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New health plans expose the insured to more risk

March 20th, 2019 | Posted in Consumer Focus, Insurance Coverage

By Julie Appleby | Kaiser Health News One health plan from a well-known insurer promises lower premiums but warns that consumers may need to file their own claims and negotiate over charges from hospitals and doctors. Another does away with annual deductibles but requires policyholders to pay extra if they need certain surgeries and procedures. BothRead More

Analysis: Single-payer healthcare is not ‘one-size-fits-all’

February 20th, 2019 | Posted in Consumer Focus, Insurance Coverage

BY JACK O’BRIEN  |   HealthLeaders Media As some federal lawmakers and state legislatures consider implementing a single-payer healthcare system, there are numerous options across the spectrum available to them, according to researchers from RAND Corporation. With the growth of the Medicare-for-All Caucus on Capitol Hill and legislation pending in both California and New York, the proposal ofRead More

The high cost of sex: Insurers often don’t pay for drugs to treat problems

February 20th, 2019 | Posted in Consumer Focus, Insurance Coverage, Prescription Drug Coverage

By Michelle Andrews | Kaiser Health News For some older people, the joy of sex may be tempered by financial concerns: Can they afford the medications they need to improve their experience between the sheets? Medicare and many private insurers don’t cover drugs that are prescribed to treat problems people have engaging in sex. Recent developments,Read More

Who Is the Patient Advocate?

December 20th, 2018 | Posted in Advocacy 101, Business Development, Consumer Focus

By Megan Headley (The following article was originally published in December in HCPro’s Patient Safety and Quality Healthcare magazine for health professionals, and is a partner publication to DecisionHealth’s Patient Advocate Report.) If you think medical school is challenging, try navigating the labyrinth of medical challenges that chronic patients face. Sorting out payment, deciding amongRead More

Taking surprise medical bills to court

December 20th, 2018 | Posted in Advocacy 101, Consumer Focus, Insurance Coverage

By Julie Appleby | Kaiser Health News Joaquin Lopez had emergency gallbladder surgery after rushing to an ER last year. He has been haggling with Baptist Memorial Hospital in Memphis over what he owes ever since. The 37-year-old college professor was hit with a nearly $8,000 bill from the out-of-network hospital — that was after theRead More

Medicare Advantage riding high as new insurers flock to sell to seniors

October 17th, 2018 | Posted in Consumer Focus, Insurance Coverage

By Phil Galewitz | Kaiser Health News Health care experts widely expected the Affordable Care Act to hobble Medicare Advantage, the government-funded private health plans that millions of seniors have chosen as an alternative to original Medicare. To pay for expanding coverage to the uninsured, the 2010 law cut billions of dollars in federal payments toRead More

New Medicare Advantage Tool To Lower Drug Prices Puts Crimp In Patients’ Choices

September 18th, 2018 | Posted in Consumer Focus, Insurance Coverage, Prescription Drug Coverage

By Susan Jaffe | Kaiser Health News Starting next year, Medicare Advantage plans will be able to add restrictions on expensive, injectable drugs administered by doctors to treat cancer, rheumatoid arthritis, macular degeneration and other serious diseases. Under the new rules, these private Medicare insurance plans could require patients to try cheaper drugs first. If those are not effective,Read More