Many Vermonters can’t afford or access healthcare, even though most are insured: The issue isn’t lack of insurance, but rather underinsurance. We highlight this growing problem plaguing consumers across the US.

FTC warns ACA marketplace insurance marketers about deceptive claims: The warnings come during open enrollment season, a period that typically creates confusion among consumers.

Ozempic is becoming cheaper for Medicare beneficiaries: Falling prices are welcome news for seniors’ wallets. But a new proposal to expand access to GLP-1s for Medicare members could threaten the federal health insurance program itself.

CVS Health names health insurance exec Aetna head: The appointment comes as part of CVS’s mixed Q3 earnings report, the first under its new CEO.

CVS Health replaces CEO Karen Lynch: With its insurance arm, Aetna, failing to meet investors’ expectations, CVS’ decision to appoint a longtime pharmacy benefit manager exec as CEO could be just what the doctor ordered to start turning its financial fortunes around.

Only 9% gave it an A, boosted by 41% of Medicare recipients who awarded an A or B compared to only 22% of people with commercial insurance. The bigger picture: Consumers’ lack of trust and general dissatisfaction with insurers follows a trend of discontent that surfaced prominently after the murder of UnitedHealthcare CEO Brian Thompson in December.

Why it matters: Commercial insurance coverage for GLP-1s is dropping, and the current administration does not support expanding gov’t plans to cover the meds for obesity. North Carolina ended coverage for state employees in January 2024. Other insurers have also ended GLP-1 coverage for weight loss.

The bottom line: Consumers have a negative perception of the health insurance industry and much of that sentiment is justifiable. The unfortunate truth is that the high cost of healthcare in the US is determined just as much by the price of healthcare as it is by insurance coverage.

Gen Z struggles to manage health and wellness: They understand the importance of taking health into their own hands but fail to deliver good results. We explore how healthcare marketers, providers, and insurers can arm this generation with the necessary support.

Lawmakers introduce bill requiring vertically integrated insurers to offload their pharmacies: Democrats and Republicans aligning on co-sponsored legislation shows that the public is at its wits’ end with rising prescription drug prices.

Nearly 60% of insured adults said they’d experienced a problem using their health insurance in the past 12 months, including denied claims, provider network problems, and prior authorization issues, according to 2023 survey data from KFF. Negative experiences. Consumers’ experience with health insurance depends on how frequently they need to use it.

Healthcare and pharma companies will lean further into D2C in 2025: They’re cutting out health insurers and PBMs that bottleneck patient access to their products and services. But the industry’s push into D2C won’t be met without challenges.

Gen Zers express a greater level of distrust of health insurance companies than all other generations, per our December 2023 US Digital Health survey. This could spell trouble for legacy healthcare organizations, particularly insurers that could lose the trust of younger consumers who are just beginning their patient journeys.

Public outcry pushed Anthem to backtrack on policy to cap anesthesia coverage: Faced with a reputational crisis, insurers and their PR teams should prioritize a clear and proactive communications shift to attempt to save face.

CMS must recalculate UnitedHealthcare’s Medicare Advantage star ratings: The ruling could be a good omen for Medicare Advantage insurers whose ratings were downgraded.

CMS must recalculate UnitedHealthcare’s Medicare Advantage star ratings: The ruling could be a good omen for Medicare Advantage insurers whose ratings were downgraded.

UnitedHealthcare recently launched a national Gold Card program whereby qualifying providers follow a simple notification process to get insurance approval instead of the more time-consuming prior authorization process.