Oct 24, 2014 | Health Navigator
The Health Affairs article reported on Consumer Directed Health Plans, noting:“Consumer-directed health plans (CDHPs), which feature a high deductible and a personal health savings account, can reduce medical spending by employers and consumers.”
“Patients enrolled in CDHPs had fewer episodes of care over the same time period than patients enrolled in traditional plans. Furthermore, these patients were found to have fewer visits to specialists, fewer hospitalizations, and lower use of brand-name drugs — all of which lowered their costs.”
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Oct 23, 2014 | Health Navigator
The Wall Street Journal article noted “The federal government … announced … that it would require people who wanted to buy a particular type of insurance called ‘fixed indemnity plans’ to demonstrate first that they also had traditional health-insurance coverage.”
“Fixed indemnity plans typically pay a limited cash benefit, with no deductible, to people who are hospitalized or encounter other medical costs. But the federal government said it was concerned that people might confuse those plans with standard health-insurance plans, and that the fixed indemnity plans alone couldn’t be considered to be coverage under the law’s requirement for most people to have insurance or pay a penalty.”
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Oct 22, 2014 | Health Navigator
Just when you thought that maybe you sort of understood the cost of an Obamacare health care insurance policy, a Kaiser Health News article noted: “This could be the next shoe to drop, as people don’t realize that if they’re buying a bronze plan, they may have to pay $5,000 out of pocket before it contributes a penny…”
“Experts worry that some enrollees will be discouraged from seeing doctors if they have to pay the full charge, rather than simply a copayment.”
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Oct 21, 2014 | Health Navigator
“If patients insist on medical procedures that science shows to be ineffective or unnecessary, they’ll have to pay for all or most of the cost.”
We all “demand” tests and prescriptions from out doctors and it is often easier for them to comply than argue. Now there may be a price to pay.
The Reuters article reported on “value-based” insurance with this vignette:
“When Tanner Martin, 17, developed excruciating back pain last year, he was sure he needed an X-ray to find out what was wrong. So was his mother, who worried that the pain might indicate a serious injury that could cause permanent disability.”
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Oct 20, 2014 | Health Navigator
The Wall Street Journal explored the health care insurance concept of Reference Pricing.
“The employee or enrollee can select any hospital or clinic but must pay the difference between the contribution limit and the actual price.”
“Reference pricing serves as a reverse deductible. Rather than the patient paying up to a defined limit and then the insurer covering the remainder, the insurer pays up to a defined limit and the patient pays the remainder. This has the remarkable feature of exposing the patient to the variation in prices for treatments that are above deductible thresholds. And the patient’s contribution isn’t limited by an annual out-of-pocket maximum.”
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Oct 19, 2014 | Health Navigator
The LATimes vignette noted “My coverage from Blue Cross Blue Shield of Illinois is exempt from the new limits because it predates the ACA, but it still has annual spending caps. The limits are $10,000 for services by providers in the plan’s network and $20,000 for out-of-network services. As a Blue Cross Blue Shield representative patiently explained to me, however, the out-of-network limit isn’t really a limit. When a customer reaches that amount, the insurer will still pay only the standard out-of-network share. That’s why my plan covered only 50% of the $54,755 charged by Tristate Care Flight to ferry me (by helicopter) from a car wreck in Quartzsite, Ariz., to a hospital in Phoenix. If Tristate wanted to bill me for the other half, the representative explained, it was free to do so.
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The Health Affairs article reported on Consumer Directed Health Plans, noting:“Consumer-directed health plans (CDHPs), which feature a high deductible and a personal health savings account, can reduce medical spending by employers and consumers.”
