3 tips to prevent surprise medical bills

surprise medical billsMy 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

Annual exams vs. annual wellness visits

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

Choosing Wisely – Use less healthcare

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

Election day and healthcare 2016

american-flagI started this blog four years ago, the day after President Obama won the general election. I needed an instrument to give voice to my frustrations and fears about the direction of our country’s health and healthcare policy.

I just re-read what I wrote back then:

So, the Affordable Care Act (ACA or Obamacare, as it’s commonly known), having survived its precipitous birth and a few close-calls with death, is poised to enter a prolonged and awkward adolescence.

I am not a huge fan of Obamacare because it seems to be more health insurance reform than health care reform.

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View Prevnar 13 ads with caution

prevnar 13Prevnar 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

Obamacare premium increases for 2017

Up, up and away!

Does anyone’s income go up as fast as their health insurance premium? I wish.

11.6%. That’s how much more my current health insurance provider wants to charge for my bronze high-deductible health plan in 2017.

And although 11.6% seems like a lot to me, another company in my state is requesting a 19.9% average increase on all its plans, with a 28% increase on its gold plan!

So far, the rate increases that have been made public in other states are all pretty high, averaging well into the double digits. So at least I’m not … Continue reading

Be informed – Shared decision-making

Shared decision-making makes better informed patients, and better informed patients use less health care.

…as many as 20% of patients who participate in shared decision making choose less invasive surgical options and more conservative treatment than do patients who do not use decision aids.

Which lowers health care costs.

…a 2012 study…showed that providing decision aids to patients eligible for hip and knee replacements substantially reduced both surgery rates and costs — with up to 38% fewer surgeries and savings of 12 to 21% over 6 months.

[It’s] estimated that implementing shared decision making for just 11 procedures would

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Harken Health – Betting on primary care

I just read about health insurance giant UnitedHealth’s bold but risky new insurance plan, Harken Health:

UnitedHealthcare is betting $65 million that it can profit by making primary care more attractive.

With little fanfare, the nation’s largest health insurer launched an independent subsidiary in January that offers unlimited free doctor visits and 24/7 access by phone. Every member gets a personal health coach to nudge them toward their goals, such as losing weight or exercising more. Mental health counseling is also provided, as are yoga, cooking and acupuncture classes.

At this time, Harken Health is only available in Chicago … Continue reading

Will Congress fight the high cost of prescription drugs?

Last November, with much media coverage, several members of Congress announced the formation of The Affordable Drug Pricing Task Force, promising to “take action to combat the skyrocketing costs of pharmaceuticals.”

Finally! I thought.

Related post: Prices continue to increase for generics

But I haven’t heard much since then.

There was a little noise earlier this month when the House Oversight Committee (of which the task force is a subcommittee, I believe) attempted to grill the now infamous Martin Shkreli about why he thought it was okay to jack up the price of Daraprim from $13 a pill to … Continue reading

New adult vaccination guidelines

The Advisory Committee for Immunization Practices (ACIP) and the Centers for Disease Control (CDC) have just released an updated vaccination schedule for adults.

I’ve included the schedule and accompanying information from the CDC’s website at the end of this post.

You can also print it out to take to your primary care provider.

Related post: Adults need vaccinations, too!

It’s color coded to make it easier to follow the recommendations, and I think it’s an improvement over last year’s chart.

A yellow row/column means the vaccine is recommended for everybody in that age group; purple indicates the vaccine is for … Continue reading

The “financial toxicity” of cancer

We’ve all heard the phrase “cancer kills.”

But guess what? So can the high cost of treatment.

I just read about a study that came out of the Fred Hutchison Cancer Research Center here in Seattle.

The results won’t surprise anyone familiar with how much cancer treatment costs (a lot!), but researchers found:

…cancer patients who go bankrupt are nearly 80 percent more likely to die than patients who don’t, and some cancers had significantly higher mortality rates. Prostate cancer patients who filed for bankruptcy were almost twice as likely to die; bankrupt colorectal cancer patients were 2.5 times more

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How narrow networks limit access

The health care blog KevinMD is a great place to read firsthand accounts of how our expensive and fragmented health care system really works (or doesn’t).

Last week I read a post by a physician who described his friend’s experience of trying to get treated for an ordinary but painful kidney stone. (I’ve never had one, but I’ve been told they are extremely painful!)

Sadly, his friend had a narrow-network insurance plan and he wasn’t able to find either an in-network specialist—urologist—or the specialized treatment that would alleviate his pain.

So here was Jeremy, an insured, otherwise healthy patient in

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Health insurance literacy – It’s not easy

Health insurance literacy is a term that has been used a lot in the media since the Affordable Care Act (ACA) rolled out a few years ago.

It basically means how fully a person understands how his or her health insurance works, as well as the lexicon of insurance-speak: words and acronyms like coinsurance, copay, deductible, premium, subsidy, provider, allowed amount, out-of-pocket maximum, balance billing, HSA, FSA, HMO, PPO, EPO, PCP, and so on.

If only people understood their health insurance, the experts moan, they would make better health choices and protect themselves financially.

I’m sure that’s true, but … Continue reading

Cost sharing and narrow networks

It’s that time of year—open enrollment for health insurance.

If, like me, you buy an individual health plan for yourself or your family, and you have been informed by your insurance company that your current plan will no longer be available, you are once again shopping for a plan that meets both your needs and budget.

The new plan I’ve been offered has both a higher premium and a higher deductible, but as far as I can tell our provider network will remain the same. That’s important, since my husband has a doctor he really likes. I had to change … Continue reading

The FDA wants new sugar rules

It’s not too late to give the Food and Drug Administration (FDA) your opinion on its latest effort to require that more information be provided on food labels.

Last year, food labels began listing the amount of added sugar per serving (usually listed in grams).

Now the FDA proposes that labels also show sugar as a percentage of the recommended daily intake or value (%DV). Labels already do this for most vitamins and minerals, fats, fiber and sodium.

Sugar’s %DV would be based on the US Dietary Guidelines Advisory Committee’s recent recommendation  that people limit sugar to 10% of their … Continue reading