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Is Medicare a Third-Party Payor?

Medicare is indeed a third-party payor for healthcare expenses. As one of the largest public health insurance programs in the United States, Medicare covers over 60 million Americans aged 65 and older and younger people with certain disabilities. When people with Medicare receive medical care, Medicare pays most of the bill directly to healthcare providers, … Read more

Can I Self-Insure My Home?

Self-insuring your home means foregoing traditional home insurance and instead using your own money to cover any losses or damages. While self-insuring may seem like a way to save on insurance premiums, it carries significant financial risks that make it impractical for most homeowners. What is Self-Insuring a Home? Self-insuring your home means you have … Read more

How Does Insurance Determine the Allowed Amount?

When you receive medical care and file a claim with your health insurance company, you may notice that the amount your provider charged doesn’t match what your insurance paid. This difference is due to the allowed amount set by your insurer. The allowed amount, sometimes called the eligible expense, is the maximum dollar amount an … Read more

Can My Employer Ask About My Spouse’s Health Insurance?

It’s becoming increasingly common for employers to inquire about a spouse’s access to health insurance. With rising healthcare costs, some companies are looking to trim expenses by limiting coverage for spouses who could get insurance through their own job. So can your employer actually ask about your spouse’s insurance when you enroll in workplace benefits? … Read more

What Are the Six Models of Managed Care?

Managed care refers to a variety of methods and systems that are intended to control healthcare costs and utilization. There are several different managed care models that organize provider networks, member services, and reimbursement approaches in order to manage the cost, quality, and access to healthcare. The six main types of managed care models include: … Read more

Can I Decline Health Insurance From My Employer?

Health insurance is commonly offered as an employee benefit by many companies. But in some cases, employees may want to opt out and decline coverage through their employer. So can you actually decline health insurance offered by your employer? The short answer is yes – employees can refuse employer health insurance coverage and waive participation … Read more

What Happens When You Pay Off Your Insurance Premium?

Paying off your insurance premium can seem like a great milestone. You no longer have a recurring payment to worry about every month or quarter. But what actually happens when you pay off your insurance early? Does your coverage stop? Do you still need insurance? Overview of Paying Off Insurance Early Let’s start with a … Read more

What is an Insurance Coverage Investigation?

Dealing with insurance companies after an accident, injury, or loss can be frustrating and confusing. You likely just want to get your claim settled and move on with your life. But often the insurance company says they need to do an “investigation” first. What exactly does this entail? Here’s an in-depth look at what an … Read more