PwC’s latest annual analysis forecasts that group health insurance costs will increase by 8.5% in 2026—the third straight year at this elevated trend. This sustained rise means health care expenses are now similar to those seen 15 years ago, after a brief dip post-pandemic. Researchers gathered data from actuaries at 24 major U.S. health plans, … Continued
When navigating the world of health insurance, you will likely encounter the term PPO (Preferred Provider Organization). A PPO plan – whether medical or dental – is about balancing the cost and convenience of care. With a PPO plan, you get the flexibility to see a wide range of doctors. You’ll save money by staying … Continued
Ever found a confusing document in your mailbox after a doctor’s visit, wondering if it’s a bill, especially with an “amount you owe” at the bottom? You’re not alone! That document is most likely an Explanation of Benefits (EOB) from your health insurance company. It’s crucial to remember: an EOB is NOT a bill. Think … Continued
Health care terms, medical bills, and forms can be hard to understand. Here are some common health care terms, and what they mean. Allowed Amount This is the maximum payment the plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.” For example, if … Continued
As the year comes to an end, a crucial compliance deadline looms for employers with health plans. Under the Consolidated Appropriations Act (CAA), health plans and insurance issuers must submit a Gag Clause Compliance Attestation by December 31, 2024. Since its enactment in 2020, this regulation prohibits health plans from including gag clauses—provisions that limit … Continued
Medical expense accounts can help you save on all kinds of healthcare costs. Here are some you may not know about yet. HSA, FSA, and HRA can typically be used for: Medical expenses: Doctor visits, surgeries, prescriptions, dental and vision care, and mental health services. Over-the-counter (OTC) medications: Many OTC medications, including pain relievers, allergy … Continued
In today’s world of complex health insurance options, High Deductible Health Plans (HDHPs) have become increasingly popular. But with a name like “high deductible,” it’s natural to have questions. Let’s break down the basics of HDHPs: What is an HDHP? An HDHP is a health insurance plan with a higher deductible than traditional plans. This … Continued
Insurance Costs Consumers typically pay the following types of costs when they have insurance. Premium: The premium is an amount of money a consumer pays for a health insurance plan. The consumer and/or their employer usually make this payment bi-weekly, monthly, quarterly, or yearly. The premium must be paid regardless of how many services, if … Continued
Does a Health Plan Typically Pay for Services from Any Doctor? Not always. Some types of plans encourage or require consumers to get care from a specific set of doctors, hospitals, pharmacies, and other medical service providers who have entered into contracts with the plan to provide items and services at a negotiated rate. The … Continued
What is Health Insurance and Why is it Important? Health insurance is a legal entitlement to payment or reimbursement for your health care costs, generally under a contract with a health insurance company. Health insurance provides important financial protection in case you have an accident or sickness. For example, health insurance may help to pay … Continued
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