the 2010 elections. (CBS News)
Free seasonal flu clinic scheduled Oct. 28 Oct 9, 2009
All insurance cards, including both Medicare and HMO cards, must be taken to the clinic, says Roseanne Morrissey, RN, the town s public health nurse. Pending the availability of additional season flu vaccine, a second clinic would be held from 9 to 11:30 a.m. Tuesday, Nov. 3, also at Congregation Shirat Hayam. (Swampscott Reporter, MA)
Insured African-Americans more likely to use emergency room than other insured groups Oct 8, 2009
Yet in a policy brief released today by the UCLA Center for Health Policy Research, researchers found that in California, privately insured African Americans enrolled in HMOs are far more likely to use the ER and to delay getting needed prescription drugs than HMO-insured members of other racial and ethnic groups ... In fact, of all HMO enrollees, African Americans were the most likely to report seeing a doctor in the past year, according to the authors of the brief, "African-Americans in... (EurekAlert!)
Health costs frozen for state workers Oct 8, 2009
The EUTF has yet to announce what will happen with premiums for Kaiser Permanente's HMO plan. "They're aware that the consultant is projecting a loss of about $2.7 million a month beginning in January," said Jim Williams, EUTF administrator. (Honolulu Advertiser)
Health care: Which is the real party of no? Oct 7, 2009
What is needed in this nation is a single-payer HMO with insurance to cover catastrophic illnesses WITHOUT pre-existing conditions. If we are the only indusrialized nation without universal health care, what does that say about the mentality and ethics of the USA. (Atlanta Journal-Constitution -- Opinion)
Georgetown senior notes Oct 6, 2009
Please bring Medicare and/or Senior HMO cards to the clinic ... The COA will photocopy Medicare/HMO cards in advance of the clinic. (Georgetown Record, MA)
Coventry to buy Preferred Health Systems Oct 6, 2009
It operates Wichita s largest HMO with 62,928 Sedgwick County enrollees, according to the Business Journal s HMO and PPO list published May 29 ... Coventry ranked No. 2 on the HMO list with 3,447 Sedgwick County enrollees ... Statewide, PHS has more than 80,000 HMO enrollees and more than 40,000 PPO enrollees. (Wichita Business Journal, KS)
Concern about mental health confidentiality Oct 3, 2009
She finally decided to go for counseling at UHS, and [after a couple of sessions] wanted to see somebody through her dad s HMO, but her parents are very much against counseling and would be furious if they found out. this holds a lot of people back from treatment. (The Digital Cardinal, WI)
UMASS AND FALLON: Mammogram reminder system studied Oct 3, 2009
Fallon Community Health Plan, a health insurer based in central Massachusetts with about 225,000 total members that offers an HMO option and is a separate organization from the Fallon Clinic physicians group, covers the entire cost of mammograms for its members, according to Beth Foley, director of Quality Programs ... "The hope is that other HMOs will institute similar reminder systems,'' said Costanza, who has also worked with Harvard Pilgrim on a similar outreach program. "Veterinarians send... (Winchester Star, MA, MA)
Health Care Bill Nears Key Milestone Oct 3, 2009
The Reps would continue to waste monies with their HMO c*r*a*p and the Dems will please insurance companies by setting up FORCED coverage. Which is better. (CBS News)
UPMC Health Plan asks for OK to raise rates 48 percent Oct 2, 2009
The base rate, which is an aggregate average, applies to all group HMO rates ... HMOs are the most restrictive form of managed care, requiring members to receive care from approved doctors ... Like most insurers, HMO products are a shrinking part of UPMC Health Plan s business, which has a total of 330,000 members, Benevento said. (Pittsburgh Business Times, PA)
Democrat compares health care to the Holocaust... Oct 1, 2009
Grayson calls health care crisis 'holocaust' - Ben Smith - POLITICO.com. segregation tomorrow. (The Drudge Report)
Your Career: Paying more for health coverage Sep 30, 2009
