A new law provides Medicare the ability to directly negotiate the prices of certain high expenditure, single source drugs without generic or biosimilar competition. The Centers for Medicare & Medicaid Services (CMS) selected ten drugs covered under Medicare Part D for the first cycle of negotiations for initial price applicability year 2026 and engaged in […]

Today, I read a post from The Maine Bureau of Insurance. It is below. If you are looking for individual or group health insurance in Maine, please only work with a licensed broker and a licensed health insurance company. ___________________________ Bob Carey, Superintendent of the Maine Bureau of Insurance, which cautioned Maine residents to be […]

You may be wondering, what is balance billing or surprise billing? It is when you see a doctor or other health care provider, and you are billed for other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network. […]

We all know that reading an explanation of benefits from your health insurance provider can be very confusing. CMS has a webpage that explains what an EOB looks like and how to read one. You can find the page here… How to read an explanation of benefits | CMS

Did you know that you can compare costs before you receive care? The Maine Health Data Organization has a great site where you can compare costs at 344 healthcare settings in Maine, including hospitals, surgical centers, diagnostic imaging centers, health centers, laboratories, and clinics. Before your next procedure, make sure to check costs. Scheduling with […]

Are you curious how much your medical provider is being paid by drug and device companies for things including but not limited to research, meals, travel, gifts or speaking fees? You can do a search here on the CMS.gov website… Program Overview | OpenPayments (cms.gov)

Federal officials have announced a new platform to report denied emergency care directly to the U.S. government. All Americans are entitled to emergency medical care under a federal law called the Emergency Medical Treatment and Labor Act or EMTALA. The law states hospitals that receive federal funds must stabilize or transfer patients needing emergency care, […]

Did your health insurance carrier deny your health claim? Did you know that you can request a report with the information the carrier used to determine whether or not to pay your claim? ProPublica is a site where you can file a claim request for that information. Find the site and how to file your […]

It’s almost time to get away for your spring vacation! Will you be traveling domestically or internationally? If so, you will need medical and trip insurance. Please contact me for more information. Click here to view the different products.