Quantcast

COMPARISON SHOPPING

We all like to shop around to get the best price.  Why not for health care?

The whole idea of High Deductible Health Plans was to give the patient more control over where they spend their health care dollars.  How can we be savvy shoppers when we can’t compare prices?

A recent study in a prestigious medical journal examined the inability to predict out-of-pocket costs of medical procedures and surgeries.  What they found was that even if you call the hospitals and doctor’s office and your health plan for a price before undergoing a procedure you cannot find out what your out-of-pocket costs will be.  They also found that if you are able to find out what the usual charge is for a procedure from the hospital, when you compare these charges with other hospitals the estimates can vary by thousands of dollars.

These variations in charges are not necessarily from different parts of the country or even in different states, these can be from hospitals in the same city, zip code, or just across the street!

WHO KNEW?

Did you know?

  • If you have a procedure done in a hospital that you may receive 3 bills
    • one from the hospital for the use of their facility and supplies
    • one from the anesthesiologist
    • one from the doctor (s) who did the procedure
  • You can be treated by a doctor who is in-network for your health plan, but is affiliated with a hospital that is not in your network.  This means that the doctor’s charges would be considered in network, but you may have to pay out of pocket for the hospital and other charges which are out of network.
  • If you have Medicare and do not check that the hospital and the doctors accept Medicare “assignment”, you may be responsible for all or part of the charges from your procedure or surgery

The moral to the story is:

  • If you are able to get a quote, make sure you get it in writing
  • Ask a lot of questions and keep asking until you get the information you need
  • Call at least 3 times with the same questions to ensure that you are getting the “correct” answers
  • Insist of speaking to a supervisor if you are not getting consistent responses to your questions
  • Always document each call, the name of the person you are speaking to, and the time and date of the call.  If you are calling a health plan, as for a reference number for each call

In Good Health

Health Champion

April 26, 2012 | Tags: , , , , | No Comments »

C is for COBRA — Critical Coverage During Hard Times

If you’re on Cobra, coverage information is as critical to your wallet as it is to your well-being. But, like most folks, you probably have so much on your plate these days, you’re missing important updates.

Last week, for instance, we received a call from one of our small business clients. Their office manager thought she read that COBRA received another extension. But she wasn’t sure. Was it true?

The answer is YES. On December 22, 2009, President Obama extended federal subsidy of COBRA for an additional six months.

Some Background:

The first federal subsidy, signed into law earlier in 2009 as part of the economic stimulus package, helped fund COBRA premiums for employees who were laid off between September 1 and December 31, 2008 — “involuntarily terminated” was the eligibility language. Eligible employees paid 35%  of the COBRA premium, while employers paid the remaining 65% and received a tax credit.

The premium reduction was also made available for group health insurance, which is required by State law to provide comparable continuation coverage (such as some “mini-COBRA” laws).

Good News. The Recent Extension . . .

  • Adds two months to the COBRA premium reduction eligibility period, which now ends February 28, 2010.
  • Increases the maximum period for receiving the subsidy, adding an additional six months, taking it from nine to fifteen months.
  • Allows for an extension of the typical grace period for those individuals whose subsidy ended before this extension was passed and couldn’t afford COBRA without it. You must pay your portion of the COBRA premium at the reduced rate by the new grace period. (Contact your carrier or speak to your Human Resource Department for specific information.)

Important Considerations. . .

  • If you paid 100% of the COBRA premium in December, after your subsidy expired, you are eligible for a credit or reimbursement of the overpayment. Contact your plan administrator for further information.
  • Be on the lookout for “notice” requirements that must be provided by plan administrators to all individuals who have qualifying events from September 1, 2008 through February 28, 2010.

Information changes rapidly and it comes at us from all sides. That’s why it’s helpful to have a reliable resource, like this Blog. We’ll work hard to give you critical, updated news and helpful links. For additional COBRA information, including helpful questions and answers, check out the Department of Labor’s website at:

http://www.dol.gov/ebsa/faqs/faq-cobra-premiumreductionEE.html

January 13, 2010 | Tags: , , , , , , | No Comments »

If you have your health….

A co-worker recently shared this story: “My mother is 84 and incredibly robust. Ever since I can remember, she’s had this one refrain: ‘If you have your health you have everything.’ Growing up, I figured this was merely a sentiment, designed to distract me from wanting all the material things they couldn’t afford. In fact, I couldn’t really internalize the value of that statement until I hit my 40’s (ah, the joys of middle age!). Now I get it.”

Listen closely to people edging toward the other side of middle age, or those challenged by illness or disability, and you’ll see a shift in values; they’re talking more about the state of their health than the status of their portfolio. They understand that things are just things. But if you have your health, you have everything.

As health care advocates, we’re reminded daily of how important our health truly is. In fact, it’s our greatest asset. Take care of it like you would your life savings: Invest in it. Manage it. Pay attention to it. Like your nest egg, once it’s gone, it’s not easily replaced.

As we look ahead to 2010, we hope the year brings you the blessings of good health. Happy New Year.

December 30, 2009 | Tags: , , , , , , , | No Comments »