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1, 2, 3 . . . it’s a big jump to 273

Between 2018 and 2021, Wilmington, North Carolina resident Stephanie Christy was covered under an individual health plan sponsored by Blue Cross Blue Shield of North Carolina (BCBSNC). Until she wasn’t…and was left… Read More

Why is insulin so expensive? California alleges manufacturers and pharmacy benefit managers are gaming the system

Let’s be real: Insulin is already expensive. A 2021 RAND report found that insulin costs approximately 10 times more for Americans than it does in other countries. So, we don’t need drug… Read More

Wait…high-deductible plans prove dangerous for patients? No way!

Chronic conditions, such as diabetes, require management, care, and medications. When insurers create hurdles that directly or indirectly block access to care, those patients suffer. And apparently, that’s exactly what’s happening across… Read More

What good are medical advances if insurance won’t pay for them?

We’ve come a long way in modern medicine, especially when it comes to HIV care. In the mid-90s, life expectancy at age 20 for HIV-infected individuals was just 39 years old. Today,… Read More

Sugar and spice, not everything’s nice…

It’s the holiday season, a time for peace and goodwill, right? Well, not quite. Because it’s also the season for contract negotiations, err . . . disputes. And it looks like insurers… Read More

Is it just us, or are claim denials on the rise?

Over the past year, hospitals across the nation have experienced a rise in denied medical claims from insurance companies. According to a recent article in Modern Healthcare, approximately 67% of healthcare leaders… Read More

News flash: North Carolinians don’t trust their health insurance provider.

According to a recent poll conducted by Raleigh-based Meredith College, most North Carolinians don’t believe their health insurance provider has their best interest in mind. For some of you, this might seem… Read More

Insurers keep winning as the healthcare profit gap widens

That payor-provider gap? It’s becoming an abyss. At this point, it’s clear that the U.S. healthcare system is simply breaking down — with billions of dollars being funneled toward insurance company shareholders,… Read More

Put up your dukes. Insurers are coming out swinging.

Contract negotiations are nothing new – hospitals and insurance companies renegotiate their rates for services regularly. But the trend of the last few years is upped aggression from payors, where networks are… Read More

More people are covered by health insurance – but health insurance covers less

Here’s the good news: The number of Americans with health insurance is hitting historic highs. And the bad news: The health insurance itself is inadequate. According to recent findings from the Commonwealth… Read More

Can the feds finally make mental health parity a reality? Here’s hoping…

The future of mental health coverage parity remains uncertain, according to a recent article from Axios. But it’s not for lack of trying. For the upcoming legislative session in February, the Senate… Read More

California governor shoots down bill to protect patient access

It’s an unfortunate ending for California patients – a utilization management bill successfully passed the state Assembly and Senate, just to be vetoed by Governor Gavin Newsom. Sponsored by California Assembly member Dr.… Read More

Rural hospitals are necessary. So why do they keep closing?

Rural hospitals are literal lifelines for the communities they serve. And yet, they keep closing across the country. A new report from the American Hospital Association (AHA) is sounding the alarm, as… Read More

Need medical care? Better prove it.

We all (unfortunately) know that getting your care covered by insurance is anything but simple. And for families with children with autism spectrum disorder, insurers like Trustmark Health Benefits make the process… Read More

Hey North Carolina, where’s the outrage on insurance increases?

Only in the insurance industry can a business secure a $500 million-dollar profit and demand that consumers pay more. According to a September 1 article published in North Carolina News, Blue Cross… Read More

The real reason for North Carolina’s mental health crisis

When health insurers stand in the way of preventive mental healthcare, the results can be dire. Though they are supposed to cover mental healthcare on par with physical healthcare services, the reality… Read More

No kidding: Americans dissatisfied with health insurance plans

Well, well, well . . . if it isn’t the pot calling the kettle black. A new poll revealed that most American consumers are dissatisfied with their health insurance plans. You don’t… Read More

With big premium bumps, Northeastern consumers may be facing a frigid financial future

We’re not saying we told you so, but we are saying we saw this coming. Health insurance premiums are up nearly 14%, and consumers across the States are already facing inflated insurance… Read More

How insurance companies police doctors through arcane policies

Insurers never miss a chance to make getting healthcare harder, do they? A new report from Modern Healthcare claims both Horizon Blue Cross Blue Shield of New Jersey and Cigna are planning… Read More

Rural or otherwise, running a hospital is no walk in the park

Running a hospital is serious business. Sure, we can talk theoretically all day about payors, providers, and the pandemonium that is healthcare . . . but the reality of the situation is… Read More

Insurance contract disputes: when the odds are not in patients’ favor

They say all’s fair in love and war. Well, not when it comes to health insurance contract disputes. At least, such is the case for one local community in California. Adventist Health… Read More

Another prior authorization delays patient care and ends in tragedy

OK, we admit it. We’re (fairly) snarky when it comes to health insurance companies. But there’s no room for snark when it comes to a recent Medscape article, which follows the journey… Read More

Health insurers don’t want to cover your care—their chronic denials prove it

In 2020, amid a global pandemic, health insurers on the Affordable Care Act marketplaces denied close to one-fifth of all in-network claims, according to a Healthcare Dive article citing Kaiser Family Foundation… Read More

Aetna sees the light (finally)

Has a health insurer actually seen the harm their restrictive policies cause for patients? According to a recent article in Fierce Healthcare, Aetna is coming to terms with the fact that last… Read More

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Insurer policies limit coverage and disrupt patient care, while producing record profits for corporate shareholders. Stay informed with the Un-covered newsletter.