…or mistakes I wish I hadn’t made
We are entering a new era in health insurance coverage and paying for health care. Kind of.
More people will have an opportunity to buy insurance through the new exchanges. However, we will also be expected to pay much more towards our care through considerably higher deductibles and co-pays.
And I suspect this is a trend that will spread to more and more insurance plans in the near future.
My family’s new deductible will be about $10,000, so I will be more motivated than ever to limit my health care expenses. But we’ve … Continue reading
An intriguing question
The other day I was complaining (again) about the steep hike in my insurance premiums when someone asked me, “Why don’t more people sign up for the health-sharing co-ops?”
“What do you mean,” I asked. “The new Obamacare CO-OPs?”
These non-profit health insurance companies received start-up grants and loans to provide more competition with not-for-profit and for-profit health insurance companies on the exchanges. They are available on about half of the exchanges. Their rates will still be comparable to other companies, though, because of the mandated benefit coverage (more benefits = higher premiums).
“No,” he said. “The … Continue reading
Tips to save money on dental care
If, like me, you buy an individual health plan, most likely it doesn’t cover dental (or vision) care.
I have priced buying separate dental coverage, but over an average year the premiums exceed any savings, so I have always chosen not to buy it.
Also, like me, if you are going to be faced with a steep rate hike for your medical insurance next year, you will not want to spend the extra money on a separate plan.
Pediatric dental care must be covered per Obamacare rules, but not adult dental, … Continue reading
The anticipated and dreaded letter . . .
. . . from my health insurance company finally arrived yesterday.
We are writing to let you know about some important changes to your individual health insurance coverage. . . . Your health insurance plan will no longer be available after December 31, 2013.
We very much want to continue serving you and so have selected a new ACA-compliant Regence plan for you. Your new plan has more benefits and a different price.
Wow. You bet it does. Looking at the enclosed rate sheet, I found my family’s new monthly … Continue reading
It’s all about the subsidies
Key to Obamacare are the subsidies or tax credits that low- and middle-income individuals and families will receive to help them pay for health insurance.
How these subsidies will work is pretty complicated, but what could you expect when two bureaucratic behemoths–health insurance and the IRS–are responsible for them?
It’s taken me ages to reach some level of understanding about the subsidies, but follow along with me and I’ll share what I know as clearly as possible.
Who is eligible?
The eligibility guidelines are straightforward:
- You do not receive or are eligible for (affordable) health
… Continue reading
Health insurance exchanges: Ready, set . . .
The health insurance exchanges, whether state or federally run, are set to open for business on October 1, or close to it.
For those who have never bought health insurance, or those who used to have insurance provided by an employer but will now be shopping on the exchanges, some of the basic concepts and definitions might be confusing.
It’s important to understand all the terms, however, so you can buy the best plan for your health needs and budget.
The biggest reform brought about by the Affordable Care Act is … Continue reading
Getting to know you
I started this blog a little less than a year ago. I was so frustrated by the decline in our health care system and the rise in costs. After listening to me vent my grievances on oh-so-many occasions, my friends and family finally suggested, “Why don’t you blog about it?” So I did.
And it’s been fun! But our health care system is still in decline and the costs are still climbing. And I’m still frustrated.
My real purpose behind the blog, I think, other than letting off some steam, was to start a conversation.
I’ve … Continue reading
Inflated hospital costs
I read an article in the New York Times yesterday that initially infuriated me. The journalist, Nina Bernstein, wrote something of an exposé on the outrageous hospital costs incurred by a group of about 100 people after suffering from an outbreak of food poisoning.
She focused on the fact that a bag of normal saline IV solution costs the hospital anywhere from $0.44 to $1.
Some of the patients’ bills would later include markups of 100 to 200 times the manufacturer’s price, not counting separate charges for “IV administration.” And on other bills, a bundled charge for
… Continue reading
Drugs costs might be higher for some
I was reading in the New York Times today about yet another delay of an Obamacare mandate.
This latest delay is regarding the new out-of-pocket(OOP) limits that insurers can charge consumers. In 2014, all plans are supposed to cap OOP costs, including the deductible, at $6,350 for an individual and $12,700 for a family.
Certain group health plans that carry separate policies for prescription drugs have been granted a one-year delay on these OOP caps (have they really not had enough time to make this work?). Such plans will have two separate… Continue reading
Obamacare kicks catastrophic plans to the curb
I read on Kaiser Health News this morning that when
ehealthinsurance.com began notifying people in non-grandfathered [catastrophic] plans that they would have to change policies next January, they got so many calls that they shut down the planned week-long email campaign after one day.
“The people that received the email were not happy at all,” says Carrie McLean, the website’s director of customer care.
Yes! I thought. That is my situation and I’m not happy, either.
Traditionally, insurance companies have offered catastrophic plans to individuals that are relatively healthy and use little health … Continue reading
As someone who advocates for less medical care, I’m always thrilled to see physicians and others in the health care industry step forward to protest over-testing, over-screening, over-diagnosing, over-treating and over-charging.
Here are some of my favorite health care blog posts and news articles from the last week.
Dr. Lamberts is embracing the newest trend in primary care: the direct-pay model. He does not accept health insurance, but rather charges a modest (age-based) monthly fee per patient. Booting the insurance companies not only lowers his overhead costs considerably, but frees him from so many … Continue reading
Shining a light on the physician-Big Pharma relationship
One of the little-known laws buried in the Affordable Care Act (ACA) is the Physician Payments Sunshine Act, which takes effect today.
I understand the impetus of this law, but I am less sure of its positive effect.
The Sunshine Act (the drafters no doubt had a mental image of exposing something slimy to the light) seeks to illuminate the financial relationships between doctors/teaching hospitals and drug companies/medical device manufacturers.
Conflicts of interest and questionable ethics have been problems for years as public funding has decreased and private industry money has … Continue reading
Physicians have a role in lowering health care costs
The Mayo Clinic has been busy this month.
Last week researchers published a report in the Journal of the American Medical Association (JAMA) titled “Views of US Physicians About Controlling Health Care Costs.”
Also last week, Mayo Clinic Proceedings published its conclusion that nearly 40% of current medical practices are of no net benefit and needlessly contribute to high health care costs.
The first study surveyed physicians’ attitudes about their role in reducing health care costs. Do they believe they can and should help rein in the cost of health … Continue reading
Dental health is important, isn’t it?
Starting in 2014, the Affordable Care Act (ACA) mandates that all insurance plans cover “essential health benefits,” including vision and dental benefits for children.
Obviously pediatric eye and dental health are important to the crafters of the ACA; but what about adults? We have eyes and teeth, too!
Even though many preventive services, such as annual exams, mammograms, and even breast pumps are covered, routine eye and dental exams are not.
I posted a few months ago that I thought it a shame that preventive vision care had received so little support in health … Continue reading
How much does good health cost? Apparently less than we are spending…
Once again, a study has shown that although Americans far outspend other countries on health care, our health is poor in comparison.
The healthiest citizens, no surprise, are in the wealthier cities and states, and vice versa. And it’s not because they can afford better health insurance. Other studies have linked education and income level to better lifestyle choices – diet and exercise – rather than access to health care.
In my opinion, we should be spending tax-payer dollars on all levels of education (Congress, what about … Continue reading