Posts Tagged ‘ insurance ’

How Patient Advocates Can Improve Health Literacy

How Patient Advocates Can Improve Health Literacy

Many clinicians, insurance company claims representatives, lobbyists, and directors of medical associations do not realize how many adults in the U.S. (90 million) are not conversant with navigating the health care system. Even if they are aware of the fact itself, the seriousness of the implications may escape them. Low levels of health education...

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Excessive Medical Treatment?

Excessive Medical Treatment?

Upon reading Tara Parker-Pope‘s article, “Too Much Medical Treatment,” I was moved to compare and contrast my experience at San Francisco Kaiser Medical Center for the same issue: a moderately-severe sprained ankle that occurred on a Sunday. I checked in to the Emergency Room and was  immediately placed in an examining room. A nurse-practitioner...

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Educational Podcasts for the Health Care Consumer

Educational Podcasts for the Health Care Consumer

Free podcasts are available to the general public, courtesy of my professional association, the National Association of Healthcare Advocacy Consultants (NAHAC).   For instance, Richard Heasley, director of San Francisco’s Conard House, presented a teleconference on May 16, 2012  entitled “Effective Teamwork with Psychiatric Patients.” Other topics include eldercare, patient safety, Medicare, and many others. You can...

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Caveat emptor*

Caveat emptor*

There is a Catch-22 (well, one of several) for health care consumers trying to manage medical expenses. This is especially galling if you happen to be in a so-called “consumer-directed health plan,” also known as a high-deductible plan. What’s the catch? The idea of the consumer-directed plan is to make you aware of how...

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California’s Criteria for Dual-Eligibles

California’s Criteria for Dual-Eligibles

Well before the PPACA was enacted, certain individuals over age 65 or collecting federal disability payments may be eligible to participate in both Medicare and Medicaid (termed “Medi-Cal” in California). Such an individual is termed a “dual eligible.” The advantages to dual-eligibility include greater financial assistance and access to services which may not be available...

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Shopping for Private Health Insurance – A Brief Primer

Shopping for Private Health Insurance – A Brief Primer

Purchasing medical insurance is much like purchasing a car. There is a host of factors attendant to each transaction which makes it difficult to compare plans and understand how much more or less one particular plan will cost compared to another. It can be done, but takes a bit of work and sometimes even...

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More Profits for Health Insurers

More Profits for Health Insurers

Here we go again. Although California health insurers cannot justify raising premiums, rates continue to grow faster than underlying costs. Premiums for hundreds of thousands of individual policyholders are to increase at 8% to 14%. This is a significant chunk of change. My policy is $1,000 monthly. So a 14% increase is $140. The...

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Are You a “Dual Eligible”? If so, your prescription drug benefits are enhanced.

Are You a “Dual Eligible”? If so, your prescription drug benefits are enhanced.

If you live in, say,  New York and are on Medicaid, then you become Medicare eligible, do you use Medicaid’s prescription plan, Medicare’s prescription plan, or both? Short answer: Both. But – once eligible for Medicare, Part D is the primary payor for dual eligibles for prescription medication and Medicaid is always the insurer...

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Medi-Cal: California’s Medicaid Program

Medi-Cal

In California, Medicaid is termed “Medi-Cal.” It is governed by federal and state governance as well as the governance of 58 counties, and is a patchwork of various programs and services subject to complex federal, state and county criteria eligibility. The applicant must supply proof of California residency. A social security number or pending application...

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Why your doctor can’t spend more time with patients.

Why your doctor can’t spend more time with patients.

Pauline Chen is spot-on with this feature: An Insurance Maze for U.S. Doctors. If you wonder why your physician seems stressed, inattentive, burned out, or any number of other states signifying that your health interests are competing for attention with other concerns, this is a primary reason why. I read this with interest, as...

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