[…] David also points out that the amounts allowed by his Blue Cross Blue Shield carrier don’t seem to have anything to do with the amounts billed by his physical therapies – the lowest allowed amount on his EOB was for the service that was billed with the highest price tag. We’ve also seen little rhyme or reason (that we can detect, anyway) in terms of how billed amounts and allowed amount correlate. […]
[…] Insuring the entire population isn’t going to solve all of our healthcare woes. For starters, even with health insurance, healthcare can still be unaffordable. And even if we were to make health insurance more comprehensive than it is now, with lower out-of-pocket costs (not likely, as the trend over the last decade has been towards higher out-of-pocket costs in order to keep premiums from increasing even faster than they already do), there would still be more than one in five people without realistic access to care – for reasons that aren’t directly related to paying for care. […]
HHS today announced new PPACA guidelines pertaining to women’s health, listing several services that must be covered by health insurance plans with no cost sharing by the insured. In scrolling through healthcare news this morning, I saw numerous headlines stating that birth control and breast pumps must be covered by health insurance with no copays. This is true, but the requirements don’t take effect for another year (August 1, 2012) and will apply to new policies that begin on or after that date. […]
[…] It’s always good to see new innovations that help to expand access to healthcare, and clinic memberships that allow people to cover their day to day medical expenses with a predictable annual fee and low cost appointments is likely to be quite popular, especially among people who can’t afford comprehensive health insurance. But as with any other product, a clear awareness of what you’re purchasing (or being offered, if an employer is covering the cost) will help to avoid future surprises.
[…] In Colorado, all policies have long been required to have a standardized plan description form (separate from the carrier-created marketing brochure), and House Bill 1166 passed earlier this year, requiring that all policy information be written at no more than a 10th grade reading level. But I think that most consumers tend to look at brochures, mailers, online advertising, and other marketing materials designed by each insurance carrier. […]
[…] I found this article by Dr. Lucy Hornstein to be particularly interesting. Dr. Hornstein takes the view that preventive care does not save money in the long run, and wonders if the provision in the PPACA to provide preventive care to everyone – with no copays or deductibles – is a wise idea. The discussion is made even more interesting with a comment from Maggie Mahar (who was referenced in the article) noting that some preventive care is more worthwhile than others. […]
This article is not the first I’ve seen that calls into question whether Obama was being truthful when he said that health care reform would be structure so that people would still be able to keep their existing health insurance if they wanted to. And it would seem that his statements did amount to a bit of over-promising. But even before the PPACA came up for a vote, many Americans weren’t in control of whether or not they got to keep their existing health insurance. […]
[…] Copays and deductibles have risen for most families over the last few years, even those who don’t have policies that qualify as high deductible. And at the same time, economic stability has decreased for most families. This isn’t a good combination, and Joe’s right about the fact that when people skip necessary routine medical care, it will likely lead to increased medical costs (and declining health) in the future.
The Healthcare Economist’s Jason Shafrin has written an interesting article about how the French healthcare system utilizes hyperbolic discounting in order to avoid moral hazard. Basically, their system requires the patient to pay up front for a visit to the doctor, but then health insurance reimburses the patient 70% of the cost. This has two advantages over a system like ours which only requires the patient to pay their copay at the time of service. First, it conveys the value of the visit. Here in the US, people who have health insurance with copays for office visit are often unaware of the actual cost of the visit. They pay their copay and the rest is billed to the health insurance company. People who read their EOBs will see the actual billed amount and the amount that the insurance company paid, but I doubt that everyone reads their EOBs […]
How To Cope With Pain brings us a truly amazing video. It’s a reminder to be thankful for all that we have, and for the things in life (like this video) that inspire us. It’s well worth the five minutes it takes to watch it.
Amy Tenderich of Diabetes Mine shares a “would you rather…?” moment from her 9-year old daughter. It’s a poignant reminder, seen through the eyes of a child, that all of the parts of our lives – even the bad parts – combine to make us who we are […]
[…] There’s no doubt that a co-insurance based system would make people more aware of what health care actually costs. Nobody should have to devote their life to trying to obtain coverage for a serious medical problem, but on the other end of the spectrum, perhaps nobody should be paying only $15 to see a doctor, and a deductible of a couple hundred dollars a year. […]
Both sides are fired up about this, and it’s a very contentious issue. We’ve already had the abortion issue get dragged into health care reform, and now illegal immigration has added more fuel to the fire. Some people might be uninterested in health care refom otherwise, but when you start talking about things like abortion and illegal immigration, it gets attention. […]
These plans (even the ones not issued through MEGA Life & Health) offer the same misleading general information that most people don’t look much beyond – a low deductible, 80/20 coinsurance, copays for doctors visits and Rx, and even maternity coverage. Check out the plan information for Colorado State University (CSU) and Colorado University (CU) […]
We have health insurance to guard against financial devastation in the face of serious health problems. But when we separate out the prescription coverage from the rest of the policy, we’re leaving seriously ill patients to fall between the cracks.
At the Colorado Health Insurance Insider, we’ve decided to start an “open mic” so our readers can express their views in an open forum. They’ll be able to get feedback from other readers and engage in discussions about Colorado health insurance topics. The opinions expressed in the “Open Mic” category do not reflect those of… Read more about Open Mic – Claims Dispute
First of all, a plan with copays is usually going to be a waste of money. A copay is a dollar amount the health insurance company has specified that you’ll pay for either doctors visits or prescription drugs. A typical plan will have $25 doctors visit copays and $15 copays for generic Rx and $30… Read more about What is a Copay?