The Kaiser Family Foundation (KFF) Health News reports that patients often are aghast at the prices of services and wonder why their insurers agreed to pay that much. Me too! I have told the story a million times about my wife almost scheduling a CT scan at a hospital near our home. The hospital had to seek prior authorization for the ($3,000+) diagnostic procedure. A day later the hospital called to say it was approved and her share of the cost would be $2,700. When would she like to schedule? My wife told me the story and within 10 minutes I found a facility with a BlueCross rate of $403.
Author: Devon Herrick
Insurers Push Back Against Drug Copay Cards That Lower Patient Cost Sharing
People in government programs (Medicare and Medicaid) are not allowed to use drug copay cards precisely for the reason drugmakers offer them: drug copay cards are a financial inducement to spend the government’s money.
What is the Purpose of Health Insurance?
This year the cost of Obamacare for someone my age living in my North Texas county is roughly $10,000 for a $10,000 deductible. That means I would pay premiums of just over $800 a month in return for coverage that would cover nothing unless my health needs exceed $800 a month for the entire year. Assuming I spent more than $10,000 during the coverage period, the ACA plan would cover only $0.60 cents of every dollar I spend above my deductible.
Trump Administration Tackles Medicaid Fraud (Starting in Minnesota)
The CMS said it will withhold over $259 million in Medicaid funds from Minnesota, an effort the Trump administration says is part of a larger crackdown on fraud in federal healthcare programs.