The Kaiser survey found that 21 percent of firms offering benefits say they are very likely to raise employees premium contributions next year, and 16 percent are very likely" to raise deductibles. Employees will be paying a greater share of cost, said Randy Abbott, a senior health benefits consultant for Watson Wyatt, a global consulting firm.That means co-payments that were $20 for a doctors visit could climb to $25, he said, and an annual deductible of $250 could easily... (MSNBC -- Business)
Consumer-driven in reverse? Sep 30, 2009
Premiums for HSAs can cost up to one-third less than regular insurance, like a preferred provider organization or HMO.. While federal lawmakers say health reform will not quash high-deductible plans, changes to these plans could at least curtail a growing source of business for health insurers, already under pressure from federal lawmakers to change their practices. (San Jose Business Journal, CA)
Public Plan Pits Democrat Vs. Democrat Sep 30, 2009
The HMOs are a phony baloney market created by republicans ... Freedom is not having to line a hmo ceo pocket ... Ughh - NO. HMO's were Ted Kennedys brain child. (CBS News)
UW students still face health-care obstacles Sep 24, 2009
If you break your leg and go to the emergency room that s covered, but when you need to see a specialist a week later, the HMO will say, you can come home. For students who need any or better insurance, Orman said 3,000 currently purchase UHS Student Health Insurance Plan, or SHIP, which offers health-care coverage to students for $1,476 per year (or $615 for the fall and $861 for the spring and summer semester). (The Digital Cardinal, WI)
National Health Care: what now? Sep 24, 2009
sue evans wrote on Sep 19, 2009 2:15 PM:" Last time there was a debate this big over health care was when the Gov't created the HMO. The Nixon era created the HMO act of 1973. Both parties were in on that one. NOT ONE politician will cite that as a past success. ". headward wrote on Sep 18, 2009 4:22 PM:" "He also addressed rumors like "socialized medicine", rationed health care and the ending of the Medicare program. (Williston Daily Herald, ND)
Health care reform that pleases liberals and conservatives Sep 23, 2009
The role of the private management companies would include setting up networks of providers (basically the PPO, HMO, and POS plans that currently enroll over 80 percent of Americans with private insurance). Negotiating discounts with healthcare providers, and competing to enroll individuals in their coverage plans. (Christian Science Monitor)
Predicament of the Haves Sep 22, 2009
Now, employees choose between a high plan that utilizes a traditional HMO; and a health savings account (HSA) with a high deductible, funded entirely by the company. If unused, it rolls over for the next year s.. (San Jose Business Journal, CA)
We need health care reform — even Joe Wilson should get that Sep 21, 2009
uncle stinky wrote on Sep 16, 2009 7:35 PM:" Ever notice how HMO and homo are almost the same word. Kind of makes you think. " ... Lodian wrote on Sep 16, 2009 1:18 PM:" Only one with a very narrow mind would think that American's that are onboard with healthcare reform must all work for an HMO. Is this a way to stop the debate? Just accuse others of working for what you oppose? Weak. " ... Lodian wrote on Sep 16, 2009 1:06 PM:" wtf wrote on Sep 16, 2009 12:21 PM:" I'll take your lack of answer... (Lodi News Sentinel, CA)
Complete Transcript: Obama on 'Face the Nation' Sep 21, 2009
I mean, let's take the Medicare HMO programs that are being run by insurance companies. It's estimated by everybody that they're overcharging by about 14 percent. (CBS News)
Read the story Sep 21, 2009
We need to go to single payer and get rid of the worthless republican created HMOs ... We need to go to single payer and get rid of the worthless republican created HMOs ... The republican creations of HMOs & PPOs over twenty years ago have failed in epic proportions. (CBS News -- Evening News)
How to curb runaway medical costs Sep 20, 2009
8 million on administrative expenses and collected more than $71 million in pre-tax profits on HMO (health-maintenance organization) plans for the first three months of this year, Arizona Managed Care Newsletter figures show. Rising premiums. (AZCentral -- News)
Rational talk about medical rationing Sep 20, 2009
