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Unlocking Affordable Healthcare: A Look at Allstate Health Access

In a world full of “what ifs,” healthcare can often feel like a puzzle. “What if I get sick or injured?” or “What if unexpected costs arise?” are common concerns that can leave us wondering about our coverage. Allstate Health Access aims to address these worries with its fixed-benefit insurance plans, offering an affordable and predictable way to manage everyday healthcare expenses.

 

What is Allstate Health Access?

Allstate Health Access provides fixed-benefit insurance, meaning you choose a set dollar amount upfront, and they’ll pay covered expenses for that plan year. A key advantage is that there are no deductibles or copays; you simply cover any costs above the chosen dollar amount. This approach makes managing healthcare costs more predictable.

While Allstate Health Access is most effective when combined with a major medical plan, it can also serve as minimum coverage if a major medical plan isn’t an affordable option. This flexibility allows you to get coverage at a cost that suits your budget.

Key Benefits and Features:

Predictable Payments: You know exactly what your plan will pay for various services, including office visits, lab tests, and hospitalization. Plus, premium rates are guaranteed for three years on all plans.

Short Waiting Periods: You get immediate benefits for injury and sickness, with a 90-day waiting period for preventative care.

Adult and Child Options: Coverage is available for all ages up to 65, with child-only plans also offered in most states.Flexibility and Renewability: You can apply anytime, and plans auto-renew, with some benefits increasing annually.

No Maximums: There are no annual or lifetime maximum caps on benefits.

First Health Network Access: Allstate Health Access plans provide access to the First Health Network, which includes 5,300 hospitals, 100,000 ancillary facilities, and 695,000 doctors and healthcare providers, offering discounts on covered services. There are no penalties for seeing out-of-network providers; the plan pays the same dollar amount regardless.

Recuro Health Virtual Care: Members have access to 24/7 virtual urgent care with zero out-of-pocket costs for conditions like colds, flu, and rashes.

Recuro Health Prescription Benefit: This includes a $0 copay for chronic conditions and urgent care medications, accepted at over 65,000 retail pharmacies nationwide. It offers a prescription benefit card, medication delivery, a national pharmacy network, and an easy-to-use member portal.

Understanding How the Plan Works:

Allstate Health Access plans pay set benefits for covered services. For example, for a preventative office visit, if the total cost after a network discount is $268.00, a Core plan might provide a total benefit of $185.00, leaving you with a balance of $83.00. For a Plus plan, the total benefit might be $235.00, resulting in a $53.00 balance.

Similarly, for a rotator cuff surgery with a total cost of $9,360.00 after a network discount, a Core plan could offer a total benefit of $6,500.00 (covering surgery, assistant surgeon, anesthesia, and ambulatory surgical center benefits), leaving a balance of $2,860.00. A Plus plan might provide an $8,500.00 total benefit, reducing your balance to $860.00

For more details and a quote just reach to me:

Andy Orlikoff

623-742-3878

www.AZhealth.us

Navigating Cancer Costs: Why a Supplemental Plan Matters

A cancer diagnosis is a life-altering event. Beyond the emotional and physical toll, it often brings a significant financial burden that many are unprepared for. While your primary medical insurance covers a portion of treatment costs, out-of-pocket expenses can quickly accumulate, creating immense stress during an already challenging time.

This is where a supplemental cancer insurance plan can make a profound difference.

The Unseen Costs of Cancer

Nobody plans for cancer, but unfortunately, it’s a reality for many. Even with excellent health insurance, you might face unexpected costs such as:

How Supplemental Cancer Coverage Helps

Allstate Health Solutions has designed cancer coverage to work seamlessly with any existing medical plan, providing a crucial safety net. These plans are affordable, easy to understand, and incredibly easy to use.

The key benefit? Cash paid directly to you.

