Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.
In many cases, the money flowed to addiction recovery programs that help rebuild lives by driving people to medical appointments and court hearings, crafting résumés and training them for new jobs, finding them housing, and helping them build social connections unrelated to drugs.
Federal law requires states to offer health insurance to many people with low incomes or disabilities. But some states, including California, are far more generous than what’s required. Budget pressures may force lawmakers to cut benefits that have led to a historic low in the uninsured rate.
These fixers, officially known as caseworkers, unraveled complex and arcane health insurance rules to solve people’s coverage issues. They worked in a little-known federal department with which most consumers never interact — until they need help.
Although knee replacements are usually covered by health insurance, amputees face roadblocks to coverage and often must prove their prosthetics are medically necessary.
A stressed primary care system has led many doctors to start practices that charge membership fees in exchange for shorter waits and longer appointments. Observers say the doctor shortage needs a more systemic fix.
Republicans are pushing to implement requirements that Medicaid recipients work in order to obtain or retain coverage. Some states try to help enrollees find jobs. But states lack the data to show whether they’re effective.
Republicans are pushing to implement requirements that Medicaid recipients work in order to obtain or retain coverage. Some states try to help enrollees find jobs. But states lack the data to show whether they’re effective.