CVS Health Is Leaving the ACA Marketplace—Here’s What That Means for You

In a major shake-up to the health insurance landscape, CVS Health announced it will exit the individual health insurance market—commonly known as the Affordable Care Act (ACA) or “Obamacare”—starting in 2026. This decision directly impacts around 1 million people currently enrolled in Aetna ACA plans across 17 states.

The news broke alongside CVS’s first-quarter earnings report, which showed a hefty $1.8 billion in net income. While this sounds like a financial win, the company is in the middle of a strategic pivot, especially when it comes to controlling rising healthcare costs in its Aetna insurance business.

So why the exit? According to CVS, it’s part of a broader plan to “refocus the company’s portfolio.” In simple terms, they’re pulling back from areas where they’re less competitive—in this case, the ACA exchanges—to double down on other parts of the business where they believe they can offer stronger care and more stability.

Here’s what CVS had to say:

(more…)

Understand Your Rights Against Surprise Medical Bills – 2022 Federal Law

The Federal No Surprises Act protects people covered under group
and individual health plans from receiving surprise medical
bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities and services from out-of-network air ambulance service providers. It also establishes an
independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is
substantially greater than the good faith estimate they get from the provider.

Starting in 2022, there are new protections that prevent surprise medical bills. If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front before your visit. If you disagree with your bill, you may be able to dispute the charges.
Click here to find out more of what you need to know about your new rights.