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A Problem With Ads for Private Medicare Plans
Tweet Share on Facebook September 25, 2008 Comment (6)Seniors can sign up for new Medicare prescription drug plans starting November 15, but they should be wary of TV and print ads aimed at influencing their choice starting now. The Kaiser Family Foundation analyzed ads that ran last year around the open enrollment period and found that—surprise!—insurers didn't always give seniors the plan details they needed to make the best choice. The foundation also found that insurers placed three times as many ads promoting Medicare Advantage (MA) managed-care plans that include drug coverage along with medical benefits as they did standalone drug plans that accompany traditional Medicare. As I've reported before, insurers get reimbursed at higher rates for beneficiaries in MA plans than for those using traditional Medicare, so it's not surprising insurers would try to encourage seniors to sign up for them.
The ads trumpeted the extra benefits available to people in MA plans, such as vision and hearing coverage, and emphasized that premiums would be low or nonexistent. But a third of the ads didn't mention that these managed-care plans often rely on networks, so there might be restrictions on providers, or that certain services might be limited. The ads that did include that information put it in the fine print. "We certainly recognize that ads have restraints of space or time," says Tricia Neuman, Kaiser vice president and director of the Medicare Policy Project. "But our concern is that the ads provide basic information that seniors can use to make informed decisions."
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Surprise! Premiums Are Up Again
Tweet Share on Facebook September 24, 2008 Comment (6)Consumers who are already scrambling to cover their food and gas bills aren't getting any relief from high healthcare costs: Premiums rose 5 percent this year, leaving the typical family with a $3,354 tab for coverage. Since 1999, premiums have more than doubled while wages rose a modest 34 percent and inflation rose 29 percent.
Premiums aren't the only healthcare cost causing financial pain, according to a closely watched annual survey released today by the Kaiser Family Foundation and the Health Research & Educational Trust. More workers this year are also facing higher deductibles, thanks in part to an increase in consumer-driven health plans, which as I've noted before aren't exactly wildly popular with consumers. The survey found that in 2008, 18 percent of workers in employer-sponsored plans have a deductible of at least $1,000, a sharp increase over the 12 percent with a deductible of that size last year. "We may be seeing the tip of the iceberg of a trend toward less comprehensive, skimpier benefits for people, with higher deductibles and higher out-of pocket-costs," said Kaiser President and CEO Drew Altman at a press conference announcing the survey findings.
If that's the case, then now more than ever you need to be scrutinizing your healthcare policy and those "explanation of benefits" documents closely to be sure you're not paying too much. Many of the hidden costs that turn up in limited benefit plans, such as caps on certain types of services and additional deductibles that kick in for hospital stays, for example, also show up in comprehensive plans. And even if your plan doesn't nickel and dime you to death, you can take steps to save on your medical bills.
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AIG to Policyholders: You Can Relax
Tweet Share on Facebook September 17, 2008 Comment (6)Corrected on 9/18/08: An earlier version of this story misstated the value of the bailout of AIG. It involved $85 billion, not $85 million.
Chances are you don't have a healthcare policy with AIG, the insurance holding company that announced an $85 billion bailout yesterday from the federal government to prevent the company from going under. AIG's health insurance business focuses on supplemental policies sold through employers that pay a cash benefit if policyholders get cancer or have a stroke, for example, and plans that cover medical and other costs if someone is in an accident or becomes disabled. AIG also sells travel insurance directly to consumers. These plans typically provide coverage if you need emergency medical care or medical evacuation while traveling overseas.
If you have one of these plans, or if your life insurance policy is with AIG, the company says not to worry. "AIG continues to operate normally and remains adequately capitalized and fully capable of meeting its obligations to policyholders," Peter Tulupman, an AIG spokesperson, told me this morning. Skeptical that he's just spouting the party line? You shouldn't be, according to the National Association of Insurance Commissioners, which represents insurance regulators from all 50 states and the District of Columbia. "If you have a policy with an AIG insurance company, they are solvent and have the capability to pay claims," NAIC President Sandy Praeger, the Kansas insurance commissioner, said in a statement.
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Who Gets Medical Care at the Grocery Store?
Tweet Share on Facebook September 12, 2008 Comment (13)There's been a lot of heated debate in the last few years over the retail medical clinics cropping up in supermarkets and drugstores around the country. Open on weekends and evenings as well as days, the clinics are typically staffed by nurse practitioners who treat a limited number of simple but acute conditions—ear infections, strep throat, urinary tract infections, etc.—and offer some preventive care, mostly immunizations.
Physician reaction has been pretty negative, centering around concerns that nurse practitioners may not be qualified to correctly diagnose and treat these conditions and worries that the clinics disrupt the patient-physician relationship, since doctors may not know about treatment their patients receive there. Advocates for the clinics, on the other hand, have argued that the clinics offer a reliable and convenient source of medical care for many people who can't get a timely appointment with their doctors or who can't see them during regular office hours.
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Sarah Palin and the Rape Kit Question
Tweet Share on Facebook September 10, 2008 Comment (163)The blogosphere is reporting that when she was mayor of Wasilla, Alaska, in the late 1990s, Republican vice presidential candidate Sarah Palin's municipal police department charged rape victims for the "rape kit" used to collect the forensic evidence necessary to convict their attackers. According to reports, this changed in 2000 when then Alaska Gov. Tony Knowles signed a bill protecting rape victims from being charged. As I wrote recently, however, the situation described in Wasilla is not unique. In all too many instances, women are still being stuck with the bill for rape kits. This despite the fact that in order to qualify for federal grants under the Violence Against Women Act, states are supposed to pick up the entire tab.
If on her watch Sarah Palin allowed women to be charged for rape kits, she has some serious explaining to do. But while she's undoubtedly the most visible offender, if the story is true, she's unfortunately not the only one to have permitted this reprehensible practice.
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An Unexpected Cost of Using Free Drug Samples
Tweet Share on Facebook September 5, 2008 Comment (13)"Ask your doctor for drug samples" is one of those predictable bromides offered anytime the subject arises of how to save money on prescription drug costs. But now a study says those freebies might actually end up costing uninsured patients more in the long run.
Why? Drug company sales reps distribute samples of the latest brand-name drugs to doctors' offices in the hope that physicians will start prescribing them. Often enough, they do, even when the choices include older but effective generic drugs that are much cheaper. This isn't the first study to find that dishing out drugs from the sample closet can cost patients more out of pocket in the long run. But this particular study focused on people without health insurance, who are likely to feel the sticker shock of a brand-name drug more acutely than patients who only have to consider a copayment.