Upon a first-time cancer diagnosis, you receive a lump-sum cash benefit. This money is yours to use however you need it – whether it’s for medical bills, rent, groceries, transportation, or even to replace lost income. This direct cash infusion helps protect your finances and provides peace of mind, allowing you to focus on what truly matters: your recovery.

Benefits You Can Count On:

Imagine receiving a $50,000 cash benefit. Even after covering significant medical bills, a substantial portion could remain to help with mortgage payments, vehicle expenses, or other critical needs.

Secure Your Peace of Mind

No one can predict the future, but you can plan for the unexpected. A supplemental cancer plan offers a practical and compassionate way to protect your financial well-being and ensure you have the resources needed to navigate a cancer diagnosis with greater confidence.

Get a quote today: www.AZhealth.us or call Andy 623-742-3878

Prepare Now for Big ACA Changes Ahead

Major shifts are on the horizon for the Affordable Care Act (ACA) in 2026 — The Trump administration’s newly proposed rule introduces changes that could leave millions of Americans without viable coverage options or struggling to afford marketplace plans.

Here’s what’s ahead—and why Short-Term Medical (STM) insurance remains a smart, strategic choice, even as we await the potential reinstatement of the previous 3-year coverage option.

Open Enrollment is Shrinking

Year-Round Enrollment for Low-Income Americans May Disappear

Subsidy Rollbacks = Steep Premium Increases

Reduced Access to Enrollment Assistance

Reach out today to learn about options available to you:

American Insurance Benefits – Andy Orlikoff

www.AZhealth.us

623-742-3878

Located locally in Surprise Arizona, and serving the entire state.

Should You Ditch Your Medicare Advantage Plan? Most People Do

If you’re tempted to ditch your Medicare Advantage plan, you’re not alone. Here’s when it’s a good idea and how to go about it.

BY

A young female medical doctor is meeting with a senior female patient. She is smiling as she is looking at her patient.

Medicare coverage doesn’t just mean signing up for government insurance. In fact, more than half of Medicare recipients now get their coverage through a Medicare Advantage plan, or Medicare Part C plan, which is offered by a private insurer.

Advantage plans are an alternative to original Medicare, replacing Part A (hospital coverage), Part B (outpatient care coverage), and sometimes Part D (prescription drug coverage).

Enrollment in these plans is expected to grow to 60% of the eligible population by 2030, with many people drawn to them because they’re often marketed as “zero premium” plans with out-of-pocket limits, while Medicare Part B has uncapped spending and charges premiums. The Trump administration strongly favors the expansion of Medicare Advantage plans.

Yet, while Advantage Plans seem like a good alternative, a substantial number of older Americans who sign up for them don’t stick with them. In fact, among those who signed up between 2011 and 2022, around half left their plans within five years.

Recent research published in the journal Health Affairs helps demonstrate why so many are opting out of their Advantage Plan during open enrollment, either by switching to a different Part C plan or by returning to traditional Medicare instead. Since these Advantage plans are less likely to attract beneficiaries over the long term, the study warns that such plans will likely have less incentive to cater to participants with chronic conditions.

Should you ditch your Medicare Advantage plan? Why others are

Researchers sought to gain insight into why Medicare Advantage participants were disenrolling by using information from the Medicare Current Beneficiary Survey, linked with data on Medicare Advantage enrollment. The survey measures patient satisfaction with access to medical care, as well as the cost and quality of the care they receive.

Researchers found two primary factors drove departures from Medicare Advantage plans, and neither was related to cost. Instead, most people who disenrolled did so because of difficulty accessing care as well as concerns about the quality of their care.

Access issues, in particular, were especially likely to prompt Advantage customers not just to switch to a different Medicare Part C plan but instead to return to traditional Medicare. This makes sense, given that traditional Medicare doesn’t impose the same limits as Advantage Plans on which doctors or care providers patients can visit.

Hospitals have also been ending their affiliations with Medicare Advantage Plans, creating huge problems when break-ups happen outside of the open enrollment period, and Advantage Plan customers suddenly find themselves without coverage at the hospital where they’d been treated.

