Every September brings updates in health insurance, and this year is no exception—especially when it comes to how major insurers are reimbursing for care. If you rely on lab tests, radiology, specialty medications, or certain surgeries, it’s important to be aware of the latest policy changes. Insurers are limiting lab test coverage, reducing radiology payments, phasing out incident-to billing, updating lab policies, revising surgery reimbursements, and making adjustments to Medicaid specialty medication and pharmacy coverage.
As someone who’s spent decades untangling this industry and making it clearer for Texans, I believe understanding these shifts is key to making confident decisions about your coverage—whether you’re an individual, family, or small business. My engineer’s mindset means I’m always comparing options and focusing on what delivers value, so I’ll be keeping a close eye on how these revised policies could affect your choices and your bottom line.