Medicaid Recertification at Scale: On-Demand Recording

A study from the New Hampshire Insurance Department released Monday found that women face challenges accessing appropriate healthcare due to provider shortages, concerns about healthcare affordability, and a low understanding of insurance coverage by participants of online surveys and group sessions. The study, funded by the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services, was commissioned to understand barriers to accessing women’s health services, with particular focus on preventive care, maternal health, and state compliance with federal market reforms. Michelle Heaton, director of Life and Health at the state insurance department, said surveys and focus groups found that consumers expressed concern over challenges that were outside of the department’s scope of work, like transportation, hospital capacity and geographical challenges. https://lnkd.in/gWcX9HZb

A study from the New Hampshire Insurance Department released Monday found that women face challenges accessing appropriate healthcare due to provider shortages, concerns about healthcare affordability, and a low understanding of insurance coverage by participants of online surveys and group sessions. The study, funded by the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services, was commissioned to understand barriers to accessing women’s health services, with particular focus on preventive care, maternal health, and state compliance with federal market reforms. Michelle Heaton, director of Life and Health at the state insurance department, said surveys and focus groups found that consumers expressed concern over challenges that were outside of the department’s scope of work, like transportation, hospital capacity and geographical challenges. https://lnkd.in/gWcX9HZb

𝐃𝐨 𝐘𝐨𝐮 𝐑𝐞𝐚𝐥𝐥𝐲 𝐊𝐧𝐨𝐰 𝐭𝐡𝐞 𝐃𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐜𝐞 𝐁𝐞𝐭𝐰𝐞𝐞𝐧 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 𝐚𝐧𝐝 𝐌𝐞𝐝𝐢𝐜𝐚𝐢𝐝? 🤔 They may sound similar, but they serve different purposes. Understanding the basics can make a big difference in insurance verification, medical billing, and patient support. 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 * Federal health insurance program * Primarily for people aged 65+ and certain younger individuals with disabilities * Eligibility is based mainly on age or disability 𝐏𝐚𝐫𝐭𝐬 𝐨𝐟 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 ✅ Part A – Hospital Insurance ✅ Part B – Medical Insurance ✅ Part C – Medicare Advantage Plans ✅ Part D – Prescription Drug Coverage 𝐌𝐞𝐝𝐢𝐜𝐚𝐢𝐝 * Joint federal and state health insurance program * Designed for eligible low-income individuals and families * Eligibility is based primarily on income and state-specific requirements 𝐂𝐨𝐦𝐦𝐨𝐧 𝐌𝐞𝐝𝐢𝐜𝐚𝐢𝐝 𝐏𝐫𝐨𝐠𝐫𝐚𝐦𝐬 ✅ Traditional Medicaid (Fee-for-Service) ✅ Managed Care Medicaid (MCO) ✅ Children’s Health Insurance Program (CHIP) ✅ Medicaid Expansion ✅ Long-Term Services & Supports (LTSS) Understanding these differences will help you navigate insurance verification more confidently and provide better support to patients. 💬 𝐐𝐮𝐢𝐜𝐤 𝐪𝐮𝐞𝐬𝐭𝐢𝐨𝐧: 𝐖𝐡𝐚𝐭 𝐞𝐥𝐬𝐞 𝐰𝐨𝐮𝐥𝐝 𝐲𝐨𝐮 𝐥𝐢𝐤𝐞 𝐭𝐨 𝐥𝐞𝐚𝐫𝐧 𝐚𝐛𝐨𝐮𝐭 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 𝐚𝐧𝐝 𝐌𝐞𝐝𝐢𝐜𝐚𝐢𝐝? #MedicalVA #MedicalBilling #InsuranceVerification #Medicare #Medicaid #HealthcareAdministration #MedicalCoding #HealthcareProfessionals

Costco And SCAN Health Plan Expand Partnership To Launch Senior-Focused Medicare Products: Costco Wholesale and SCAN Health Plan have expanded their strategic partnership to develop a suite of senior-focused insurance products aimed at improving value, accessibility and the overall Medicare experience for older adults. The expanded alliance represents Costco’s first comprehensive partnership with a Medicare plan. The post Costco And SCAN Health Plan Expand Partnership To Launch Senior-Focused Medicare Products appeared first on Pulse 2.0.

