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☆ These 5 strategies can help you avoid surprise medical bills
▼ + stars: | 2023-09-18 | by ( Sponsor Post | Created Unitedhealthcare S Surest With Insider Studios | ) www.businessinsider.com time to read: +6 min

Other recent regulations require hospitals to post prices online, and while these efforts offer important protections for people, there are various other ways to help avoid an unexpected medical bill. To help avoid that, confirm with your health plan that any services or tests are covered under your benefits. Negotiate surprise billsIn the event of a surprise bill, there are several steps to pursue. No one wants a surprise medical bill. Learn more about how to avoid surprise medical bills at surest.com.

Persons: Donna O'Shea, — Organizations: Population Health, Insider Studios Locations: surest.com

☆ Uninsured Americans pay high costs for an insulin Eli Lilly vowed to price at $25, Sen. Warren says
▼ + stars: | 2023-07-13 | by ( Annika Kim Constantino | ) www.cnbc.com time to read: +2 min

An Eli Lilly and Company pharmaceutical manufacturing plant is pictured at 50 ImClone Drive in Branchburg, New Jersey, March 5, 2021. Uninsured Americans pay nearly $98 on average for a vial of Eli Lilly 's generic insulin, even after the company pledged to cut the product's list price to $25 per vial, according to a report released Thursday by Sen. Elizabeth Warren. Eli Lilly earlier this year vowed to slash the list price of its generic insulin, Lispro, from $82.42 per vial starting on May 1. The survey found that a third of pharmacies charged uninsured patients $164 or more for a vial of Eli Lilly's Lispro. Eli Lilly did not immediately respond to a request for comment on the survey.

Persons: Eli Lilly, Sen, Elizabeth Warren, Eli Lilly's, Eli Lilly's Lispro, Warren, Joe Biden's Organizations: Company, Medicare Locations: Branchburg , New Jersey, Indianapolis, Massachusetts, U.S

☆ Americans are struggling to afford Ozempic, even with insurance
▼ + stars: | 2023-06-05 | by ( Lydia Ramsey Pflanzer | ) www.businessinsider.com time to read: +3 min

Americans are struggling to afford the buzzy weight-loss drug Ozempic. Americans are struggling to afford the buzzy weight-loss drug Ozempic, even with insurance coverage, a new study shows. Especially after a 2022 study found that people who stopped taking Ozempic regained two-thirds of their weight within a year. And Medicare, the federal program that covers healthcare for people 65 and older, is prohibited by law from covering any weight-loss medications. Meanwhile, other Americans will continue to go to Canada, Mexico, and unregulated online pharmacies to get the weight-loss medications for cheap.

Persons: Ozempic, Utibe Essien, Essien Organizations: UCLA, Employers Locations: Canada, Mexico

Circuit Court of Appeals, the U.S. Justice Department said the order, from U.S. District Judge Reed O'Connor in Fort Worth, Texas, "has no legal justification and threatens the public health." It asked the court to stop the order from taking effect until it can fully hear the administration's appeal. He found that the federal task force that decides what preventive care must be covered under the federal healthcare law, also known as Obamacare, was unlawfully appointed, voiding all of that task force's determinations since 2010. More than 150 million people were eligible for preventive care free of charge as of 2020 under Obamacare, according to U.S. Department of Health and Human Services data. Reporting By Brendan Pierson in New York; Editing by Alexia Garamfalvi and Jonathan OatisOur Standards: The Thomson Reuters Trust Principles.

☆ Health plans could soon reduce coverage for preventive care. Here's what to know
▼ + stars: | 2023-04-13 | by ( Annie Nova | ) www.cnbc.com time to read: +2 min

Around 100 million people with private insurance got preventive care required under the ACA in 2018, one estimate found, making it the provision with the widest reach. Insurers generally must not impose copays or deductibles on the recommended preventive care. "Many preventive care services are not covered by this decision," Simon said. Health plans will still be required to ensure no copays for many preventive services, including birth control and mammograms, Simon said. Some states have their own mandates, meanwhile, around free preventive care.

☆ US Justice Dept appeals Obamacare ruling blocking coverage mandate- White House
▼ + stars: | 2023-03-31 | by ( ) www.reuters.com time to read: +1 min

WASHINGTON, March 31 (Reuters) - The U.S. Justice Department is appealing a decision by a Texas judge that blocked Obamacare's mandate that health insurance plans cover preventive care at no cost to patients, the White House said on Friday. U.S. District Judge Reed O'Connor in Fort Worth, Texas, on Thursday blocked the federal government from enforcing requirements that insurance plans cover preventive care, including screenings for certain cancers and pre-exposure prophylaxis against HIV (PrEP). If O'Connor's ruling is not paused or overturned on appeal, insurers will be able to charge patients copays and deductibles for such services in new insurance plans. "The president is glad to see the Department of Justice is appealing the judge's decision," White House Press Secretary Karine Jean-Pierre said in a statement. "Preventive care saves lives, saves families money, and protects and improves our health," she said.

