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

June 30th, 2017

What a difference a week makes! SB 562 Update

Thanks for tuning in for our series on single payer!  What a difference a week makes; big update on SB 562.

On Friday, 6/23/17, CA Assembly Speaker Anthony Rendon (D-Lakewood) shelved the proposal saying it is “woefully incomplete” and has postponed any further legislative action until January 2018.

“If you think health care is expensive now, wait until you use what it costs when it’s free.”  – P.J. O’Rourke

The Insurance Mom’s colleague, Michael Lujan (one of CA’s best-known expert insurance legislative analysts) offers this in his amazing post on LinkedIn:

Single Payer (SP) would:

  • Replace all forms of private and public health insurance in California with a state government-run health system.
  • Would eliminate an estimated half million insurance, health care administration and related jobs, tripling our current unemployment rate. And without payroll contributions going into the system, there will be no money to pay unemployment benefits.
  • Could make California a health care destination for anyone seeking “free healthcare” as neither citizenship, nor permanent residency is required to use the SP system.
  • Requires massive tax increases. The additional 15% payroll tax would make California the highest taxed state in the country.

If enacted, The Healthy California Act (SB 562) would be the largest tax increase in California’s history. The entire state general fund is $183 billion. As proposed, the bill would cost an estimated $400 billion for the initial year and unknown costs for subsequent years. While that may seem like a deal-killer, the bill moved forward to the State Assembly and should not be ignored (when it resurfaces in 2018).

While this bill may be dead in the water, single payer / universal healthcare / socialized medicine / Medicare-for-all have been floating around the brains of the public.  The Insurance Mom wants her kiddies well-informed about …

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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 6th, 2016

Health Insurance Forecast for 2017– Are YOU Prepared?

Hello, Friends!

 

Are you ready for health insurance news for NEXT year??   Sit, get cawfee, or a cocktail and let’s tawk!

 

This interesting article from the NY Times and this one from the Free Beacon each have loads of important info, but here’s the gist….

 

The SAME news: the NEXT open enrollment period will be 11/1/16 through 1/31/17.

 

The HAPPY news: Obamacare will be rating health insurance plans based on how many doctors and hospitals are in their networks.  BUT (as I am your interpreter of bulls*#$) this doesn’t necessarily mean that doctor networks are going to improve for individual plans.  It just means there’s more transparency for you to make informed choices.

 

The PHEW! news: there’s a new thing next year called “continuity of care.”   What do you do if your doc leaves your network?  Often they leave or get dropped from the network without any heads up to YOU.  BUT in 2017, if you’re in an “active course of treatment,” you’ll be able to continue seeing the doctor if they leave the network.

 

The BAD news: out-of-pocket maximums are going up.  WAY UP!  In some states, they’ll increase from $6500 to $7150 for individuals, and from $13,000 to $14,300 for a family.

 

The YUCKY news: The Beacon article anticipates that deductibles in most states will see increases , too.

 

The WORST news: hold on to something…  premium increases are on the horizon for 2017.

 

The more you know, the more prepared you’ll be for 2017.…

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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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July 20th, 2016

“What’s Up, Doc?” Blog Series Part 7: The Doctor is in! Now What?!

Look at you, friend of The Insurance Mom!  You’ve learned so much from our first, second, third, fourth, fifth, and sixth parts of our series, “What’s Up, Doc?” Don’t you feel well-informed and powerful!?
Here’s the next revelation, “The Doctor is In!  Now What?”

 

  1. Remind Doc Hollywood of any important medical history.   Do NOT assume they remember everything about you.  If you’re seeing this doctor for the first time give a brief summary of important medical history.
  2. As I mentioned in the second part of our series, always have a current copy of your medical records.   Before seeing a new doc for the first time, email a copy of your chart FIRST.    Hopefully, this will get your new doc up to speed before you get there.
  3. If you’re there for a physical (aka check-up, aka preventive care), remind the doctor that’s the ONLY purpose for your visit.    I want YOU to give explicit permission to the doc if she’s going to do additional tests or treatments that are NOT included in your free physical.  The Insurance Mom also recommends referencing this website which lists all of the stuff that has to  be covered by your insurance (it’s part of the Affordable Care Act!)… so you know your rights!
  4. Ask LOTS of FAQs.   There is always another question to ask!   So ASKAsk for clarification if you need it.  Ask the doctor WHY she is recommending this particular course of treatment or prescription.  Ask about side-effects.  Ask about likely outcomes.    Ask what alternative options may be available.   Just because a doctor makes a suggestion, doesn’t mean it’s a recommendation… or the best recommendation.

