As part of the Affordable Care Act, health insurers must spend at least 80% of the money they earn from premiums on actually providing health care, with the remaining cash used to cover all administrative, advertising and payroll costs. Those insurers with plans that don’t follow this ratio are soon supposed to start giving the extra money back in refunds and discounts. But new legislation introduced in the Senate this week could jeopardize this, while giving insurance companies even more money to stick in their dog pillows.
Alex is 24 years old and was laid off last year. He’s trying to sign up for a high-deductible health insurance plan from Humana One, but they’ve rejected him because he’s got a mess of health issues: “At my last checkup I mentioned occasional knee pain, occasional indigestion, and the fact that I experienced palpitations extremely rarely.” Or as Human describes it, “a medical history of bursitis, tendonitis, osteoarthritis, palpitations and irritable bowel syndrome (IBS).”
Had a problem with my Mom’s Medicare Part D Prescription Drug plan with Humana. Their mail order pharmacy (RightSource) advertises a two-week turnaround from date of sending-in an order to receipt of medications. However after three weeks, RightSource had not acknowledged receipt of the order. A RightSource phone rep said the logging-in of orders was being delayed by two to three weeks due to heavy volume. This delay — in the case of meds for a 93 year-old lady — was unacceptable.