Some of us have HMO plans that come with a physician referral process, and long waits for appointments. Rationing. (Albany Times Union)
Stacy Kniffen Paquet to Speak at 2009 Risk Management and Finance Summit for Nonprofits Sep 19, 2009
Additionally, OneBeacon Professional Insurance provides employment practices liability insurance, management liability and tailored products for complex organizations including health care provider excess insurance and HMO reinsurance. About OneBeacon: OneBeacon Insurance Group's underwriting companies offer a range of specialty and segmented commercial and personal insurance products sold through select independent agents, regional and national brokers, and wholesalers. (PR Newswire)
Treating Health Like Car Can Save Money Sep 18, 2009
"If you have, say, Crohn's disease, you want to designate your primary care physician as your specialist in your HMO, if you can.". "Although employer coverage usually is still your best bet, you may do better on your own," wrote columnist Kimberly Lankford. (Click2Houston, TX)
Blue Care Network buying Lansing-based HMO Sep 17, 2009
Sparrow Health System owns the Lansing-based HMO, which has about 80,000 members. Southfield-based Blue Care Network has about 680,000 members. (Ionia Sentinel-Standard, MI)
Arbitrary Government And Health Care Sep 16, 2009
On top of that we are carrying multi million dollars salaries for healthcare HMO CEOs , companies that do nothing but push billing. A phony baloney market created with the stroke of a republican pen. (CBS News)
Some Firms Are Already Bending Stubborn Health Care Cost Curve Sep 16, 2009
And WellPoint compared its group insurance accounts in 2008 and found HMO and PPO rates went up 7% to 10% from the previous years, while CDHPs went down. If you're an employer struggling to get control of health insurance premiums, those numbers will get your attention. (Investors Business Daily)
Bulletin Board Sep 15, 2009
Residents 65 and older are requested to bring their Medicare and Medicare HMO insurance cards to verify information on the registration form. GIRL SCOUT MEMBERSHIP DRIVE. Thursday, Sept. 24, from 6 to 8 p.m. at Thayer Public Library, Logan Auditorium, 789 Washington St. For information or to sign-up visit www. (Braintree Forum, MA)
Thousands in D.C. Protest Gov't Spending Sep 13, 2009
Those government programs given to HMO's even worse ... Meanwhile, patients suffered HMO rationed care, and were increasingly denied or excluded. (CBS News)
What does your family want/need in health insurance? Sep 11, 2009
If we all were able to choose our own plans then it would be exactly what we wanted-as large of co-payments/co-insurance as we want, POS, PPO or HMO, etc. But it would be our choice. (Atlanta Journal-Constitution -- Living)
Panel discusses how to pay for health care reform Sep 11, 2009
Because we the business community and the taxpayers pay through property taxes for Medicaid, through taxes on the covered lives assessment, the HMO premium tax, the HCRA [state Health Care Reform Act] surcharge. In New York it is] $4. (Albany Business Review, NY)
Click to read:Obama Tells Congress to Stop Bickering Sep 10, 2009
Ohhh, we heard from the insurance companies twenty-five years ago when they told us their HMO and PPO programs would rectify everything. LOL LOL Yeah, right. (CBS News)
Via Christi exploring sale of Preferred Health Systems Sep 10, 2009
PHS is Wichita s largest HMO with 58,843 Sedgwick County enrollees, according to the 2008 Wichita Business Journal Book of Lists. It is also the sixth largest PPO with 21,155 enrollees in Sedgwick County. (Wichita Business Journal, KS)
Don't Do It Like the Japanese Sep 9, 2009
Ban HMOs, Repeal the HMO Act of 1973 and Medicare part D. ... Replace HMOs and Insurance with non-profits under Hill-Burton standards. (The American Conservative)
Wall Street ends up on M&A hopes, strong commodities Sep 9, 2009
Wall Street ends up on Ms, strong commodities - Yahoo. Search Type Choose a search type from the items below. (Yahoo News -- Press Releases)
Abrasive town hallers falling into Obama's trap Sep 9, 2009