☆ Biden administration appeals Texas court decision striking down free Obamacare coverage of preventive care
▼ + stars: | 2023-03-31 | by ( Spencer Kimball | ) www.cnbc.com time to read: +3 min

The Biden administration on Friday appealed a Texas federal judge's decision to strike down free Obamacare coverage of preventive health-care services ranging from screenings for certain cancers and diabetes to HIV prevention drugs. HHS estimates that 150 million Americans benefited from the free screenings, counseling, medications and other forms of health care that prevent disease under the Obamacare requirements. Working class Americans will get hit the hardest and might forgo essential health care because they can't afford the cost, Gostin said. O'Connor ruled that Obamacare cannot mandate free coverage of health care recommended by the Preventive Services Task Force because the organization's members were appointed in an illegal manner. They also argued the Preventive Services Task Force was appointed in an unconstitutional manner and therefore its recommendations cannot serve as the basis of an Obamacare mandate.

☆ 75% of Medicare beneficiaries worry about affording costs beyond premiums. Here’s how high out-of-pocket costs can go
▼ + stars: | 2023-03-24 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

watch nowOther beneficiaries instead decide to pair Parts A and B with a standalone Part D plan and, often, a Medigap plan, which covers part of the out-of-pocket costs that come with Parts A and B. Basic Medicare has no out-of-pocket limitIf you have only basic Medicare, there is no cap on what you might spend in any given year. "If you can find a plan that has a lower out-of-pocket limit, such as $3,000 or $4,000, that is a benefit to you." "Both Medigap and Medicare Advantage Plans do a good job of this, since most Medigap plans cover the 20% [coinsurance] and Advantage Plans have caps on Parts A and B spending." Part D does come with catastrophic coverage that kicks in once out-of-pocket expenses reach $7,400 in a given year, Roberts said.

☆ How to factor your health into your financial planning, according to a doctor-turned-advisor
▼ + stars: | 2023-03-14 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +3 min

"A healthy person needs a totally different [financial] plan from someone who has health issues." This document outlines the health care you want and don't want if you become unable to communicate those desires yourself. You also should have powers of attorney assigned to trusted individuals for health care and, separately, your finances. "Everyone needs those documents, but especially if you have significant health issues," McClanahan said. Your use of health care should be considered

☆ How the New $35 Cap on Insulin Costs Will Work
▼ + stars: | 2023-03-02 | by ( Peter Loftus | ) www.wsj.com time to read: 1 min

The new $35 cap on out-of-pocket costs for insulin is here, though it isn’t for everyone, and some people may experience delays in getting the price break. Starting Jan. 1, Medicare members, who include people 65 years and older and people with disabilities, should pay no more than $35 a month in copays or other out-of-pocket costs for an insulin prescription. Medicare benefit plans and in some cases drug manufacturers will pick up the rest of the drug’s cost.

☆ Most Medicare Advantage users are happy with their plan. What to do if you're not
▼ + stars: | 2023-03-02 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

momcilog | E+ | Getty ImagesFor the most part, Medicare beneficiaries in Advantage Plans are happy with their coverage, a new study suggests. However, if you're among those who are not thrilled about your 2023 Advantage Plan, you can do something about it. Or, they can drop the one they have altogether in favor of basic Medicare (Part A hospital coverage and Part B outpatient care coverage). Additionally, if you drop your Advantage Plan, don't assume that you'll be able to get a so-called Medigap policy, which many beneficiaries pair with basic Medicare. This means that once you move to a different Advantage Plan or drop it for basic Medicare, the change is generally locked in for the year.

☆ Medicare expenses in retirement could top $383,000 for a couple with high drug costs, study finds
▼ + stars: | 2023-02-16 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +5 min

"You don't want to be shocked when you get to retirement and find this out, or discover that Medicare doesn't cover everything," Fronstin said. Representing an extreme case, a couple with high prescription drug expenses would need to have saved $383,000 to have a 90% chance of having enough to cover their health-care costs. Advantage Plan coverageThe second coverage scenario analyzed in the study involves a Medicare Advantage Plan, which delivers Parts A and B, and typically Part D, as well extras like dental and vision. Of Medicare's 64.5 million beneficiaries, 29.1 million are enrolled in Advantage Plans and that number is expected to continue growing. While many Advantage Plans have no premium, they do have their own deductibles, copays or coinsurance and out-of-pocket maximums that vary from plan to plan.

