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

August 7th, 2015

The DOL says Insurance companies are SOL denying certain lady stuff!

On May 11th, The Department of Labor issued a statement clarifying the terms the Affordable Care Act outlined in regards to preventative services covered AND lady visit stuff.  It made sure that these terms are no longer ambiguous.  THAT means insurance companies can’t jump around covering a few things they were denying before this statement was released.  We did a little announcement a few blogs ago, but I also wanted to share this link as it was helpful to a few clients who were confused about BRCA testing and Contraception.  Click to find out more:

http://ubabenefits.hs-sites.com/blog/preventive-service-requirement-faq

 

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June 23rd, 2015

ACA woes?  Hospitals and Docs feel it too!

Life since the Affordable Care Act is an interesting environment.  Everything is changing at such a rapid pace, no one knows how to keep up.  Hospitals are in the same boat, too!

In a recent study, 75% of hospitals have reported an increase of emergency room traffic since the ACA started.  Not only that, but there’s a huge increase in the number of people in Medicaid (in CA it’s Medi-Cal).   BUT doctors don’t want to take new Medicaid patients because Medicaid pays doctors so poorly.

So just because more people have access to health insurance, it doesn’t necessarily mean they have access to timely medical care.     And that, my friends, is true no matter what health insurance you have or whenever you try to see a doctor!

My assistant was sick a few weeks back, and she had the WORST time getting an appointment to see her doctor!  I think doctors offices may be feeling strapped for time too!

Some food for thought while we peel back the many layers of this onion.  And keep in mind to plan ahead when you can, keep ahead of illness so you’re not scrambling when you really need help.  Check out the article with more info from the President of the American College of Emergency Physicians:

http://www.benefitspro.com/2015/05/04/er-visits-keep-climbing-under-ppaca.…

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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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July 9th, 2014

Long-Term Care Clarity!

Does Medicare cover long-term care expenses?  The answer may surprise you!

 

There was a neat article this week in the LA Times about Long-Term Care Insurance which spelled it out very nicely.

 

If you haven’t given much thought to how you’d pay for long term care expenses, you’re not alone.    Most of us haven’t.   But, the BIG question is:   Would you be able to afford it?

 

In California, the average annual cost for long term care – today — is about $82,000 a year.  Wow, that hurts!   If you cover your ass(ets) and get long-term care insurance, you’ll significantly reduce your costs.

 

So . . . DOES Medicare cover LTC?  No!     Does your health insurance cover LTC?   No!

 

Not a happy prospect.   We are all about protecting your money over here, so it may be time for you to start thinking about it, too.  Remember: the younger you are when you plan ahead the more you save.  The ‘Mom’ only wants what’s best for her little kiddies!

 

Educate yourself on the details of the ins and outs with the article here and contact The Insurance Mom for a chat about your future.  Mind your P’s and Q’s and you’ll be taken care of . . . long-term.…

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March 10th, 2014

Is your medication worth $84,000? You tell me . . .

I just read an article about new drug treatments for Hepatitis C.  Hep C is the #1 cause of liver transplants in America.  Serious problem, right?  Drug companies have come up with a serious answer . . . but to the tune of $1,000 per pill, making one course of treatment with this new drug cost $84,000!!!

What does that mean?  It means that if drugs cost this much, it drives up the cost for health insurance for EVERYONE!  Yes, you too, person without Hep C.  Health insurance rates will go up for everyone because of the cost of drugs like these.  And insurance companies may tell people to try the older, less effective drugs first to try to save money when they really need the new stuff.  Not fair on either end, is it?

And that’s not all.  This article also says that this is just the beginning of pricey drugs.  We’re going to see huge spikes in cost for treatments for MS, cancer, and more in the coming years causing health insurance premiums to skyrocket.  Ouch!!!

Is it worth it?  Heck no!  Who’s to blame?  Not who you would think.

I want to know…  why aren’t the pharmaceutical companies being regulated too?  Of course, these drugs do cost money to research and produce, but why this much?  It seems to me that all of the weight of health care reform is falling on the shoulders of the insurance companies where the focus should be broadened to include pharmaceutical companies, hospitals, labs and doctors.

Tell me, friends, what do you think?…

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May 14th, 2013

Did the doctor tell you… ?