A new bill would create a government-run public health insurance option on the ACA marketplaces starting in 2028. The Medicare-X Choice Act would offer a plan covering primary care without cost-sharing, reimburse providers at Medicare rates (with up to 50% increase in rural areas), and require Medicare/Medicaid providers to participate. The bill would also permanently extend enhanced premium tax credits, which expired at end of 2025. Since then, average monthly marketplace premium payments jumped 58% ($113 to $178). This is a Democratic proposal in a Republican Congress, so passage is unlikely near-term. But it signals the policy direction if political dynamics shift. https://hubs.ly/Q04qJz570

🏥 30-Day U.S. Healthcare Claims Processing Series – Day 4 Understanding the Types of Health Insurance in the U.S. Before processing a healthcare claim, the first step is identifying the patient's insurance type. Each insurance plan has different eligibility rules, benefits, claim requirements, and payment policies. 1️⃣ Commercial Insurance Private health insurance provided by companies such as Cigna, Aetna, UnitedHealthcare, Elevance Health, and Humana. Most people receive it through their employer, while others purchase it individually. Covers: Doctor visits, hospital care, surgeries, lab tests, and prescription drugs. 2️⃣ Medicare A federal health insurance program mainly for: - People aged 65+ - Certain individuals with disabilities - People with ESRD Parts: - A: Hospital care - B: Medical services - C: Medicare Advantage - D: Prescription drugs 3️⃣ Medicaid A joint federal and state program for eligible individuals and families with limited income. Benefits and eligibility vary by state. 4️⃣ Managed Care Plans Designed to improve quality while controlling costs. - HMO: PCP and referrals required - PPO: More flexibility, no referral needed - EPO: In-network providers only (except emergencies) - POS: Combination of HMO and PPO features 5️⃣ TRICARE Healthcare coverage for active-duty military personnel, retirees, National Guard, Reserve members, and eligible family members. 6️⃣ Workers' Compensation Covers medical treatment and wage benefits for employees injured or made ill because of their work. 💡 Key Takeaway Every insurance type has different coverage and claim rules. Identifying the correct payer is the foundation of successful claims processing and faster reimbursement. 💬 Question: Which insurance type do you work with the most? #USHealthcare #ClaimsProcessing #MedicalBilling #RevenueCycleManagement #HealthInsurance #Medicare #Medicaid #TRICARE #HealthcareCareers #LinkedInLearning

Triage is offering multiple webinars on health insurance changes, geared to patients/caregivers (including one in Spanish), advocacy orgs, and HCPs. That is true patient advocacy. Respect!

Health insurance is changing at an unprecedented pace. New federal and state laws, regulations, and court decisions are reshaping Medicaid, Medicare, and Marketplace coverage. These changes represent one of the most significant shifts to our health insurance system in years, and because implementation will vary from state to state, understanding what they mean won't be straightforward. Are you overwhelmed by keeping up with the changes? At Triage Cancer, we're hearing more and more questions from patients, caregivers, advocates, and health care professionals who are trying to understand what these changes mean for themselves or the people they serve. That's why we've created a series of free webinars designed for different audiences, including health advocacy organizations, patients and caregivers, and health care professionals. Our goal is to provide practical, accurate, and timely information that helps people understand what's changing and what it means for their health coverage. We'll also be releasing new Quick Guides and state-specific resources in the coming months to help people stay informed, avoid losing health insurance, and understand their #healthinsurance options for 2027. Register for one of our upcoming webinars: https://lnkd.in/ggYjqDRT #Medicaid #Marketplace #Medicare

Senate Finance Committee Ranking Member Ron Wyden (D-OR) and fellow Senate Democrats released a Request for Information last week outlining proposed reforms to the United States health insurance system, one of which is adding a Medicare-like public option. The memorandum seeks stakeholder input and is intended to shape a future Democratic healthcare reform agenda. It will likely rekindle a debate among Democrats between those who seek incremental change versus Medicare for All advocates. https://lnkd.in/g7RjbDpU

So many adults dismiss Medicare. Even some doctors do. Have you taken care of a patient with Medicare? Have you actually had Medicare and used it? It's an incredible machine, functioning in a very complex system. Fraud? Of course. Do you own a business where your employees or customers or vendors aren't skimming off the top? You'd be the only one. Inefficient? No doubt. Inefficiency and waste are proportional to budgets and growth. Medicare doesn't just give you "health insurance", you're getting coverage for a lot of other ancillary healthcare needs. This isn't an ad for Medicare. And it definitely isn't to argue for "Medicare for all". But if you don't understand Medicare, don't have it, or never managed a patient inside it, don't dismiss it. And if you have a cadillac health insurance plan and trying to compare it to Medicare, you're not comparing apples to apples.