Insurers

Stranded by the Pandemic, He Had Only Travel Insurance. It Left Him With a $38,000 Bill.

Duy Hoa Tran, a retired Vietnamese schoolteacher, arrived in Los Angeles in February 2020 to visit his daughter and 2-month-old grandson. Two weeks later, the door closed behind him. To prevent the spread of covid-19, Vietnam shut its borders. No commercial flights would be allowed into the country for the next 18 months. Tran’s daughter, …

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KHN’s ‘What the Health?’: Why Health Care Is So Expensive, Chapter $22K

Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Congress appears to be making progress on its huge social spending bill, but even if it passes the House as planned the week of Nov. 15, it’s …

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Medicare Enrollment Blitz Doesn’t Include Options to Move Into Medigap

Medicare’s annual open-enrollment season is here and millions of beneficiaries — prompted by a massive advertising campaign and aided by a detailed federal website — will choose a private Medicare Advantage plan. But those who have instead opted for traditional Medicare face a critical decision about private insurance. Too often the import of that choice …

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New Health Plans Offer Twists on Existing Options, With a Dose of ‘Buyer Beware’

Trendy-looking websites promise convenience and freedom from networks, at far less than the cost of traditional health insurance. “Welcome to insurance that’s finally fair,” says one, in bold lettering. “Take care of your health with one easy app,” says another. It’s all part of shopping for health coverage in 2021. While they’re still niche products, …

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California’s Reboot of Troubled Medi-Cal Puts Pressure on Health Plans

When Denise Williams’ baby boy was 2 months old, she became alarmed by a rattling sound in his lungs and took him to the emergency room. While undergoing treatment, he spiraled into a disabling neurological disorder. Now 2 years old, Markeano is attached to breathing and feeding tubes. He can’t walk or move his arms. …

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Jaw Surgery Takes a $27,119 Bite out of One Man’s Budget

For years, Ely Bair dealt with migraine headaches, jaw pain and high blood pressure, until a dentist recommended surgery to realign his jaw to get to the root of his health problems. The fix would involve two surgeries over a couple of years and wearing braces on his teeth before and in between the procedures. …

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Análisis: ¿No quieres una vacuna? Prepárate para pagar más por tu seguro de salud

La tasa de vacunación contra covid-19 en Estados Unidos es de alrededor del 60% desde los 12 años en adelante. Esto no es suficiente para alcanzar la llamada inmunidad colectiva, y en estados como Missouri, donde varios condados tienen tasas de vacunación inferiores al 25%, los hospitales están abrumados por brotes graves de la variante …

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Analysis: Don’t Want a Vaccine? Be Prepared to Pay More for Insurance.

America’s covid-19 vaccination rate is around 60% for ages 12 and up. That’s not enough to reach so-called herd immunity, and in states like Missouri — where a number of counties have vaccination rates under 25% — hospitals are overwhelmed by serious outbreaks of the more contagious delta variant. The vaccine resisters offer all kinds of reasons for refusing the free …

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Diabetes Drug’s New Weight Loss Formula Fuels Cost-Benefit Debate

The long list of side effects that follow ads for the newer expensive drugs to treat Type 2 diabetes sometimes include an unusual warning: They might cause weight loss. That side effect is one that many people — especially those with Type 2 diabetes, which is associated with obesity — may desperately want. So it’s …

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What insurers’ premium rate filings can tell us about predicted health utilization in 2022

An examination of health insurers’ premium rate filings for 2022 shows that most are not factoring in additional costs or savings, which indicates that they expect health utilization to reach pre-pandemic levels.

Contraception Is Free to Women, Except When It’s Not

For Stephanie Force, finding a birth control method that she likes and can get without paying out-of-pocket has been a struggle, despite the Affordable Care Act’s promise of free contraceptives for women and adolescent girls in most health plans. The 27-year-old physician recruiter in Roanoke, Virginia, was perfectly happy with the NuvaRing, a flexible vaginal …

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Pandemia eleva el número de beneficiarios de Medicaid a más de 80 millones

Las últimas cifras de inscripción al Medicaid muestran que creció de 71,3 millones de miembros en febrero de 2020, cuando la pandemia comenzaba en los Estados Unidos, a 80,5 millones en enero, según un análisis de KFF de datos federales. La recesión causada por la pandemia y un requisito federal de que los estados mantuvieran …

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Pandemic Swells Medicaid Enrollment to Record 80 Million People

The pandemic-caused recession and a federal requirement that states keep Medicaid beneficiaries enrolled until the national emergency ends swelled the pool of people in the program by more than 9 million over the past year, according to a report released Thursday. The latest figures show Medicaid enrollment grew from 71.3 million in February 2020, when …

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Bright Health follows rival Oscar Health down IPO path

Bright Health has filed preliminary paperwork for an IPO, joining its rivals in the insurance technology space in going public. Though there are few confirmed details at the moment, Bright Health is reportedly looking to raise $1 billion through the offering.

