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Thursday, Dec 3 2015

Full Issue

Insured By A PPO? Beware Of Costly Trap As Insurers Remove Out-Of-Network Limits

A trend among this year鈥檚 marketplace plans leaves some consumers responsible for potentially unlimited bills when they thought they had some financial protections. And in other Obamacare news, The Texas Tribune reports on a rise in health insurance scams.

Citing the flexibility they offer, many consumers choose health plans that provide some coverage outside the insurer鈥檚 network. Traditionally, such plans not only paid a portion of the bill, but also set an annual cap on how much policy holders paid toward out-of-network care. Not anymore. (Appleby, 12/3)

It might be a sign directing callers to an 800 number where they can get help choosing an Affordable Care Act plan 鈥 for a fee. Or it might be a cardboard poster attached to a telephone pole offering 鈥淩eal insurance. Not Obamacare.鈥 In any case, advocates for the uninsured warn, if it asks for money, it's probably a scam to prey on low-income Texans seeking mandated insurance coverage under President Barack Obama鈥檚 signature health law. Nonprofit workers in the Rio Grande Valley say they鈥檝e seen an increase this year in sales tactics 鈥 including the examples cited above 鈥 that are at best unethical and at worst illegal, charging low-income Texans fees for assistance they are entitled to receive for free. (Walters, 12/2)

Elsewhere, other health law developments are reported from Georgia and Virginia -

More than 100,000 Georgians have signed up for coverage in the insurance exchange as of Nov. 28, federal officials announced Wednesday. The state鈥檚 total of 105,299 trailed only Florida, Texas and North Carolina among the 38 states that use the federally run marketplace, created under the Affordable Care Act. It鈥檚 the first state-by-state enrollment breakdown since open enrollment began Nov. 1. (Miller, 12/2)

Federal officials say nearly 87,000 Virginians have chosen health plans in the insurance marketplace created by President Barack Obama鈥檚 health care law since an open enrollment period began on Nov. 1. The U.S. Department of Health and Human Services released the 2016 enrollment figures Wednesday. (12/3)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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