Thanks for following along to our virtual tour of the doctor’s office!  Now, talk to me.  Share your funny / interesting …

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June 15th, 2016

“What’s Up, Doc?” Blog Series Part 2: What Do Before Your Visit

Welcome back, folks!  Thanks for following our series, “What’s Up, Doc?”

 

You’ve read the first part in our series, “How Do I Find a Doctor?”  and you’ve found a doctor you like.  Now let’s dive into the visit.    What to do before you schedule your appointment.

 

  1. Make absolutely SURE that your doctor is IN-network on your plan BEFORE your visit.  If you haven’t been in a while, it’s possible things have changed.   Search the provider directory at your insurance company’s website.
  2. If they are IN-network, you will probably have a co-pay for the office visit.   If you don’t remember how much your copay will be, check your ID card. The co-pays for primary care and specialists should be listed right on the front!
  3. Know what a co-pay means!  Remember… the office visit fee co-pay is what the doc charges you just for showing up and reading old magazines!   They call it the “consultation.”   Sometimes the office visit co-pay is all you’ll pay.  But sometimes, you will also pay for any medical services the doctor does to/for you.
  4. Register at your insurance company’s website.  There are lots of cool tools available… including a whole run down of your insurance benefits.
  5. Download a copy of your benefits into your phone (let it be smart for you!)     Know more than the receptionist about your plan… stay in control of your money!

 

As always, please keep me posted on your rolling thoughts, tips, tricks, and FAQ’s!  I want to hear from YOU!…

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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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March 4th, 2016

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

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

“The Insurance Mom’s Guide to Better Living

Through (Cheaper) Chemistry”

 

You’ve followed PART ONE and you understand how your plan works and the formulary (aka list of drugs your insurance company covers.)  Now what if your drug isn’t in the formulary??

 

I get lots of calls from people complaining their drugs were in the formulary and now they’re not.   Drugs get dropped from formularies all the time.  Check out this article on the 50+ drugs dropped from insurance in 2016.

 

Get mad, punch a pillow,  and then use some of the following suggestions to get your plan to work for you.  If you’re lost or need advice, call The Insurance Mom for a hug, a chicken soup recipe, and some morale-boosting information!

 

PART TWO: FIGHT FOR YOUR RIGHTS TO AFFORDABLE MEDS!

Advocate!  If your drug is dropped from the formulary, ask your doctor if there are other Rx alternatives.   And then check with your insurance company to see if they’re in the formulary.

 

Get Squeaky!  If your doc says, “nope, sorry, you need THIS exact drug,” tell the doctor’s office to call your insurance company to get a Prior Authorization.   It’s time to be a squeaky wheel!

 

Squeak Some More! If the Prior Authorization doesn’t work, ask the doctor’s office to help you file an Expedited Appeal.  Remember to tell the doctor when you ask for the Prior Authorization that this second step may be next.  The doctor should be able to file the Expedited Appeal during the same phone call to your insurance company.  Save time by telling them upfront!   And hurry up and wait . . . this process can take a while.  Click this hyperlink for more tips on filing …

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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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February 19th, 2016

Intro: The Insurance Mom’s Guide to Better Living Through (Cheaper) Chemistry!

Hi Insurance Mom Family,

 

OK, let’s talk prescriptions.  But Mom… they’re so expensive!  I know, sweetie.  The Insurance Mom hears you.

 

Yet another (un)intended consequence of the Affordable Care Act… formulary shrinkage.    The formularies are the lists of drugs your insurance company covers – generic and brand name.   Most people just pay up at the pharmacy and don’t know they can actually shop around for better prices.   Just because you have health insurance doesn’t mean you’re getting the best price!

 

To help you along the way, we’ve written a blog series we call …

“The Insurance Mom’s Guide to Better Living

Through (Cheaper) Chemistry.”

high-cost-prescription-medications-health-care-concept-money-flowing-open-pill-white-background-34658791

 

This FIVE part series walks you through money saving tips & tricks from the moment the doctor writes the script to the moment you pick it up at the pharmacy.  Keep tuning back for the next five Fridays to learn to speak Rx.

 

As an intro, click the hyperlinks for these great articles from the website, GoodRX and another one from Consumer Reports.

 

In the meanwhile, talk to me!  What are your insurance concerns for the coming year?…

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