PhRMA

MARCH 29, 2023

The Patient Experience Survey (PES) series continues to reveal how health insurance is not working as it should for too many Americans — especially vulnerable groups.

Insurance 288

Insurance Documentation 288

STAT

OCTOBER 17, 2024

People who rely on Medicaid continue to get medical care at high rates, and it’s presenting a growing challenge for the major health insurers who cover them. 

Insurance 106

Insurance 106

STAT

SEPTEMBER 13, 2024

For years, health insurers battled to gain market share in the lucrative privatized Medicare program. When insurers release their 2025 plan offerings on Oct. Now, the opposite is true. Some of the companies say they designed their 2025 plans with an eye toward ditching members.  1, there likely will be fewer choices and freebies. 

Insurance 137

Insurance 137

Fierce Healthcare

SEPTEMBER 26, 2024

State laws mandate insurers cover a 12-month supply of contraception but this requirement is rarely followed by insurers, a JAMA Health Forum study reviewing Medicaid plans in nearly a dozen states | Insurance plans are supposed to cover a 12-month supply of birth control pills, but a recent study found that requirement is rarely followed.

Insurance 120

Insurance 120

Pharmacy Times

DECEMBER 21, 2023

Overtime, children can outgrow food allergies, like milk and eggs—however, children with private insurance are more likely to outgrow allergies than those with public insurance.

Insurance 145

Insurance 145

Fierce Healthcare

SEPTEMBER 19, 2024

Major Indiana managed care organizations and health systems are blamed for defrauding the state Medicaid system by tens, if not hundreds, of millions of dollars, says a newly unsealed whistleblower | A newly unsealed lawsuit alleges major health insurers and health systems defrauded Indiana Medicaid by hundreds of millions of dollars, with the government (..)

Insurance 136

Insurance Hospitals 136

Drug Topics

APRIL 11, 2024

Joe McKamey, general manager at Marcrom’s Pharmacy, highlights the potential pitfalls or misconceptions that pharmacies may encounter when opening a Medicare-focused insurance agency.

Insurance 154

Insurance 154

Pharmacy Times

SEPTEMBER 3, 2024

Patients with DLBCL on Medicaid had worse survival outcomes than those on commercial insurance, but there were no statistically significant differences in survival between races.

Insurance 132

Insurance 132

STAT

JULY 3, 2024

More than two dozen Medicare Advantage insurers received higher quality marks for 2024, based on a STAT review of new data released July 2 by the federal government. Federal courts required the Centers for Medicare and Medicaid Services to make changes after ruling the agency made mistakes with its own methodology.

Insurance 119

Insurance Health Insurance Companies 119

The Checkup by Singlecare

APRIL 14, 2024

Without insurance coverage, Rexulti’s average price is around $1,926 for a 30-day supply. Is Rexulti covered by insurance? Insurance is often the go-to option for reducing prescription drug costs. The drug’s FAQs state that 97% of health insurance plans nationwide will cover it. at Albertsons, $1686.88 at CVS, $1719.42

Insurance 98

Insurance Insurance Coverage FDA Dosage 98

Pharmacy Times

OCTOBER 21, 2024

The implementation of accountable care organizations (ACOs) also worsened disparities in any emergency department or hospital use for Medicaid-insured children with asthma.

Insurance 122

Insurance Hospitals 122

The Checkup by Singlecare

OCTOBER 8, 2024

Although it’s effective, it can be expensive without insurance. How much does Kerendia cost without insurance? Prices fluctuate, though, and the cost of Kerendia without insurance varies by pharmacy and the dosage prescribed. Is Kerendia covered by insurance? This translates to approximately $28 per pill.

Insurance 52

Insurance Insurance Coverage Dosage FDA 52

STAT

MAY 29, 2024

Health insurers are telling shareholders that they are ramping up the use of artificial intelligence and are hiring talent to implement the technology across their organizations. However, all five of the insurers STAT contacted declined to elaborate on how they are using AI. Continue to STAT+ to read the full story…

Insurance 145

Insurance 145

The Checkup by Singlecare

OCTOBER 8, 2024

Without insurance, the cost of Xigduo XR varies by dosage, averaging about $390 per month, but there are ways to make it more affordable. Is Xigduo XR covered by insurance? Most Medicare and insurance plans do not usually cover Xigduo XR oral tablets. How much does Xigduo XR cost without insurance?