… that you’re entitled to every bit of information in your own medical records? Thanks to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), that’s one of your rights as a patient. Ask yourself: “Do I really know what’s in my medical records?”, and if you don’t, then make sure you get a copy of your chart!

It’s just fine to be picky with your doctors, and to demand clear information from them. First of all, this transparency from your doctor builds trust, and can help you both understand one another more clearly. It can be much more motivating to comply with your doctor’s orders once you know why they’re making them! Access to your records also allows you more opportunity to think critically about your needs, which in turn helps you ask better questions and ensures better care.  You can spot mistakes as they happen and get them immediately corrected (yes, doctors make chart note mistakes all the time).

Furthermore, if you decide you need a second opinion for anything, or if you see multiple specialists, needing a copy of your records can be a terribly inconvenient delay, so it’s ideal to have them around! In the worst scenarios, if you feel your doctor’s care for you just isn’t good enough, your records can be a useful tool for determining where the problem lies and whether you should look for a new doctor.

As the world of health insurance changes, it’s likely that your doctor will have less and less time to spend with you.  So make every moment count!   Before I leave every doctor’s office I get a copy of that day’s chart notes.  It’s my right — and yours — to have them.  Be bold and don’t let anyone deny you yours. It’s your …

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October 14th, 2012

No Kids… Free Birth Control!

That’s right, the rumor is true… being responsible no longer costs money!   Under the federal reform laws, as of August 1, 2012, almost all health insurance plans cover your generic birth control 100%.   No co-pays, cash or credit card required to protect you and your man against an unexpected pregnancy.

The federal law says that health insurance plans must now pay 100% for generic birth control pills and all other prescribed and FDA-approved birth control methods.   If you got your health insurance after March 23, 2010 (when the law was enacted), then this means you!

So rock on with your free birth control.   But please don’t make The Insurance Mom remind you to stay safe and use protection… that goes without saying (but I thought I’d say it anyway)!…

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May 1st, 2012

Kids, kids, kids…

If you’re in California and have health insurance in California, then this one’s for you.

As of 7/1/12, you’re all going to have maternity benefits added to your existing coverage.  Wahoo!

Yes, it’s true… SB 222 and AB 210, passed last year by our illustrious governor, are going to give each and every one of you this brand new benefit in your health insurance.

The new benefit will include, office visits, prenatal care, delivery and postnatal care.    The benefits for maternity costs will be treated just like any other benefits under your plan… deductible and co-pays will still apply.

And to reassure your pretty little heads, because this benefit is being added to all plans – and, therefore, the cost risk is spread over many, many more policies – your monthly premiums should not be affected.

Babies for all!…

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March 5th, 2012

More Cheap Drugs In Your Neighborhood

What do ex-Facebook employees do when they leave the mother of all jobs?   Of course, they start their own online service, GoodRx.com.

Want to find the best price for your prescription at a pharmacy near you?   Type in the name of your drug and zip code.  Et voila!   You’ll see all of your local pharmacies and what they’re charging.  There are even handy coupons for some drugs.

Wouldn’t it be great to pay less than your insurance co-pay for prescriptions?    Yes, of course it would!

Another handy resource from The Insurance Mom to you!…

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December 7th, 2011

Lipitor, be gone!

The Insurance Mom is thrilled to tell you how to save even more money on your prescriptions if you have those pesky cholesterol problems and have been taking — or are about to start taking — Lipitor.

The 17-year patent has finally expired… wahoo!  Now the drug is available in generic form.    Atorvastatin is the generic name to ask about at the doctor’s office or pharmacy.

Today’s health insurance plans usually have a “tiered” drug benefit.   Drugs on Tier 1 are the least expensive; most of them are generics.   Atorvastatin has been added to most formularies at the Tier 1 level, meaning they’re going to save you SO much money!

If your doctor insists that you continue to take the brand name drug Lipitor, well…   Tell your doctor you want him/her to pay for it!     Or give you free samples.    It’s been moved to Tier 3 in most formularies and is going to put a severe cramp in your monthly budget!

Fight for your money!  Spend less.  Use generic drugs.  It will not only cost you less but it will cost the insurance companies less too.  If we all insist on prescriptions for generics only, then the insurance companies spend less on ridiculously high-cost drugs and we could all have an impact on how insurance premiums rise every year.

And just think, if you’re spending less on prescriptions you’ll have more money available for sushi!…

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