Researchers also revealed that individuals with health issues were more likely to switch out of their Medicare Advantage plan. Those who described themselves as being in poor health were:

  • More than twice as likely as other Advantage members to express difficulty with getting care;
  • More than three times as likely to be dissatisfied with the quality of care they are getting
  • More than twice as likely to be unhappy with the cost of their care
  • More than twice as likely to be dissatisfied with their specialty care.

“People who stay in [Medicare Advantage} are shopping for better service, but … those who switch to traditional Medicare are the ones potentially with high health care needs, who are much more strongly driven by dissatisfaction with access to care issues ” said Geoffrey Hoffman, Ph.D., Associate Professor, U-M School of Nursing and one of the study’s authors.

This tendency to switch between Advantage plans or back to original Medicare could undermine the long-term effectiveness of these plans while also driving up the nation’s cost to provide original Medicare. The study warns that Advantage plans will likely focus on the short-term healthcare needs of beneficiaries due to plan hopping.

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UnitedHealth’s collapse reveals the flaw at the heart of Medicare Advantage

The nation’s largest insurer is stumbling from crisis to crisis.

In early April, market analysts touted UnitedHealth Group as a “tariff safe haven.”And why not? The Trump administration had just announced an increase in payments to Medicare Advantage plans in 2026. Surely profits would likewise increase for UnitedHealth — not only the nation’s largest insurer, but specifically the largest provider of Medicare Advantage plans.

But, less than two months later, the company is in a state of free fall. Its collapse reflects not simply the troubles of the broader health care market, but also the troubles with Medicare Advantage, the program set up with the idea that the private sector could provide better health care than traditional Medicare at lower prices.

The company faces three federal investigations.

Instead, Medicare Advantage has only succeeded at juicing corporate profits, charging more — and denying more care — than traditional Medicare. And as for UnitedHealth Group, it’s looking quite possible the company’s bottom line was padded by billing fraud and patient abuse.

The company faces three federal investigations, looking at allegations of civil and criminal fraud and antitrust violations. The Wall Street Journal reported in February, for instance, that the DOJ is investigating whether UnitedHealth made its clinician employees record questionable diagnoses that make Medicare Advantage patients appear sicker than they are. This practice, known as “upcoding,” triggered extra federal payments. (UnitedHealth told the Journal it stands “by the integrity of our Medicare Advantage program.”)

And last week The Guardian alleged the company secretly paid nursing homes to prevent or delay transfers of Medicare Advantage patients to hospitals, something that saved the insurance giant money — but cost patients desperately needed care.

“At least one lived with permanent brain damage following his delayed transfer,” The Guardian reported, “according to a confidential nursing home incident log, recordings and photo evidence.” Five current and former UnitedHealth employees told The Guardian that the company “pressed nurse practitioners to persuade Medicare Advantage members to change their ‘code status’ to DNR” – or “do not resuscitate” — rendering them ineligible for “certain life-saving treatments that might lead to costly hospital stays.” (UnitedHealth denied the allegations.)

Somehow, that’s not the end of UnitedHealth’s troubles. A group of investors recently sued the company, claiming it had misled them about its financial outlook following the fatal shooting of Brian Thompson, CEO of UnitedHealthcare, UnitedHealth Group’s insurance arm. (UnitedHealth denied the lawsuit’s allegations.) In mid-May, UnitedHealth Group CEO Andrew Witty suddenly resigned for “personal reasons,” and the company withdrew its earnings guidance to Wall Street for 2025 after a disastrous first quarter, claiming it had underestimated its Medicare Advantage costs.

Because UnitedHealth is vertically integrated, it simultaneously pays for care through UnitedHealthcare and provides care through its health care services arm Optum, which includes both physician practices and pharmacies. This setup gives the conglomerate enormous leverage to dictate which claims are covered, which physicians patients can see and which medications are prescribed to them.

UnitedHealth’s Medicare Advantage strategy has proven very lucrative — until now.

