Paying for Health Care

who should pay for health care?

Paying for health care: the conversations continue in Washington about Medicare: reduce, eliminate, or even expand the program to universal coverage. It is my opinion that many in Washington really don’t know much about the current program, looking only at the bottom line and not at the Medicare recipients.  I’m not sure what the Medicare program is going to look like for 2019 or how much it will cost the enrollees.

Several states recently filed a suit against the Federal government; citing the unreasonable financial burden being imposed at the State level, as Federal financial support is being reduced for the Medicaid program.

As we approach open enrollment for health insurance at the end of the year, expect to hear a lot more about: what the Feds want to cover and what they want the consumer to pay for directly, proposed alternative coverage options, the ongoing debate about whether or not to eliminate the Affordable Care Act, as well as how much the consumer might expect to pay for their health insurance next year: premiums and deductibles are expected to increase again in 2019.

Paying for Health care: veterans

Privatization of the VA program, the second largest budget item for the Federal Government, also continues to be discussed. President Trump has signed a bill which expands private care for veterans outside of the VA system. https://www.usnews.com/news/news/articles/2018-06-06/trump-to-sign-bill-expanding-private-care-for-veterans

Locally, Rush Medical Center has received a major grant to further their PTSD program. Great news for so many afflicted with this disease.  https://shar.es/a1nolA

paying for health care; the unexpected costs

Have you or someone you know made an Emergency Room visit this year? Chances are that the physicians providing the care were contracted to the facility, not on staff of the hospital. This could result in out of network charges to you which you were not expecting. In an emergency situation you are seeking care, not asking the various health providers whether they are covered by your insurance plan.

These additional charges for which you are responsible are called “balance billing”, with no federal protections in place for the consumer. Here is an analysis of how states are dealing with this issue. If you experience this personally, I would recommend that you consider filing a grievance with your insurance provider with the assistance of a health care advocate or other professional. https://www.commonwealthfund.org/publications/issue-briefs/2017/jun/balance-billing-health-care-providers-assessing-consumer

It’s not just the Emergency Room charges which might surprise you. Here is another reason that you should become very familiar with your medical insurance coverage before you need to use it. https://khn.org/news/father-and-son-injuries-lead-to-the-mother-of-all-therapy-bills/

paying for health care: social media usage

Do you have any idea how much of your personal information is accessible by others through your use of the internet? Our privacy expectations have changed so much with the introduction of social media. Insurance companies are using the data obtained about you in determining your rates for coverage.

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwjg5JjAnr3cAhUCWq0KHd_dD0EQFjAAegQIChAB&url=https%3A%2F%2Fwww.propublica.org%2Farticle%2Fhealth-insurers-are-vacuuming-up-details-about-you-and-it-could-raise-your-rates&usg=AOvVaw0o21zjIRBTr0SZHMEohgdM

paying for health care: mid-year review

At this point in the year you have most likely utilized your health insurance to see a provider, have lab tests or x-rays done, or purchased prescription medications. I imagine you have been surprised at the amount of the co-pays for those provider visits, plus the additional out of pocket expenses you are being charged before you meet your deductible. I would anticipate even higher out of pocket expenses for next year in addition to increased premiums and deductible amounts.

Take some time now to review your current coverage so that you know how next year’s plans compare. I also recommend that before you enroll in a plan you ask your preferred providers what insurance plans they will be accepting. You don’t want to be surprised when you need care.

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