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Karla Flores

Insurance RX

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Surprise Medical Bills

September 10, 2026 By Insurance Experts

Surprise out-of-network billing and related patients’ costs are increasing among inpatient admissions and emergency department visits to in-network hospitals, according to a study published Monday in JAMA Internal Medicine.

Click here to read the full article. 

 

Filed Under: Health Insurance, Medical Costs

What is Hospital Observation and Are You Covered?

July 15, 2026 By Insurance Experts

How Do I Know if I’ve Been Assigned Observation Status or Inpatient Status?

Hospital observation services are short-term outpatient services received when you are in the hospital for monitoring purposes and/or to determine whether you should be admitted as an inpatient. It is important to know that if you are receiving observation services (sometimes referred to as under observation status), you have not been formally admitted to the hospital as an inpatient, even if you are given a room or stay overnight.

This makes it difficult for you to tell if you’re an inpatient or an observation patient. You can’t assume that, just because you’re in a regular hospital room or in a hospital bed rather than on a gurney, you’re an inpatient. Your doctor or attending medical staff would be able to inform you.

Nor can you assume since you’ve been in the hospital for a few days you’re an inpatient. Although observation is intended for short periods of time, it doesn’t always work that way. For example, you go to the emergency room for stomach pain, after a diagnostic blood tests and or imaging/x-rays, there is no conclusive diagnosis and the doctor places you into observation for an overnight stay.

Most private insurance plans do not cover observation. That is why it is important for you to ask the doctor or medical staff if you are being placed in observation or admitted as an inpatient.

However, there is a supplemental plan that can help pay for hospital observation. Contact me for more information.

Filed Under: Health Insurance

Retirement

July 9, 2026 By Insurance Experts

You don’t have to put off retirement due to health insurance costs. There are many affordable options for health insurance after corporate group insurance. Currently private health insurance plans consist of the Affordable Care Act Plans (most costly), Short Term Plans that offer coverage from 30 days to 12 months (soon to be 36 months) and Indemnity Permanent Plans with zero or low deductibles that provide unlimited hospitalization benefits. The advantage of private health insurance is that you can customize the plans to fit your needs and budget. Contact me with questions!

Filed Under: Affordable Care Act, Health Insurance, Medicare

Thank you for your Life-Saving Gifts!

June 14, 2026 By Insurance Experts

Every unit of donated blood potentially saves a life. Around the world, blood and blood products help patients suffer less from lift-threatening conditions. This enables them to live longer with a higher quality of life. TV shows like the Korean War’s MASH to present day CODE BLACK demonstrate how quickly emergency situations consume units of blood. Yes, these programs are good entertainment. They also highlight the importance of readily available, safe blood products.

We thank blood donors around the world who make this possible. Their regular contributions are our only means of having an adequate blood supply. But even with their help, many countries continue to have shortages.

World Blood Donor Day globally celebrates donor contributions and raises the awareness of the need for more. The World Health Organization (WHO) designates June 14th as the day to honor Dr. Karl Landsteiner. He discovered the main blood groups in 1900 which now allows blood to be transfused with greater safety. We thank him… and every individual who donates… the chance of longer life with better health.

For more information, contact: World Health Organization,  202.974.3000,  www.who.int

 

 

 

 

 

Filed Under: Health Insurance

Small Business Health Insurance Options

April 14, 2026 By Insurance Experts

Amy Penna, in her article “Small business health insurance: The state of the market and what small businesses are doing about it”, states:

“You don’t have to look hard to find evidence that group health insurance has become prohibitively expensive for small businesses with fewer than 50 full-time employees. As we’ve reported in the past, annual group health insurance premiums in 2017 for small businesses were $6,486 for single coverage and $17,615 for family coverage. 

Additionally, traditional group health benefits come with other costs that can stretch a company’s budget. The cost to administer group health benefits adds up to over $12,000each year. With figures like these, it’s no wonder that the number of small businesses offering group health insurance has declined by 25 percent since 2010. Currently, less than half of small businesses offer any kind of health insurance to their workers.”  

Many small businesses would like to offer health insurance benefits but finding traditional group insurance is too expensive. There are alternatives solutions such as a taxable wage increase or tax-free personalized benefits (QSEHRA) and other options that benefit both the employer and the employee in these ways:

  • The health insurance plan belongs to the employee and, in the event, the employee leaves employment, they are not without health insurance nor are they subject to the high cost of COBRA.
  • The employee has more options to customize their health insurance to fit their needs and budget.
  • The employer is not involved with the annual task of reviewing health insurance plan benefits. As one employer recently stated, “I can be out of the business of health insurance and not feel pressured on making the right plan options for my employees. I have also been the person they come to when they are not happy with their insurance. It is a great relief not to have to deal with those issues.”

The Taxable Wage Increase method increases employee’s wages so they can afford to purchase a health plan. On the company side, business owners don’t have to worry about playing middleman between the insurance company and their employees. On the other hand, the employee pays income tax on the increased wages. However, the premium can be lower than that of a group plan premium so the employee still comes out financially ahead and they have a health insurance plan customized to their needs.

The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) also known as a small business HRA, is a company-funded, tax-free health benefit used to reimburse employees for personal health care expenses. The business must establish legal QSEHRA plan documents, including a summary plan description to comply with IRS and Department of Labor requirements.

Filed Under: Health Insurance

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News

  • Surprise Medical Bills
  • 4 Ways to Thrive As We Age
  • The Eyes Have It!
  • What is Hospital Observation and Are You Covered?

Talk to an Expert

Are you unhappy with your health insurance premium? Are your employers paid health insurance premiums too expensive? Are you self-employed and looking for affordable health insurance? Are you in a job transition and don’t where to go for health insurance? Are you working in a corporate job just for the health insurance benefits? If you answered “yes” to any of these, I can help you.

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