National Association of Medicaid Directors’ Post

A new lawsuit against Anthem Blue Cross Blue Shield of New York has been filed to address "ghost networks." It's about time, too. What is a ghost network? It is the phenomenon to describe when you call clinician after clinician only to find: 1. They aren't taking clients 2. The phone number doesn't work 3. The practice doesn't exist anymore 4. The clinician doesn't take that insurance anymore 5. Or any other barrier to access to care This issue has been around for a while and has been a burden for clients and therapists, but it has reached a volume that has garnered attention. The issue is that #insurance companies can boast a huge network of providers to satisfy their network access requirements, but the available network is much smaller. More than 80% of providers were “ghosts” – unreachable, out-of-network, or unavailable for appointments for some Medicare Advantage plans. Reaching a tenable solution is essential, but sadly, we have arrived at a place where laws and lawsuits must be filed to achieve value in healthcare for people who need care. I wish you luck this open enrollment season as you find the best insurance company to work with in your area. If you are #credentialing with an insurance company, double-check that they are a good partner. More to come on how to determine which insurance company to partner with.

Are you tired of restrictive insurance plans dictating your practice? Vision Care Direct offers a doctor-driven alternative that puts YOU in control. Enjoy higher reimbursements, flexible plan options, and local ownership that reinvests in your community. Take charge of your future with VCD. #Optometry #IndependentPractice #VisionCare #SupportLocal

👶 Becoming a parent is a life-changing event. Our checklist outlines key steps to secure your family’s financial future. ----- Assuris – the not for profit organization that protects Canadian policyholders if their life and health insurance company fails. To learn more, follow us and visit: https://assuris.ca/. #ProtectedByAssuris #ProtectedFuture #LifeInsurance #HealthInsurance #Family #Parenthood

🚨 Attention Physicians! 🚨 If you're wrapping up your training this week, NOW is the right time to secure your coverage. Don’t miss out on significant discounts related to your training institution. In the video below, I explain why acting now is crucial and how you can benefit from these limited-time discounts. At Pattern, we specialize in helping physicians like you compare and secure the best disability insurance policies. Our mission is to make this process simple and stress-free so you can focus on your new journey in medicine. 🔍 Watch the video to learn more and reach out if you have any questions. We're here to help you make the best decision for your future. #Physicians #DisabilityInsurance #LifeInsurance #PatternLife #MedicalTraining #PhysicianWellness #InsuranceDiscounts #SecureYourFuture #ResidentPhysicians #PhysicianFinance

In February 2024, following an unfortunate accident on the football ground, I underwent surgery for a MEDIAL MENISCUS TEAR, confident in the belief that my Starhealth Insurance Assure Insurance Policy would cover the expenses. Despite their initial assurance for cash reimbursement after denying cashless hospitalization, I was left bewildered when informed that my claim was rejected on the grounds of a "pre-existing condition" – a fact that is both baseless and incorrect. The reason provided contradicts every experience I had leading up to the surgery and my understanding of the policy's terms. This situation not only sheds light on the distressing process policyholders must endure during their most vulnerable times but also raises significant concerns about the integrity and transparency of Starhealth Insurance's claim evaluation process. I am sharing my story here on LinkedIn, a platform of professionals and regulatory authorities, to not only seek justice for my case but to also raise awareness about the practices that can undermine the trust between insurance providers and their policyholders. This incident highlights a critical need for a transparent, fair, and efficient approach to handling claims, ensuring that no other policyholder has to face such unwarranted hurdles in times of need. I urge Starhealth Insurance to reevaluate the decision, keeping in mind the genuine circumstances leading to the claim. Additionally, I call upon the relevant regulatory bodies and consumer protection agencies to take notice of such practices that can detrimentally affect the rights and financial health of consumers. This is more than just a claim; it's about the principle of trust and fairness in the insurance sector. Let's stand together for transparency and justice. #InsuranceJustice #FairTreatment #HealthInsurance #ConsumerRights Anand Roy

Did you know that long-term care in a nursing home can cost more than $10,000 per month? Planning for this expense is crucial to protect your assets. Andrew Schierberg of Stages Law discusses three ways to prepare for long-term care costs, including private pay, long-term care insurance, and Medicaid planning. He explains why planning for Medicaid at least five years before care is needed can yield the best outcomes. Watch the video to learn more and take steps to secure your future today.

Direct primary care is growing and will be the wave of the future. It allows for more personalized, comprehensive care to address complex issues and restores the focus of primary care by taking third-party insurance out of the equation 🌊

Navigating Medicare can be overwhelming for seniors, especially when faced with multiple plan options, complex enrollment processes, and frequent updates that impact coverage. In this episode, Mary Crean and guest host Cathy Fan, Actuary, Head of Life and Health Product Development at Nassau speak with licensed insurance agent and owner of Brickhouse Agency, LLC, Nikki Feret and licensed insurance agent and owner of Professional Business Insurers, Jason Gutcheon to break down the essentials. They discuss Medicare Advantage, Medicare Supplement Insurance, and the key differences between them, guiding listeners through the pros and cons of each plan type. The episode also covers important timelines for enrollment, critical changes coming in 2025, and why an annual review of Medicare plans is essential. With practical tips and insights, this conversation empowers beneficiaries to make informed, confident decisions about their health care. Listen to learn more: https://nfg.link/3YBVyLb

Added Protection for You and Your Family! Even if you’re well prepared, accidents happen. And they happen to all kinds of people every day. What’s even more unexpected are the out-of-pocket expenses associated with them—even if you have major medical insurance. That’s how Aflac can help. Aflac pays cash benefits directly to you (unless otherwise assigned) to help with things like out-of-pocket medical expenses, the rent or mortgage, groceries, or utility bills. Helping you with the medical expenses that major medical doesn’t cover—and much more. The Aflac Accident Indemnity Advantage® insurance policy has: • No deductibles and no copayments • No lifetime limit—policy won’t terminate based on the number of claims filed or the dollar amount of claims paid • No network restrictions—you choose your own healthcare provider • No coordination of benefits—we pay regardless of any other insurance Policy Benefits Include: • Daily hospitalization benefits payable for hospital stays. • Benefits payable for emergency treatment, X-rays, and major diagnostic exams. • Benefits payable for follow-up treatments and physical therapy. • Transportation and lodging benefits payable for travel to receive treatment. All this for only around $10 per week! For more details, contact me at seraphim@seraphimwood.com with "Accident Plan" in the Subject Line! #accidentshappen #accidents #moneypaidtoyou

What are my options? 🧐 Did you know that around 52% of people reaching the age of 65 will need some sort of long-term care service in their lifetime* 🚑 Two ways to fund long-term elder care for yourself or a loved one can be through: Long-Term Care Insurance or Medicaid 💊 Long-Term Care Insurance can be set up in a variety of ways such as; the traditional way, using partnership plans, or getting life insurance with long-term care riders 📑 In Indiana, you can apply for Medicaid through the Family and Social Services Administration (FSSA), though you must meet qualifying income and asset conditions 📚 Learn more about Long-Term Elder Care and start setting up your complete #EstatePlan by setting up a No Obligation Consultation, call (317) 803-4180 or visit lifespanusa.com 🌐 *via morningstar.com #EstateLaw #EstatePlan #EstatePlanner #EstatePlanningAttorney #EstatePlanningLawyer #Attorney #Lawyer #PlansThatWork #PeopleWhoCare