My peek into the future
Health insurance companies in my state finally submitted their requests for 2018 rate hikes.
Usually I can look up this info online by mid-May, but all the partisan and intra-party bickering over the future of healthcare in this country has left insurance companies scratching their figurative heads over how to price next year’s policies.
I remember a time when I never gave my health insurance much thought. Like my car or home insurance, it didn’t change much year to year, and was simply there when I needed it.
But for the last ten years or … Continue reading
My guest post today is from Matthew Bahr, a healthcare finance specialist.
I’ve posted about surprise medical bills before. Sadly, they are becoming more common as healthcare costs continue to rise and provider networks shrink.
Consumer Reports estimates about one third of patients with health insurance receive these unexpectedly high medical bills.
Thank you, Matthew, for sharing your tips and expertise with my readers! FN
Although we know healthcare costs a lot of money, it still stings when we see that bill.
You might think because you’re insured, your insurance will cover most or many of the costs. But … Continue reading
More tests = more money
Anyone who has read my blog over the years knows this is a subject I come back to again and again: the overuse of screening and diagnostic tests.
It’s a problem in our healthcare system for a couple of reasons.
First, the majority of healthcare providers are paid based on volume. In other words, the more patients they see, the more tests they run, the more surgeries they perform, then the more they get paid. It doesn’t matter if the outcome is poor, because they still get paid. In fact, they make even more money … Continue reading
This guest post is from a good friend of mine. She’s not in the healthcare industry, but she is one of the most savvy healthcare consumers I know. When she was telling me about some of her recent dealings with providers and insurance, I immediately asked her to write up her experiences to share with my readers!
I don’t willingly part with my money, especially when I see a healthcare provider.
I question unnecessary tests, and I don’t want the office staff to be cavalier about spending my money. I expect the office to be familiar with my insurance plan, … Continue reading
Happy New (Calendar) Year!
It’s the start of a new year or, in health insurance lingo, the start of a new calendar year deductible. I’m reposting this from last January, because this month is the best time to start trying to schedule that annual exam or annual wellness visit (it could take weeks, after all, to get an appointment!).
I usually advise people to get any screening tests or annual exams done early in the year, just in case an abnormality is found and more testing/treatment is necessary.
Especially with the current trend towards enormous deductibles (up to $14,300 for … Continue reading
Taxpayers footing the bill
I watched this on my local news the other night: Runaway drug price hikes squeeze Washington’s budget.
Our state is one that expanded Medicaid under the Affordable Care Act (ACA), so I knew we were spending a lot. But I had no idea now much. Through the first 9 months of 2016, my state has spent $1.1 billion on prescription drugs.
Not total medical care. Just prescription drugs.
And Washington is not the only state facing a fiscal nightmare because of skyrocketing drug costs.
Almost half of that spending is for the really high-priced specialty … Continue reading
My goal for 2017? Use as little healthcare as possible
How will healthcare change under a new president and political party?
That’s a question I can’t answer. As I wrote in my last post, both candidates had multiple-point plans to tweak/improve/repeal/replace the Affordable Care Act, aka the ACA or Obamacare.
But I don’t know what will change or when.
What I know for sure is that for 2017 my premiums will be 20% more expensive, my co-insurance and co-pays will be higher, and my current primary care doctor will no longer be in-network.
I can and will shop around … Continue reading
The shrinking drug formulary
Insurance companies have several ways to cut their costs.
We are all familiar with higher premiums, higher co-pays, increased deductibles, and narrower provider networks. These will all be apparent when we look at our policies for 2017.
A lesser-known strategy is to remove high-cost drugs from the drug formulary—the list of medications that insurance will cover.
Insurance companies typically work with a pharmacy benefits manager, or PBM, which acts as the middleman to negotiate drug prices with drugmakers.
Exploding drug costs
The Affordable Care Act made it mandatory that health insurance plans offer prescription drug … Continue reading
Prevnar 13: As seen on TV
I was watching TV the other evening and, as usual, was forced to sit through multiple back-to-back prescription drug commercials.
One that caught my attention was for Prevnar 13, which is one of the pneumonia vaccines. (13 because it protects against 13 strains of streptococcus pneumonia.)
The commercial stated Prevnar 13 was for adults aged 50 and older.
That statement’s true, but needs some clarification.
Yes, Pfizer did get FDA approval a few years ago to market Prevnar 13 to adults over the age of 50. Previously, the vaccine was only used for … Continue reading
Many years ago I had a primary care doctor who used to perform a total body skin examination (TBSE) on me every year as part of my annual exam.
Of course, those all-inclusive physicals are a thing of the past. I haven’t had a physician perform a TBSE for a long time.
I often wondered about that. A TBSE seems like a relatively easy and harmless way to quickly screen for skin cancer. The goal, of course, is to find a melanoma, the deadly skin cancer, when it’s small and possibly curable.
But the go-to source for screening … Continue reading