Insurance 52

Insurance Dosage Generic Medicine FDA 52

STAT

JULY 17, 2024

Wall Street’s reaction was swift Wednesday after Elevance Health said that the amount of care its Medicaid members are getting is outpacing what states are paying the insurer to treat those members.

Insurance 129

Insurance 129

Fierce Healthcare

JUNE 27, 2024

Health insurance premiums are putting major pressure on small businesses, according to a new analysis from the JPMorganChase Institute. Health insurance premiums are putting major pressure on small businesses, according to a new analysis from the JPMorganChase Institute.

Insurance 104

Insurance 104

Fierce Healthcare

MAY 13, 2024

The gap between insurance plans and Medicare's payments to hospitals for inpatient and outpatient services widened over the course of just a couple of years, a new study from RAND Corporation | A new report from RAND Corporation highlighted just how much more employers and private insurers are paying hospitals for inpatient and outpatient services. (..)

Insurance 134

Insurance Hospitals 134

The Checkup by Singlecare

OCTOBER 9, 2024

Without insurance, Spravato can be very costly. Related: Spravato coupon | Spravato details Is Spravato covered by insurance? Not all Spravato-certified treatment centers may be in-network with your insurance plan, so if you have insurance, you will save money by using an in-network provider.

Insurance 52

Insurance Dosage Insurance Coverage Controlled Substances 52

Drug Topics

APRIL 6, 2024

Joe McKamey, general manager at Marcrom’s Pharmacy in Manchester, Tennessee, talks about why pharmacies should open their own Medicare-focused insurance agency and what steps and preparations they can take to ensure a successful launch and operation.

Independent Pharmacies 144

Independent Pharmacies Insurance 144

Drug Topics

JUNE 21, 2023

Antiobesity medications are considered to be 'vanity drugs' by many private insurers, and the refusal to cover obesity treatment is counterproductive because of obesity's many health consequences.

Insurance Coverage 183

Insurance Coverage Insurance 183

Fierce Healthcare

SEPTEMBER 25, 2024

Startup Medicare Advantage insurer Zing Health banked a $140 million funding round it intends to use to enhance its special needs plans. Startup Medicare Advantage insurer Zing Health banked a $140 million funding round it intends to use to enhance its special needs plans.

Insurance 117

Insurance 117

The Checkup by Singlecare

OCTOBER 9, 2024

The 10 mL (100 unit/mL) vial is $350 without insurance. Is Fiasp covered by insurance? Fiasp is covered on the majority of commercial insurances as well as those Medicaid and Medicare Part D health insurance plans that cover Novolog ( insulin aspart ). How much does Fiasp cost without insurance?

Insurance 52

Insurance Communication 52

The Checkup by Singlecare

JUNE 27, 2024

A transmitter costs $366 without insurance and lasts for about 90 days. Is a Dexcom G6 transmitter covered by insurance? Dexcom G6 transmitters, along with other components of the system, are typically covered by insurance, Medicare , and Medicaid when certain criteria, such as Type 1 diabetes, are met.

Insurance 97

Insurance Insurance Coverage FDA 97

Fierce Pharma

SEPTEMBER 24, 2024

drug prices, the role of insurers and pharmacy benefit managers (PBMs) often commands at least some of the attention. | At the Senate committee hearing on Novo Nordisk's prices for Ozempic and Wegovy, debate around insurance coverage and pharmacy benefit managers took up much of the conversation.

Insurance 104

Insurance Insurance Coverage 104

The Checkup by Singlecare

SEPTEMBER 19, 2024

Without insurance, the average cost of Synjardy is $789 for 60, 12.5-1000 Is Synjardy covered by insurance? Coverage varies depending on your specific insurance plan. Each health insurance company has certain eligibility requirements, including its drug formulary. How much does Synjardy cost without insurance?