Mental Health Services Wane as Insurers Appear to Skirt Parity Rules During Pandemic

Therapists and other behavioral health care providers cut hours, reduced staffs and turned away patients during the pandemic as more Americans experienced depression symptoms and drug overdoses, according to a new report from the Government Accountability Office. Use Our Content It can be republished for free. The report on patient access to behavioral health care …

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After Accident, Patient Crashes Into $700,000 Bill for Spine Surgery

Mark Gottlieb’s life changed in an instant when another driver crashed into his car, damaging four vertebrae in his upper spine and smashing six teeth. In the months following that January 2019 crash, Gottlieb got the teeth crowned and, for debilitating neck pain, tried injections, chiropractic care and physical therapy. The treatments were all covered …

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The Great Undoing: Which of Trump’s Policies Will Biden Reverse?

KHN has put together an interactive tool of significant health policies implemented by the Trump administration using its own authority — executive orders, agency guidance or formal regulations — and is tracking Biden administration and court actions. We will update this chart as actions are taken. Topics: Affordable Care Act | HHS Operations | Immigration …

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‘Painless’ Glucose Monitors Pushed Despite Little Evidence They Help Most Diabetes Patients

In the nation’s battle against the diabetes epidemic, the go-to weapon being aggressively promoted to patients is as small as a quarter and worn on the belly or arm. This story also ran on NBC News. It can be republished for free. A continuous glucose monitor holds a tiny sensor that’s inserted just under the …

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Head-Scratching Over Newsom’s Choice of Blue Shield to Lead Vaccination Push

USE OUR CONTENT It can be republished for free. California Gov. Gavin Newsom, struggling to salvage a once-bright political future dimmed by his mishandling of the covid crisis, tapped nonprofit health insurer Blue Shield of California last week to allocate the state’s covid vaccine. The company has thus far said little about how it plans …

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Surprise Federal Drug Rule Directs Insurers to Reveal What They Pay for Prescription Drugs

Health insurance companies will have to give their customers estimated out-of-pocket costs for prescription drugs and disclose to the public the negotiated prices they pay for drugs, under an unexpected new Trump administration rule. The administration said those requirements, part of a broader rule issued Oct. 29 forcing health plans to disclose costs and payments …

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COVID + Influenza: éste es un buen año para vacunarse, aconsejan expertos

La temporada de influenza se verá diferente este año, ya que los Estados Unidos se enfrentan a una pandemia de coronavirus que ya ha matado a más de 176.000 personas. Muchos estadounidenses son reacios a ir al médico y los funcionarios de salud pública temen que las personas eviten vacunarse. Aunque a veces se considera …

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COVID + Influenza: This Is a Good Year to Get a Flu Shot, Experts Advise

Flu season will look different this year, as the country grapples with a coronavirus pandemic that has killed more than 172,000 people. Many Americans are reluctant to visit a doctor’s office and public health officials worry people will shy away from being immunized. Although sometimes incorrectly regarded as just another bad cold, flu also kills …

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Don’t Count on Lower Premiums Despite Pandemic-Driven Boon for Insurers

When COVID-19 smacked the United States in March and April, health plans feared medical costs could skyrocket, jacking up premiums drastically in 2021, when millions of the newly unemployed might still be out of work. But something else happened: Non-COVID care collapsed as hospitals emptied beds and shut down operating rooms to prepare for an …

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For COVID Tests, the Question of Who Pays Comes Down to Interpretation

In advance of an upcoming road trip with her elderly parents, Wendy Epstein’s physician agreed it would be “prudent” for her and her kids to get tested for COVID-19. Seeing the tests as a “medical need,” the doctor said insurance would likely pay for them, with no out-of-pocket cost to Epstein. But her children’s pediatrician …

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Must-Reads of the Week

The Friday Breeze Want to read the best and most provocative stories from the week? Welcome to the Friday Breeze, where we compile them all — so you’re set with your weekend reading. While you, loyal reader, wait for a wonderful new permanent Friday Breeze writer to start breezing, welcome to this week’s rundown brought …

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