Insurance Blog Articles

Balancing the Books: Navigating Rising Pharmacy Costs in Your Group Health Plan

Rising pharmacy costs, particularly for specialty drugs and GLP-1s, are creating an "affordability crunch" for small businesses. At Lourie Life & Health, we understand and provide more than just insurance; we offer strategic consulting to keep your employee benefits sustainable. From traditional, level-funded plans and ICHRAs to supplemental "gap" coverage, we can help you navigate complex pharmacy models and funding structures to protect your bottom line while providing quality care for your employees.

Balancing the Books: Navigating Rising Pharmacy Costs in Your Group Health Plan

Rising pharmacy costs, particularly for specialty drugs and GLP-1s, are creating an "affordability crunch" for small businesses. At Lourie Life & Health, we understand and provide more than just insurance; we offer strategic consulting to keep your employee benefits sustainable. From traditional, level-funded plans and ICHRAs to supplemental "gap" coverage, we can help you navigate complex pharmacy models and funding structures to protect your bottom line while providing quality care for your employees.

Balancing the Books: Navigating Rising Pharmacy Costs in Your Group Health Plan

Rising pharmacy costs, particularly for specialty drugs and GLP-1s, are creating an "affordability crunch" for small businesses. At Lourie Life & Health, we understand and provide more than just insurance; we offer strategic consulting to keep your employee benefits sustainable. From traditional, level-funded plans and ICHRAs to supplemental "gap" coverage, we can help you navigate complex pharmacy models and funding structures to protect your bottom line while providing quality care for your employees.

Balancing the Books: Navigating Rising Pharmacy Costs in Your Group Health Plan

Rising pharmacy costs, particularly for specialty drugs and GLP-1s, are creating an "affordability crunch" for small businesses. At Lourie Life & Health, we understand and provide more than just insurance; we offer strategic consulting to keep your employee benefits sustainable. From traditional, level-funded plans and ICHRAs to supplemental "gap" coverage, we can help you navigate complex pharmacy models and funding structures to protect your bottom line while providing quality care for your employees.

Balancing the Books: Navigating Rising Pharmacy Costs in Your Group Health Plan

Rising pharmacy costs, particularly for specialty drugs and GLP-1s, are creating an "affordability crunch" for small businesses. At Lourie Life & Health, we understand and provide more than just insurance; we offer strategic consulting to keep your employee benefits sustainable. From traditional, level-funded plans and ICHRAs to supplemental "gap" coverage, we can help you navigate complex pharmacy models and funding structures to protect your bottom line while providing quality care for your employees.

Understanding Funeral Costs: Why reviewing your options with Lourie Life & Health matters

When a loved one passes away, families should be allowed the space to grieve and honor their memory. Unfortunately, many are instead faced with immediate and unexpected financial pressure. Final expense insurance—often called burial or funeral insurance—is a simple, affordable way to ensure those costs are covered. But what happens if you don’t have a plan in place?

At Lourie Life & Health, we believe in protecting your family’s financial future. Understanding the realities of end-of-life expenses is the first step in making sure your loved ones aren’t left with a heavy burden.

Protecting Your Income, Your Business, and Your Family’s Financial Future

Being self-employed brings many rewards: flexibility, independence, and the satisfaction of building something that’s your own. But it also means you’re responsible for more than just your daily tasks—you’re responsible for protecting your family from financial hardship if the unexpected happens.

At Lourie Life & Health, we specialize in helping entrepreneurs and small business owners navigate these unique challenges. Unlike working for a large company, self-employed individuals don’t receive automatic benefits. If you haven’t reviewed your life coverage, you may be leaving a serious gap in your financial safety net.

Are you looking for more affordable ways to offer group health insurance?

As a small business owner, offering health insurance to your employees can be a great way to attract and retain top talent. But we know it’s not always easy to navigate the options—especially when you want to keep costs manageable and have the flexibility to fit your business’s unique needs.

At Lourie Life & Health, we’re here to help you find the best health insurance solutions that work for both you and your employees. Whether you're just starting to explore options or you’re looking for more control over your costs, we’ve got you covered.

Understanding ACA Subsidies and $0 Premium Plans

Health insurance can be expensive, but thanks to the Affordable Care Act (ACA), there’s a way to make it more affordable for millions of Americans. If you’ve heard about ACA subsidies and $0 premium plans but aren’t sure how they work, you’re not alone! We’re here to help break it down and explain how you could save on your health coverage.

