After Supreme Court Ruling, Some Questions Remain About Health Benefits For Gay Spouses
Also in the news, a look at the recurring problem of out-of-network surprise charges and an article about lack of dental coverage for seniors.
Reuters:
Gay Marriage Ruling Leaves U.S. Firms Unclear On Spousal Benefits
The Supreme Court was definitive in its decision to legalize gay marriage nationwide, but what is far from clear is whether U.S. companies must offer corporate benefits to same-sex spouses. Many large and mid-sized employers are self-insured, which means their benefits are governed by a 1974 act that has no language on preventing discrimination based on sexual orientation. The Employee Retirement Income Security Act allows companies to bypass differing state laws that complicate healthcare options for employees spread out across the country. (Gumpert, 7/16)
Related KHN coverage: High Court’s Decision On Same Sex Marriage Expected To Boost Health Coverage Among Gay Couples (Hancock, 6/29)
Los Angeles Times:
Out-Of-Network Costs Lurk Even At In-Network Hospitals
Lorena Martin's 18-year-old son, Robert, hurt his ankle playing football one recent Friday evening. He was in pain and unable to walk, and she was concerned that he'd done real damage. Both her doctor's office and the nearby urgent care center were closed, so with no other options, she took him to the emergency room. The hospital was in her health plan's network — she'd made sure of that. Once there, Martin paid a $50 co-pay and later received a bill for an additional $270, which she expected. ... But she was in for a surprise. Several weeks later she got a bill for about $1,400 from the doctor who saw her son in the emergency room for less than 10 minutes. (Zamosky, 6/17)
Reuters:
Add Bite To Your Retirement Dental Plan
If you plan to retire soon, add this item to your to-do list: a visit to the dentist before your dental insurance disappears. Retirees transitioning to Medicare are often surprised to learn that the program does not cover routine dental care or more complex procedures. Overall, 40 percent of the 65-plus population has some form of dental benefit, according to the National Association of Dental Plans. For seniors who use Medicare Advantage managed care plans, about half offer very limited coverage for cleanings and exams. A small percentage of seniors have dental insurance from a former employer, and Medicaid covers dental care for low-income residents in some states, although benefits vary. Some buy individual commercial plans or have coverage through an association such as AARP. (Miller, 7/16)