Short term health insurance….A horse (of course) or Mr. Ed?

It looks like a horse. It smells like a horse. It rides like a horse. It must be a horse, right? Well, maybe, unless it’s the Famous Mr. Ed. For those of you too young to remember, Mr. Ed was a talking horse who could only be heard by his owner, and was a bit of a troublemaker. He looked like a horse, but he didn’t behave like one.

I found myself thinking about him when I saw this sign posted at an intersection a few weeks ago. Health insurance is health insurance is health insurance, right? Not if you were Melissa.* read more

In or Out, Round About – Navigating Out of Network Providers

Stethoscope and hundreds of American dollars

Health insurance is complicated and healthcare costs a lot. If you’re not up for a complicated read, here’s the short version: Don’t use out of network providers if you can avoid it. If you think healthcare is expensive, out of network healthcare is very expensive! But if you want to dig a bit deeper, read on.

 

Maybe your doctor has recommended you see a certain specialist who’s not in your insurance network. Maybe you’re in an accident and the closest hospital isn’t in your insurance network. What then? read more

It costs how much??

Health care costs scrabble

Anymore, it seems for most of us every medical bill has a surprise when we first open the envelope!

How does a provider (doctor, hospital, laboratory, imaging center) decide how much healthcare costs? It’s a pretty closely guarded secret, and it’s not uniform across providers. But suffice it to say, it definitely requires some serious accounting that is largely invisible to consumers. Coined the “chargemaster” by Time author Stephen Brill, providers establish a base price for each and every service they provide. This is the price that they bill insurers and patients without insurance for services. It includes their overhead costs (staff, facilities, billing), and is essentially the base price for services. Understandably it’s higher for hospitals who have more significant overhead costs and lower for office based providers. Consider this “retail” pricing. read more

Does Insurance Cover That?

insurance

Inevitably when I’m asked what I do and respond that I’m a private patient advocate, one eyebrow raises, followed by “What’s that?”

My “Private Patient Advocate” elevator speech goes something like this:

“Private patient advocates are independent professionals that help patients and their families clarify options for managing their healthcare as well as the cost of their care. This might mean things like sourcing a doctor for a second opinion, facilitating better coordinated care, researching nursing homes, or negotiating insurance claims and medical bills.” read more