Anthem individual insurance plans bid goodbye to Affordable Care Act (ACA) markets across the nation to focus on the growth of its Medicare Advantage business, an experience more sweet than bitter; the insurance giant's third quarter profits were up 29 percent, year over year.
Enrollment in Anthem's insurance plans may have taken...Arizona News
In May, a final rule from the Centers for Medicare & Medicaid Services (CMS) opened the doors for Medicare Advantage (MA) insurers to offer long-term care benefits to members. About 7.5 percent of MA plan enrollees in 2019 may have access to in-home support services or extra benefits, according to CMS officials.
In a speech...Arizona News
MA insurers are auditing patient's medical charts to find more diagnosis codes in effort to get larger reimbursements from the Medicare program. The business of insurance encourages the documentation of all possible diagnoses to generate billions in profits. Modern Healthcare cites an Anthem lawsuit as an example of the returns...Arizona News
Many MA plans offer over the counter (OTC) supplementary benefits and even a special OTC card for use at the point of sale - in 2019 Anthem MA customers can get free two-day shipping from Walmart for qualifying OTC purchases when orders total $35 or more.
When 90 percent of U.S. households live within 10 miles of America's largest...National News
Uncertainty surrounds potential mega-healthcare mergers as the CVS-Aetna deal and Cigna's acquisition of Express Scripts are in question. Just last year, the Justice Department thwarted the Cigna-Anthem and Aetna-Humana mergers.
The California Insurance Commissioner is adamant that the CVS-Aetna $69 billion merger proposal be blocked...National News
Medicare Advantage enrollment is projected to rise to 38 million, or 50% market penetration, by the end of 2025.
Anthem, Humana and WellCare Health Plans are signaling plans to aggressively grow their Medicare Advantage businesses with the help of mergers and acquisitions. The three health insurers are in a competitive battle with...National News
Anthem has shocked insureds in six states: Georgia, Indiana, Missouri, Kentucky, New Hampshire and Ohio.
In recent years, Anthem has begun denying coverage for emergency room visits that it deems “inappropriate” because they aren’t, in the insurance plan’s view, true emergencies.
The problem: These denials are made after...
The potential merger between CVS and Aetna could be worth more than $66 billion.
The online retailer Amazon's flirtation with the pharmacy business has been raised as a factor in the merger. But many industry experts say CVS and Aetna have another huge competitor on their minds: UnitedHealth Group. Kaiser Health News quotes Ana Gupte,...
She brings a wealth of experience to the role.
Richard Boals retired in July after serving 45 years with the Phoenix-based insurer.
Kehaly spent the past 25 years with Anthem, holding various senior level positions through the years. Most recently, she oversaw 5,000 employees and 27 million members in individual, small group, large...