Here are all the articles I've written about covered treatments. Enjoy!

August 17th, 2016

“What’s Up, Doc?” Blog Series Part 11: All Better… But OUCH, This BILL!!

Oodles of gratitude for taking this virtual trip to the doctor with us!  Here’s even more in the series “What’s Up, Doc?”  Catch up with parts one, two, three, four, five, six, seven, eightnine, and ten.

And now, our last in the series… “All Better… But Ouch, THIS BILL!!”

  1. Your doctor is IN-network right?    The doctor’s office MUST submit the bill (aka “the claim”) directly to your insurance company.
  2. The IN-network doctor CAN ask you for the office visit co-pay at the time of the visit.    But, for medical services done during the visit…
  3. The IN-network doctor canNOT charge you until after the insurance company applies the IN-network discounts (the negotiated rate).
  4. When you get a bill from the doctor’s office, be sure that the IN-network discounts have been applied.   How do you know?
  5. … because you got an Explanation of Benefits (EOB) from the insurance company!   Check the EOB against the provider’s bill, and THAT’s how you know you’re getting the right discounts.
  6. If the doctor is OUT-of-network you’ll be submitting your own claims to your insurance company – and the doctor can charge you whatever she likes, there are no discounts.
  7. If you have an HMO, you must ONLY see a doc in your HMO group.  There are NO benefits in an HMO if you go to an out-of-network doctor.

Talk to me!  Was this helpful?  What was your fave piece of info?  Suggestions and thoughts are welcome.  And as always, reach out to us for any of your insurance needs.…

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August 3rd, 2016

“What’s Up, Doc?” Blog Series Part 9: The Doorknob Moment… and Other Missed Opportunities

Welcome back to our series, “What’s Up, Doc?”  You can check out the first, second, third, fourth, fifth, sixth, seventh, or eighth parts by clicking the hyperlinks to get up to speed.  And now, “The Doorknob Moment… and Other Missed Opportunities.”

 

  1. Be your own team!  Prepare in advance for your visit.   Patients who take a more active role in their medical care have better physiological improvement.  Remember, this is a TEAM effort between you and the doctor… with you as the Team Captain!
  2. Ask your most important FAQs first!   Don’t wait until you’re dressed and leaving the office!  They say in psychotherapy the most impactful part of the session is usually the last 5 minutes.  Don’t take that approach with your medical doctor or you could miss talking about some important info.
  3. This tip is for the fellas:  speak up!  Don’t be macho, tell the truth.  If something is ailing you, it’s better for your doctor to know so she can help.   This visit is not the place to put on a brave face.    Statistically, women are better than men at asking questions about their medical issues.  Not that we’re better or anything (wink, wink), we just go to the doctor more often so we have more practice.
  4. ASK if the doctor will communicate by e-mail.   Often e-mails become a valuable part of your chart.   If you happen to forget to ask an important FAQ or need further clarification, having a doctor who uses technology is critical!
  5. If the doctor doesn’t use email, find out the easiest way to communicate with her after the visit… phone, fax, carrier pigeon, smoke signals?    For example, does she return phone calls after normal office hours?  What about in real emergencies?

 

Look at how smart …

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June 8th, 2016

“What’s Up, Doc?” Blog Series Part 1: How to Find a Doctor

Wanna get more out of your visit with the doctor?  Here’s a great 2005 LA Times article coupled with expertise from The Insurance Mom herself.  Despite the new world order created by the Affordable Care Act, this info will still help you!

 

Watch for our new multi-part blog series, “What’s Up, Doc?” We’ll be sharing some tips & tricks about how find a good doc, how to talk to your doc, how to get the most out of your health insurance and, ultimately, how to feel like your doc really “hears” you.

 

First steps first…. getting a doctor you know and trust.  The Congressional Quarterly recently shared a report from the CDC which says up to 26.7 % of Americans may have access to healthcare now, but they don’t have a “usual place for medical care.”    They “haven’t found the right provider or been diligent about making appointments to see them.”  With more people using insurance now more than ever, doctor’s offices are busy and only taking certain types of insurance.    We call that “rationed health care.”

 

You don’t want Dr. Do-little, so now it’s time to research, research, research!  You do it for the best new sushi bar, or best deal on contractors and best prices for a car, why not with your doctors?

 

  1. Call The Insurance Mom.  She has loads of recs for docs in the LA area.
  2. Search your insurance company website for doctors in your immediate area.   Remember… IN-network means oodles of money-saving!
  3. Compare that list of IN-network docs to Yelp OR HealthGrades or RateMD’s.
  4. Don’t wait until you’re sick to get in with a doc.  Use a check-up as a good intro to meet & greet your new doctor (that way if/when you get sick you have a familiar face at
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May 20th, 2016

Are YOU sick of paying an arm and a leg?

Hello, World Wide Web,

My lovely office elf saw this video on social media the other day.  It got quite a lot of hits, and brings up some things I keep hearing when people call my office.  People often ask, “why isn’t it easier to find out what medical costs COST?”  This young dad-to-be found out why NOT… give it a watch HERE.

So why not?  Well, folks, the medical industry has always functioned with a pay-no-attention-to-the-man-behind-the-curtain attitude.  Those things are hopefully shifting for the better.

In the meanwhile, do your own research and listen to your super smart and sassy Insurance Mom!

  1. Some insurance companies are now offering a price estimator.  While these numbers are not exact, they WILL help you have a general understanding of what it may cost.  AND it will also compare and contrast with hospitals and doctors in your area!
  2. Do telemedicine!  Lots of plans have embedded telemedicine.  This is for minor medical concerns only.  For a copay (and, if it’s not included in your plan, a low monthly fee) you can video chat with a doctor, they can call in prescriptions, and give you a medical exam.  They’re now offering therapy online too!  The Insurance Mom is a big fan of LiveHealthOnline.  Call or email us if you have questions!