All he had to do was keep bellyaching about the greedy HMOs and rising health care costs and simply rode the improving economy to even more congressional seats in 2010 ... Matt Hickman wrote on Sep 8, 2009 2:40 PM:" To Ben,I agree. That's why I think Obama pushed so hard on this so early, so there would be plenty of time before Nov. 10 to backpedal and pass some mealy-mouthed legislation that binds the hands of the insurance companies a little bit and allows them to continue to broadcast HMO... (Sierra Vista Herald, AZ)
Health Care: The HSA Solution Sep 8, 2009
No insurance company, HMO, or government bureaucrat will have the power to tell you whether you can receive health care. This plan gives patients complete control and complete coverage that is affordable and accessible. (Human Events Online)
'24 hours in the ER' shows challenges of health system Sep 8, 2009
They belong to an HMO in California, but Leilani is in an interim period until her "guest membership" in a Virginia HMO begins in 30 days ... "We chose the HMO because the co-pays were better, and my payment was less through my employer," says Susan Herzog, 49 ... She and her daughter appreciate the savings from the HMO but aren't always happy with the quality of care. (USA Today -- News)
AG to investigate claim 1 in 5 HMO claims denied Sep 4, 2009
Place an obit: (559) 441-6228. Web Search powered by YAHOO. (Fresno Bee -- State)
Passionate boos, cheers mark Eshoo meeting on health care Sep 4, 2009
" No one is paying most, if not all of us, a dime. For example, I am simply using my own brain, my own eyes and ears to read legislation and watch speeches from Pres. Obama, Barney Frank and Pelosi. Have you read the legislation? Also, I did comment that many of these posts show a VERY simple minded arrogance that the elite Palo Alto liberal opinion must be one of brilliance and the rest of us are either paid off, or stupid or angry or easily swayed by FOX, etc, etc., etc. Wake up and see that... (Palo Alto Online, CA)
Calif. AG to probe rejection of medical claims Sep 4, 2009
AG to investigate claim 1 in 5 HMO claims denied. California Attorney General Jerry Brown is looking into claims that the state's top health insurers reject about 20 percent of medical claims. (Fresno Bee -- Business)
A $2.3 billion fine? Thats hitting a mule with a 24 Sep 3, 2009
Before Medicare D was enacted, Medicare was solvent well into the late 2020 s early 2030 s. The legislation was crafted to strip as much money as possible from the fund and give it to large corporations and hmo s ... And with increasing frequency you have to sometimes fight with private insurance, HMO, PPO, or Medicare and Medicaid if you took it (most don t because it doesn t reimburse your cost of labs) to get to use the drug that will be the most benefit to your patient with the least side... (Atlanta Journal-Constitution -- Opinion)
Humana makes dental deal with Sun Life Sep 2, 2009
The marketing agreement lets employers purchase Humana s dental HMO as the low-cost option on a Dual Select Dental Plan, with a Sun Life plan as the high-cost option ... The dental HMO dental plans are offered by HumanaDental Insurance Co. and underwritten by CompBenefits Dental Inc., DentiCare Inc. and CompBenefits Co., all of which are Humana subsidiaries ... With a dental HMO, members can see a primary care dentist within the network as often as necessary. (Louisville Business First, KY)
Senior Subjects: A fitting tribute for Kennedy Sep 2, 2009
Even HMO s rapidly deteriorated into a system where large panels of doctors are approved providers if they accept the HMO s fee schedule, and physicians are under pressure to cut costs and see ever more patients in ever shorter appointments if they wish to maintain their incomes. To me it seems logical that we should learn from the experience of other nations who have shown that they can take care of the medical needs of every citizen. (Lincoln Journal, MA)
Independence Blue Cross Takes Steps to Prepare for H1N1 and Seasonal Flu Sep 2, 2009
Independence Blue Cross's HMO and PPO health care plans have consistently received the highest ratings from the National Committee for Quality Assurance. Independence Blue Cross supports comprehensive health care reform that would extend coverage to all Americans, reduce costs, and improve quality. (PR Newswire)
