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Health Insurance & Benefits
Plan types, HSAs/FSAs, open enrollment, and navigating coverage denials/appeals.
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PhilHealth, private insurers build on Yakap to maximize primary care coverage
2+ hour, 5+ min ago (252+ words) The Manila Times THE Philippine Health Insurance Corp (PhilHealth) and major health maintenance organizations (HMOs) and private health insurers (PHIs) have joined hands to make primary healthcare more affordable and accessible for Filipinos.PhilHealth, together with Maxicare Healthcare Corp., MediCard…...
Intellicare puts healthcare access at the heart of growth, pays ₱9.35 billion in claims in first half of 2026
9+ hour, 27+ min ago (1007+ words) As the Philippine health maintenance organization (HMO) industry continues to grow, Intellicare is putting healthcare access at the heart of that growth, paying ₱9.35 billion in healthcare benefits and claims in the first half of 2026. The latest Insurance Commission (IC) performance…...
HMP Wymott prisoner died after mental health not escalated
14+ hour, 38+ min ago (463+ words) A prisoner at HMP Wymott in Lancashire died after his worsening mental health was not escalated despite repeatedly telling staff he was having thoughts of self-harm, a watchdog report has found. A newly published report by the Prisons and Probation…...
CHRISTUS Health Plan to withdraw from Medicare Advantage
14+ hour, 37+ min ago (233+ words) The Moore County News-Press TEXARKANA, Texas -- Thousands of East Texas seniors with CHRISTUS Medicare Advantage plans will need to find a new provider for coverage by Dec. 7 this year. Beginning in 2027, most of the carriers that will be quitting Medicare…...
Medicare Advantage Premiums Fall 16.5% Even as Insurers Cut Networks
20+ hour, 26+ min ago (348+ words) Medicare Advantage premiums are set to fall 16.5% in 2027, even as UnitedHealthcare, Aetna and Humana reduce networks and plan availability. Medicare Advantage premiums are set to fall sharply in 2027, but some beneficiaries may have fewer doctors and plan options to choose…...
Divergent Cost Trends for 3 Advanced Cancers, 2013 vs 2022: A Commercial Claims Analysis
20+ hour, 36+ min ago (699+ words) A comparison of 2013 and 2022 data shows that cancer costs are not uniformly rising. Costs decreased for metastatic colorectal cancer but increased for both metastatic non–small cell lung cancer and multiple myeloma. Methods: Using MarketScan Commercial Claims and Encounters data,…...
Another Brick in the Wall: OIG Backlog Adds to Credentialing Delays
1+ day, 2+ hour ago (282+ words) New providers seeking to participate in Texas Medicaid face months of delays in getting clearance from the Texas Health and Human Services Office of Inspector General, according to a source familiar with the applications. Apparently, some providers have been trying…...
How an AI Agent Delivers Prior Authorization Decisions for Health Plans
1+ day, 6+ hour ago (1177+ words) Members and provider offices call because the decision already exists inside the plan's utilization management system and nobody has told them yet. The clinical reviewer finishes the case and records the determination. From that moment, the member waiting on a…...
Oral Targeted Anticancer Medication Use Following High-Deductible Health Plan Enrollment
1+ day, 14+ hour ago (390+ words) The American Journal of Managed Care Employer-mandated enrollment in a high-deductible health plan did not reduce use of oral targeted anticancer medications among patients commercially insured between 2007 and 2021. Am J Manag Care. 2026;32(10):545-547 The study included 124 members with an employer-mandated switch…...
UnitedHealthcare and Aetna Shift 2027 Medicare Advantage Toward HMOs, Making Doctor Network Checks Vital Before Open Enrollment
1+ day, 21+ hour ago (967+ words) The two largest names in Medicare Advantage are steering 2027 members toward plans with tighter doctor networks. UnitedHealthcare will exit some areas where it offers a higher share of preferred provider organization (PPO) plans, and Aetna is expanding health maintenance organization…...