How Does a Health Insurance Policy Work? | Health Insurance Terms Explained

Trying to navigate the ins and outs of health insurance can sometimes feel like a whole new language, but understanding a few key terms is the first step toward making the most of your coverage. At Lourie Life & Health, we’re here to help you break it all down, so you can feel confident about your health insurance choices.

Understanding Health Insurance & The Basics of the Affordable Care Act (ACA)

Navigating health insurance can be overwhelming, but the Affordable Care Act (ACA) offers important protections and opportunities for many individuals and families. That’s why our team is here to break down how the ACA works and how it can benefit you.

Are You Working Past 65? Discover How Employer Coverage Affects Medicare Enrollment

Are you or your spouse planning to continue working past age 65 and will still be covered by an employer health plan? You might be wondering how Medicare fits into the picture, and we’re here to help you understand how to make the right decision for you and your family.

Medicare Supplement vs. Medicare Advantage (Part C): What’s the Difference?

How & When to Enroll in Medicare: A Simple Guide from Lourie Life & Health

Turning 65 and becoming eligible for Medicare is an important milestone, but figuring out how and when to enroll can feel overwhelming. At Lourie Life & Health, we’re here to guide you through the process so you can make informed decisions about your health coverage! Let’s talk Medicare enrollment: When you need to and what you’ll need for the process.

Understanding Medicare Enrollment Periods: Your Guide to Choosing the Right Plan

Navigating Medicare can feel overwhelming, especially when it comes to knowing when and how to enroll in or change your coverage plan. At Lourie Life & Health, we’re here to help simplify the process for you!

Entender el seguro de salud y los fundamentos de la Ley del Cuidado de Salud a Bajo Precio (ACA)

Navegar por el seguro de salud puede ser abrumador, pero la Ley del Cuidado de Salud a Bajo Precio (ACA) ofrece importantes protecciones y oportunidades para muchas personas y familias. Es por eso que nuestro equipo está aquí para desglosar cómo funciona la ACA y cómo puede beneficiarle.

Medicare Supplement Plans: Filling the Gaps in Original Medicare

If you’re navigating Medicare, you might be wondering how to cover the out-of-pocket costs that Original Medicare doesn’t fully cover, like co-pays, co-insurance, and deductibles. That’s where Medicare Supplement Plans (also known as Medigap) come in. Keep reading to learn more about Medicare Supplement Plan basics, so you can make an informed decision that’s right for you!

Major Health Insurers To Streamline Prior Authorization

The major US health plans have recently announced that they are working on steps to speed up the prior authorization process. Consumers have complained for years that it takes too long to get a procedure or special medication approved. We are excited to see this happen as it will be a major win for our clients. Read this article to learn more. 

Scammers Are Targeting Grandparents—Here’s How to Stay One Step Ahead

Imagine getting a call in the middle of the night from someone claiming to be your grandchild, panicked and in trouble. They say they’ve been in an accident or arrested—and they desperately need money. Your heart races. You’d do anything to help. That’s exactly what scammers are counting on. The Federal Communications Commission (FCC) has recently issued a warning about a rise in what's known as the “grandparent scam”—a sneaky and heartless scheme targeting older adults with urgent, emotional phone calls meant to trick them into sending money.

Medicare Advantage (Part C) Explained: An all in one Medicare plan.

If you’re eligible for Medicare, you’ve probably heard of Medicare Advantage (Part C). At Lourie Life & Health, our team is driven to help you understand how it works and whether it’s the right choice for you. Keep reading to learn what Medicare Advantage is, how the benefits work, and why it might be a good option if you’re looking for an all-in-one Medicare plan.

Medicare Basics: Understanding Parts A, B, C, and D

If you're approaching the age of 65 or are newly eligible for Medicare, understanding the basics of the program is essential for making informed decisions about your health care coverage. At Lourie Life & Health, we’re here to simplify Medicare and guide you through the process so you can feel confident about your insurance decision. Here’s a short and sweet breakdown of the four basic parts of Medicare: A, B, C, and D.

The Personal Economic Impact of Medical Costs

When a study published in the National Library of Medicine surveyed 910 people who had undergone bankruptcy, it revealed the true impact of medical expenses and strains on the economic lives of everyday Americans. The majority of respondents, 58.5%, said they “very much or somewhat agree” that medical expenses served as a contributor to their bankruptcy.