Insurance 52

Insurance Insurance Coverage Health Insurance Companies Independent Pharmacies 52

Fierce Healthcare

SEPTEMBER 5, 2023

Self-insured employers pay more for a host of medical procedures than fully insured employers, and just why should be investigated by policymakers, according to a

Insurance 120

Insurance 120

The Checkup by Singlecare

OCTOBER 9, 2024

Without insurance, Prolensa will cost, on average, $475 for one 3 mL bottle of the 0.07% solution. Is Prolensa covered by insurance? How much does Prolensa cost without insurance? The cost of Prolensa eye drops without insurance may vary by pharmacy. The generic equivalent of Prolensa was approved in 2023.

Insurance 52

Insurance Dosage 52

STAT

MARCH 25, 2024

The public will soon find out whether the federal government is willing to meet the health insurance industry’s demands and deposit more money into the bank accounts of next year’s Medicare Advantage plans.

Insurance 111

Insurance 111

STAT

FEBRUARY 7, 2024

In recent months, the federal government has repeatedly told Medicare Advantage insurers that they cannot use artificial intelligence or algorithms to deny medical services the government routinely covers.

Insurance 145

Insurance 145

The Checkup by Singlecare

SEPTEMBER 17, 2024

Depending on eligibility and conditions, Opzelura may or may not be covered by your insurance plan. Without insurance, Opzelura has a retail price of $2,755. Is Opzelura covered by insurance? Opzelura coverage by insurance plans or Medicare Part D will vary by plan. Your cost with insurance coverage will vary by plan.

Insurance 52

Insurance Insurance Coverage Immunization Dosage 52

The Checkup by Singlecare

OCTOBER 3, 2024

Without insurance, the most common dosage of Belsomra may cost more than $600 per month. Is Belsomra covered by insurance? Many private health insurance plans typically cover Belsomra. However, coverage can vary depending on the insurance company and plan. Several factors can affect insurance coverage for Belsomra.

Insurance 52

Insurance Mail-Order Pharmacies Dosage Insurance Coverage 52

The Checkup by Singlecare

OCTOBER 3, 2024

Although it’s effective for treating pain from endometriosis, it may be difficult for some people to pay for, at over $1,600 for a month’s supply without insurance. We’ll go over the specifics about paying for Orilissa with or without insurance and share some ways to save. Is Orilissa covered by insurance?

Insurance 52

Insurance Health Insurance Companies Dosage Pharmaceutical Companies 52

STAT

JANUARY 31, 2024

Cigna is officially exiting the Medicare business, agreeing to sell all of its Medicare insurance plans to Health Care Service Corp., a large Blue Cross Blue Shield insurer, for $3.3

Insurance 140

Insurance 140

Fierce Healthcare

MARCH 4, 2024

Insurance network coverage dramatically impacts whether a person remains in treatment for opioid use disorder, according to results shared by treatment provider Ophelia. | In-network insurance coverage goes a long way in making sure individuals continue opioid use disorder treatment, according to a study out of Health Affairs.

Insurance Coverage 120

Insurance Coverage Insurance 120

STAT

APRIL 9, 2024

One of the country’s biggest life insurers is venturing into genetic testing, an area that’s historically been a minefield for that industry, in a purported effort to keep its members alive longer.    MassMutual announced Tuesday that it’s offering many of its 4.2 The Springfield, Mass.-based

Insurance 145

Insurance 145

The Checkup by Singlecare

JUNE 13, 2024

Without insurance, the prescription birth control, NuvaRing, costs $234 for 1, 0.12-0.015 Is NuvaRing covered by insurance? Most health insurance plans usually cover NuvaRing. This means your insurance company wants to verify NuvaRing is medically necessary before they agree to cover it. 0.015 mg/24-hour ring.

Insurance 83

Insurance Insurance Coverage Independent Pharmacies Dosage 83

STAT

FEBRUARY 23, 2024

Hospitals, pharmacies, and other health care providers are getting stuck in an insurance processing logjam after UnitedHealth Group disclosed a cyberattack within a recently acquired subsidiary that serves as a central hub for payments across the industry.

Insurance 145

Insurance Hospitals Insurance Processing 145