☆ Veterans Affairs Agency Waives Doctor Copays for Native Veterans
▼ + stars: | 2023-01-21 | by ( Ben Kesling | ) www.wsj.com time to read: 1 min

The Department of Veterans Affairs said it would waive all copays for eligible American Indian and Alaska Native veterans, in an effort to boost use of primary-care medicine among traditionally underserved populations. “It’s no mystery to a lot of people that healthcare is sometimes hard to come by in many Native American communities,” said Travis Trueblood , director of tribal health for the VA, adding that this policy tries to help address that discrepancy.

☆ Open enrollment for 2023 health insurance through the public exchange ends Sunday
▼ + stars: | 2023-01-15 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +1 min

If you don't have health insurance for 2023, you may still be able to get it through the public marketplace. Open enrollment for the federal health-care exchange ends Sunday, with coverage taking effect Feb. 1. If your state operates its own exchange, you may have more time. Most marketplace enrollees — 13 million of 14.5 million in 2022 — qualify for federal subsidies (technically tax credits) to help pay premiums. For the most part, people who get insurance through the federal (or their state's) exchange are self-employed or don't have access to workplace insurance, or they don't qualify for Medicare or Medicaid.

☆ Starting Tuesday, all U.S. military veterans in suicidal crisis will be eligible for free care at any VA or private facility
▼ + stars: | 2023-01-13 | by ( Https | Media-Cldnry.S-Nbcnews.Com Image Upload Newscms Courtney-Kube-Circle-Byline-Template.Jpg | Courtney Kube | ) www.nbcnews.com time to read: +2 min

Beginning Tuesday, U.S. military veterans who find themselves in suicidal crisis will be eligible for free emergency medical care at any Department of Veterans Affairs facility or any private facility. Unlike for most other medical benefits, veterans do not have to be enrolled in the VA system to be eligible. The VA already provides emergency suicide care, but with the new benefit, veterans will not have to pay any copays or fees for their care. If the veterans receive care at a private facility rather than at a VA facility, the government will cover the costs. “Veterans in suicidal crisis can now receive the free, world-class emergency health care they deserve — no matter where they need it, when they need it, or whether they’re enrolled in VA care,” VA Secretary Denis McDonough said in a statement.

☆ Here are key things you need to know if you’re eyeing a Medigap policy alongside basic Medicare
▼ + stars: | 2023-01-06 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +7 min

For about 23% of Medicare's 65.1 million beneficiaries, the solution for covering those outlays is a so-called Medigap plan. The reasons that some beneficiaries instead choose Medigap alongside basic Medicare vary from person to person, according to Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans. watch nowHere's what to know about Medigap policies if you're considering purchasing one. There's huge variation in costDespite Medigap policies' standardization, the premiums can vary greatly. The way a Medigap plan is 'rated' also mattersAnother difference in Medigap premiums can come from how the plans are "rated."

☆ There's still time to get health insurance through the public exchange — and you may qualify for help paying premiums
▼ + stars: | 2023-01-02 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +1 min

Anyone without health insurance has about two weeks left to get 2023 coverage through the public marketplace — and subsidies could make it affordable. Open enrollment for the federal health care exchange runs through Jan. 15, with coverage taking effect Feb. 1. Most marketplace enrollees — 13 million of 14.5 million in 2022 — qualify for federal subsidies (technically tax credits) to help pay premiums. For the most part, people who get insurance through the federal (or their state's) exchange are self-employed or don't have access to workplace insurance, or they don't qualify for Medicare or Medicaid. As of Dec. 15, nearly 11.5 million people had selected a plan through the marketplace, according to CMS.

☆ Some Medicare costs are heading higher in 2023, while others are going down. Here's what you need to know
▼ + stars: | 2022-12-29 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

Part B premium and deductible will be lowerThe standard Part B premium will be lower in 2023 — $164.90, down from $170.10 in 2022. While most beneficiaries pay the standard premium, higher-income enrollees pay more due to income-related surcharges (see table below). However, "they are calculated based on income two years prior," said Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans. And, some of those options either have no monthly charge or will pay your Part B premium. The maximum out-of-pocket limit for Advantage Plans will be $8,300 in 2023 for in-network services.

