What Is Adverse Selection in Health Insu...

Adverse selection happens when there is an imbalance between high-risk or sick policyholders and healthy policyholders within the realm of health insurance. The most common way of adverse selection occurring is when sick people who need more protection and coverage begin purchasing up policies in a higher rate than those who are healthy who need little to no coverage and may not purchase a plan at all.   This can eventually lead to significant financial issues within the insurance industry, amounting to higher health insurance premiums for users. While the Affordable Care...

How to Compare Health Insurance Plans

There’s no denying it, shopping around for a health insurance plan can be incredibly daunting. But, open enrollment starts on Nov. 1, so now is the time to examine your options for the coming year! If your job doesn’t supply you with a health care plan, and you shop for coverage through the marketplace, it’s a good idea to start your research early, as there are a lot of options! No matter where you get your healthcare coverage from, it’s vital for you to understand the plans fine print, how it’ll cover your needs, and what out of pocket...

What is a PPO Plan?

“Preferred Provider Organization” plans, commonly referred to as PPO plans, are one of the most common types of health care coverage within the Individual and Family market. What’s great about PPO plans is that they allow policyholders to visit whichever in-network physician or healthcare without needing a referral from a primary care doctor. How does a PPO plan work? While you usually won’t require to appoint a primary care physician, PPO plan members are encouraged to use the insurance company’s network of preferred doctors. Naturally,...

The Individual Mandate Could Be Coming B...

It looks as if California will be reinstating the Individual Mandate. Earlier this year, identical bills were brought to the California Senate and Assembly calling for all Californians to have health insurance coverage by 2020 or pay a tax penalty. These were brought forward to reverse the repeal by Congress of the federal order that was a part of the Affordable Care Act. Since the Affordable Care Act came into effect, California’s uninsured rate dropped from 20% to 7%. “I don’t see a very rosy picture of what is happening now that the (federal) mandate is gone,” said...

The State of the Opioid Crisis in Americ...

It’s no secret that the United States is currently undergoing an opioid epidemic. It’s said that more than two million Americans have grown dependant on or abused prescription pain pills or street drugs that have the opioid classification. What are opioids? These are drugs are formulated to recreate the same pain-relieving effects attributed to opium. The term can be used when talking about legal painkillers (morphine, oxycodone, hydrocodone) prescribed by doctors as well as illegal drugs like heroin or fentanyl. Out of the 72,000 documented overdose deaths that occurred...

How AI Will Improve Health Care in 2019

More than half of health care professionals anticipate the widespread adoption of artificial intelligence (AI) by 2025. This shouldn’t come as much of a surprise. AI already plays a huge role in the public service, education, banking, and construction sectors, so it makes sense that health care is next on the list. Expect health insurance companies and medical professionals to adopt AI platforms to save time and money while improving the accuracy of claims. Health insurance companies and providers won’t be the only ones to benefit, though. You can expect huge improvements...