How about you, my friends?  Have YOU had issues with unpredictable medical costs?  Share with me!

 …

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February 26th, 2016

PART ONE: The Insurance Mom’s Guide to Better Living Through (Cheaper) Chemistry

Here’s PART ONE in our series we call . . .

“The Insurance Mom’s Guide to Better Living

Through (Cheaper) Chemistry”

The Insurance Mom

PART ONE: EDUCATE YOURSELF!   

 

The Affordable Care Act has created a LOT of confusion for everyone – especially the doctor’s offices!    Learn how your plan works before you go to your appointment!   If you have problems getting affordable prescriptions, ask your doctor for alternative options.

 

Learn your tiers!  The formularies are the lists of drugs your insurance company covers.   If your drug IS in the formulary, it will be categorized into one of four tiers – generic and brand name.   Generic drugs are cheaper.   If the cost of a brand name drug makes you sick, call your doctor and ask for samples.  OR ask if they will prescribe a generic!…

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August 27th, 2015

The Insurance Mom’s Handy Cheat Sheet!

Are you confused and frustrated by your health insurance?  Having health insurance can be like eating your broccoli … necessary but not fun.

But now, you can understand more about how to make your insurance money work for you!  Here it is … your one stop guide to health insurance cheat sheet:

The Insurance Mom Cheat Sheet

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June 4th, 2015

Good news for the ladies!!

Hurray!

On 5/11/15, the Department of Health and Human Services (ObamaCare)  told insurance companies they HAVE to give ladies access to  ALL federally approved methods of birth control.  NO EXCEPTIONS!

Women’s groups have been reporting that IUD’s, Plan B, the patch, and the ring have been refused by many insurance companies.  According to the White House, this is breaking the law.

Another positive step in the enforcement of some good bits of the Affordable Care Act.

http://www.ibamag.com/news/white-house-cracks-down-on-insurers-flouting-birth-control-requirements-22455.aspx

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May 12th, 2015

YOU’RE A COMPARISON SHOPPER FOR OTHER THINGS, THEN WHY NOT FOR MEDICAL STUFF?

You’re a smart shopper.  You do your research.  You clip coupons.  You read Yelp reviews, compare online ratings and costs.    So why is it when it comes to your health, you don’t do the same?

The Insurance Mom is here to help you be your own best advocate.  In this new world of Affordable-Care-Act-madness  here are some handy do-it-yourself tips to get the biggest bang for your health plan buck and save you money in the long run.    Just because you have health insurance doesn’t mean you’re automatically getting the best deals.

When you have the ability to plan before diagnostic tests, procedures, and doctor visits:

Check out this nifty website from Health Care Blue Book.  It will compare and contrast costs for doctor visits, procedures, hospitals and other facilities, as well as the Fair Price for a medical services from different locations.    A friend found that two hospitals near him were charging very different amounts for the EXACT SAME diagnostic tests.  One was $1,400, the other was $6,400!!! Very smart shopping! When you can, plan!

https://healthcarebluebook.com/page_Default.aspx

When your prescriptions get too spendy, we have three suggestions:

GoodRx to compares costs of different meds at different pharmacies in your area.  Didn’t think there would be a difference, did you?  Give it a try and you’ll see costs vary from one pharmacy to another.    Make an informed choice about how and where you shop.

www.goodrx.com

There’s a free discount card available with just a simple click!  Go to Water Tree Health’s website for great discounts on pharmaceuticals, diabetic supplies, even some pet supplies!

http://www.watertreehealth.com/our-products/

I get a lot of questions on this one.  For certain medications, you can shop outside of the country and see a big discount.   Pharmacy Checker is a good example of how to compare drug prices …

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March 19th, 2015

Why we love John Oliver OR How to get a free lunch!

The Insurance Mom is a big fan of “Last Week Tonight” with John Oliver.   I thoroughly enjoyed his expose (which aired on 2/8/15) about the relationship between doctors and pharmaceutical companies.

The gist is this . . . it has been a long-time practice of pharmaceutical companies buying doctors lavish lunches, providing divine holidays, inviting them to be a brand ambassador, speaking at events, and paying the docs handsome sums.   It’s one thing to hand out free samples.  But some of these practices are bordering on bribery, false advertising and in the process, perhaps skewing the doctor’s medical practices towards the companies’ products.   John Oliver wondered why it is that some medical offices advertise a free lunch in their job postings.   Is it possibly because Big Pharma is footing the bill?!

Aren’t you curious about what your doctor is up to?   Here’s the website where you can see what kind of benefits your doctors may be receiving from Big Pharma.  Go to https://openpaymentsdata.cms.gov/ to find out more.…

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March 4th, 2015

Pop Quiz! Did you study LTC?

Whether or not you’ve studied the articles in the last week on Long Term Care Insurance, The Insurance Mom has a pop quiz to see if you’re ready for Long Term Care Insurance!

 

Answer the following for yourself and your family, True or False:

I’m between the ages of 40-65 or I have parents in that age range.

We’re relatively healthy and have no major medical problems now.

We for sure don’t have an extra $90,000 for unexpected expenses should I (or my parents) need long term care in the future.

We’re not strong enough to fireman carry each other!

 

If these ring true for you or a family member, you should think about Long Term Care Insurance – TRUE!  Call The Insurance Mom and heave a sigh of relief!…

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