2025 Medicare Prescription Drug Cap

Starting January 1, a new $2,000 out-of-pocket spending cap for prescription drugs is in effect for Medicare Part D beneficiaries, expecting to save millions of seniors an average of $400 per year. The cap applies to all Medicare Part D plans and Medicare Advantage plans that include prescription drug coverage. This change also eliminates the "donut hole" or coverage gap. The cap covers medications within a plan's formulary, including deductibles, copayments, and coinsurance, but does not include drugs outside the formulary, those covered by Medicare Part B, or Part D premiums. Read more here

2025 Medicare Annual Enrollment Period (Oct 15 – Dec 7) - Service Area Reductions in South Carolina

As the 2025 Annual Enrollment Period (AEP) approaches, Medicare beneficiaries across South Carolina, and most of the country, will face significant disruptions due to service area reductions (SARs) from major Medicare Advantage insurance companies. In our state, these disruptions affect all 46 counties. Thousands of members will lose access to their current plans.

Medicare Drug Prices 2026

Medicare Drug Prices: The Biden administration announced today the first Medicare drug price negotiations, resulting in a $6 billion savings across 10 drugs to take effect in 2026. Read more here.

Nursing Home Options

Medicare.gov has a feature that allows you to find and compare Medicare-certified nursing homes based on a location and compare the quality of care they provide and their staffing. This is a great tool that may be useful for your clients. Check it out here.

Fewer Americans are buying life insurance. Here’s when you might need it.

According to a recent CNBC article by Greg Iacurci, less American households own life insurance than in any period over the last 25 years. There are many reasons to consider life insurance; mortgage protection, final expenses, and debt payoff are just a few. Give us a call to learn more.

Out-of-pocket cost of some asthma inhalers has been capped at $35 a month.

Great news! As of June 1, the out-of-pocket cost of some asthma inhalers has been capped at $35 a month. Find out more by clicking here

Did you know that Medicare covers many preventive health services?

At no cost to the member, Medicare covers a wide range of preventive screenings. This includes tests for heart disease, colorectal cancer, Hepatitis, lung cancer, HIV, mammograms and more. 

Medicaid Debt Leads to Poor Health & Premature Death

According to a report posted by the Association of Health Care Journalists, U.S. consumers are more likely to have worse health status and higher rates of mortality when they have medical debt in collections. Read more here.

Medicaid Unwinding SEP Extended

CMS has extended the Special Enrollment Period for individuals and families who lost Medicaid or CHIP coverage due to Medicaid unwinding. The new deadline has been extended to November 30, 2024. Please click here for more information.

Ozempic Coverage

What Is The Health Insurance Marketplace?

Check out this great article in Forbes Advisor explaining how the Health Insurance Marketplace works. 

Medicare Advantage Enrollment Growth

Medicare Advantage Enrollment Growth: For the first time in Medicare’s history, more than half of all eligible people with Medicare, or 30.8 million people in 2023, are enrolled in private Medicare Advantage plans. Check out this article by KFF for more info.

Free COVID Tests

Free Covid Tests: Don’t forget that you can order four free Covid tests. With the uptick in cases, this would be a good time to do so. Order here.

Why use a local agent when looking at Medicare or Health Insurance options?

You cannot turn on the TV or open your computer without seeing dozens of celebrities or actors talking about some great benefits that you may be missing with your health coverage. You’re then directed to a call center, and that’s where things can go wrong. Read Article >>

What Should You Consider During the Medicare Annual Enrollment Period?

There’s still time…
The Medicare Annual Enrollment period runs from October 15 – December 7. This is a very important time of the year when you should review your Medicare plan and make changes where necessary. Read Article >>

Keep your Summer Sweet and Don’t Overheat

This year’s summer hot spell has hit record numbers. Extreme heat temperatures can be dangerous for everyone, young or old. Do not let the summer heat stop you from enjoying your summer. We are so busy trying to stay cool, that we forget the harshness of heat stress and...

The Sun, Summer and Your Skin

As summer approaches we must remember, that as great as the sun feels on our skin, we need to remember the sun can produce harmful rays that can burn our skin. Although the spots and moles on our skin may be painless and small, they should not be ignored. You should always...

5 Reasons To Get A Colonoscopy This Month

March is National Colorectal Cancer Awareness Month. To help end the rising number of colon cancer diagnoses, we must start with prevention. Here are 5 reasons to schedule a colonoscopy this month.   5. Colorectal cancer is the 2nd leading cause of cancer-related...

Time for a Life Insurance Checkup

Change is Constant in Life One thing that is a constant in life is change.  Our bodies change, our health changes, our income changes, our family size changes, our friends change, cars, homes and so much more. When it comes to your life insurance, your priorities and...