The Mark Cuban Cost Plus Drug Company negotiates directly with drugmakers. So far, that's been the strategy for the Mark Cuban Cost Plus Drug Company. In October, Cost Plus Drug Company announced a partnership with Capital Blue Cross. Cuban said he wanted Cost Plus Drug Company to be as transparent as possible on pricing. Cost Plus Drug Company is considering a test program for insulin that would offer a 90-day supply of insulin, or a total of 12 vials, for $170.

☆ You can still sign up for 2023 health insurance through the public marketplace — but waiting past Dec. 15 can delay coverage
▼ + stars: | 2022-12-14 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

FamVeldIf you don't have health insurance lined up for next year, there's still time to get private coverage through the public marketplace. The deadline is Dec. 15 — Thursday — to sign up on Healthcare.gov for a health plan to take effect Jan. 1. Most marketplace enrollees — 13 million of 14.5 million — qualify for federal subsidies (technically tax credits) to help pay premiums. For enrollees who get subsidies, coverage is generally dropped after three months if premiums are not caught up. That's been the case even if a worker wanted their dependents covered too — meaning the actual cost of family coverage could far exceed that threshold.

☆ How Much Car Insurance Do I Need?
▼ + stars: | 2022-11-13 | by ( ) www.wsj.com time to read: +11 min

We’ll guide you through how to decide what car insurance works for you––making sure you get the coverage you need without breaking the bank. Required coverage amounts vary by state, but often match the minimum liability insurance coverage requirements. At the same time, if you have collision insurance (more on this below) and a low deductible on your health insurance plan, this insurance could be largely redundant—and you may well be safe with your state’s minimum. How much collision insurance coverage do I need? Also just like collision insurance, the coverage limit for comprehensive insurance is typically the cash value of your car.

☆ Here are 4 ways to take advantage of your health-care expenses before the end of the year
▼ + stars: | 2022-11-13 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +5 min

Take advantage of reaching your deductibleIf you've met your plan's deductible, you may be able to pay less for qualifying health-care services before the end of the year than you would after the deductible resets Jan. 1. Once you've met your plan's deductible, you may or may not face copays or coinsurance — it depends on your plan's out-of-pocket maximum, which may be higher. See if you can get the medical expense tax deductionThere is a tax deduction for medical expenses, although it comes with parameters that prevent some taxpayers from using it. For starters, you can only deduct health-care expenses that exceed 7.5% of your adjusted gross income. Its gains grow tax-free, and as long as withdrawals are used for qualifying medical expenses, tapping those funds also comes with no tax.

☆ Before dropping a Medicare Advantage plan altogether during open enrollment, compare these key costs
▼ + stars: | 2022-11-02 | by ( Sarah O'Brien | ) www.cnbc.com time to read: +4 min

FatCamera | E+ | Getty ImagesFor some Medicare beneficiaries, an Advantage Plan ends up not being a good fit. Here's what to consider if you want to ditch an Advantage Plan altogether. Danielle Roberts co-founder of Boomer Benefits"There is not a guarantee that the underwriter will approve you for the Medigap policy," Roberts said. This means it may be wise to avoid dropping your Advantage Plan until you know you'd be able to get the Medigap policy. That 12-month trial period lets you drop an Advantage Plan and return to the Medigap plan you were previously enrolled in.

The cost of insulin remains a barrier for many Americans with diabetes who depend on the drug, research published Monday suggests. It was the first time that the CDC had included questions about insulin use, though concerns about sky-high insulin prices have been reported for years. Meanwhile, those with public health coverage, such as Medicaid and Medicare, had the lowest rates of rationing. According to the American Diabetes Association, people with type 1 diabetes need, on average, two to three vials per month. He said the "most ambitious" proposal he would like to see in the U.S. is universal health coverage with no copays for consumers.

☆ Insulin: 1.3 million Americans with diabetes rationed their supply in the past year, study finds
▼ + stars: | 2022-10-17 | by ( Naomi Thomas | ) edition.cnn.com time to read: +10 min

They looked at how commonly these people rationed insulin because of how much it cost. “What we found was that nationwide, about 1.3 million Americans with diabetes rationed insulin annually, and that’s about 16.5% of all those people who use insulin,” Gaffney said. Although there’s no known way to prevent type 1 diabetes, type 2 can be prevented or delayed with healthy lifestyle changes, including losing weight and being active. Her own research into a single diabetes center found high rates of insulin rationing. T1 International is led by people with type 1 diabetes who support local communities, giving them the tools they need to access insulin and diabetes supplies.

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