Moreover, UnitedHealth also reimburses its own physician practices and pharmacies much more than competitors. A recent Federal Trade Commission report found the average markup could be more than 7,700%. This systematic under-reimbursement leaves independent physician practices struggling to keep their doors open, and some then sell to Optum, reinforcing UnitedHealth Group’s monopoly power. Disparate payments likewise squeeze independent pharmacies out of business, stranding patients in care deserts.

Ethics aside, UnitedHealth’s Medicare Advantage strategy has proven very lucrative — until now. Since 2003, its annual revenue has increased nearly 15 times over — to $372 billion last year — and its Fortune ranking has climbed 59 spots, to fourth. This strategy also inspired competitors — including CVS Health’s Aetna, Elevance Health’s Anthem, and Humana — to pursue a similarly vertically-integrated business model and Medicare Advantage billing practices. Early this month, the Justice Department sued all three for allegedly paying brokers hundreds of millions of dollars to steer older Americans to their Medicare Advantage plans — and to steer clear of potential enrollees with disabilities. (The companies have said they will fight the allegations.)

Older Americans are drawn to Medicare Advantage because most plans offer supplemental benefits, such as vision and dental coverage, and lower cost-sharing requirements than traditional Medicare. It’s not until they require lifesaving medical care that the program’s disadvantages — including rampant denials — reveal themselves.

For more than two decades, patients and taxpayers have paid a steep price for the Medicare Advantage grift. Only in the last few weeks, though, have shareholders felt any sort of pinch from Medicare Advantage. Finally, it seems UnitedHealth Group’s size and business model may be liabilities rather than assets.

Although the Trump administration plans to hike Medicare Advantage payments next year, plans are still reeling from a Biden administration rule that limited upcoding. UnitedHealth Group also floundered because, as mentioned earlier, Medicare Advantage costs exceeded expectations. More specifically, patients sought more care than expected during the first three months of the year, perhaps in part because of pent-up post-pandemic demand. Regardless of the reason, UnitedHealth had to provide more service, as The Wall Street Journal explained, both as an insurer paying for claims and as a provider “absorbing the higher cost of delivering that care.”

A growing number of members of Congress from both parties are sounding the alarm.

This is the fundamental flaw at the heart of Medicare Advantage. Plans are beholden to shareholders, who seek short-term profits. Profits are only achievable through the widespread denial of care. Meanwhile, plans use these profits to buy up entities along the health care supply chain, whose clinicians and other employees can do the insurance company’s bidding.

A growing number of members of Congress from both parties are sounding the alarm. Reps. Lloyd Doggett, D-Texas, and Greg Murphy, R-N.C., recently requested an investigation into private Medicare Advantage plans. Rep. Pat Ryan, D-N.Y., sent a letter to Attorney General Pam Bondi, urging her to hold UnitedHealth Group accountable. At a recent meeting of the Senate Judiciary Committee, several senators called for breaking up big insurers like UnitedHealth. Sen. Cory Booker, D-N.J., decried “a level of corporate violence that is costing American lives, a level of colossal greed at the expense of patient wellbeing.” Sen. Josh Hawley, R-Mo., echoed this sentiment. “Why shouldn’t we be breaking you guys up?” he asked. “[T]his looks like classic monopolist behavior. The patients are getting screwed. … You’re getting rich.”

Meanwhile, traditional Medicare chugs along, costing Americans 20% less than its for-profit rivals while besting them on a majority of care metrics. It turns out the federal government is a much better steward of taxpayer dollars than rapacious executives and shareholders. Yet, traditional Medicare now only covers a minority of Medicare patients.

It’s time to face the truth. Medicare Advantage — like all private health insurance — is structurally unsound. Nothing short of a complete overhaul can cure the U.S. health care system of this disease.

If you would like a quote on a true Medicare Supplement, please reach out to us!

Andy Orlikoff

623-742-3878 or [email protected]

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