Even Patients Are Shocked by the Prices Their Insurers Will Pay 鈥 And It Costs All of Us
Health care prices are on the rise, and patients are flummoxed that even insurance companies aren鈥檛 doing more to control costs.
Insurers
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They Need a Ventilator To Stay Alive. Getting One Can Be a Nightmare.
Few nursing homes are set up to care for people needing help breathing with a ventilator because of ALS or other infirmities. Insurers often resist paying for ventilators at home, and innovative programs are now endangered by Medicaid cuts.
By Jordan Rau This Health Economist Wants Your Medical Bills
Season 14, Episode 3A longtime health economist sets her sights on lowering Americans鈥 insurance premiums.
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So Your Insurance Dropped Your Doctor. Now What?
Patients sometimes find themselves scrambling for affordable care when a contract dispute causes a hospital 鈥 and most of the doctors and other clinicians who work there 鈥 to be dropped from an insurance network. Here are six things to know if that happens to you.
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As Insurers Struggle With GLP-1 Drug Costs, Some Seek To Wean Patients Off
Conventional wisdom says GLP-1 drugs must be taken indefinitely to maintain weight loss. But a growing number of researchers, payers, and providers are challenging that consensus and exploring whether 鈥 and how 鈥 to taper patients off expensive GLP-1 drugs.
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When Hospitals and Insurers Fight, Patients Get Caught in the Middle
About 90,000 people spent months in limbo as central Missouri鈥檚 major, and often only, provider fought over insurance contracts. Patients getting caught in the crossfire of disputes has become a familiar complication, as about 8% of hospitals have left an insurer network since 2021. Trump administration policies could accelerate the trend.
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Insurers and Customers Brace for Double Whammy to Obamacare Premiums
Consumers face both rising premiums and falling subsidies next year in Obamacare plans, with insurers seeking increases to cover not only rising costs but also some policy changes advanced by President Donald Trump and the GOP.
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5 Takeaways From Health Insurers鈥 New Pledge To Improve Prior Authorization
Dozens of health insurance companies pledged on Monday to improve prior authorization, a process often used to deny care. The announcement comes months after the killing of UnitedHealthcare executive Brian Thompson, whose death in December sparked widespread criticism about insurance denials.
By Lauren Sausser and Phil Galewitz -
Their Physical Therapy Coverage Ran Out Before They Could Walk Again
Health plans limit physical or occupational therapy sessions to as few as 20 a year, no matter the patient鈥檚 infirmities. The limits persist despite federal rules banning insurers from setting annual dollar limits on the care they will provide.
By Jordan Rau -
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The Medicare Advantage Influence Machine
New court filings and lobbying reports reveal an industry drive to tamp down critics 鈥 and retain billions of dollars in overcharges.
By Fred Schulte and Holly K. Hacker -
Perspective
How Your In-Network Health Coverage Can Vanish Before You Know It
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of 鈥渜ualifying life events.鈥 But insurers鈥 contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
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The Colonoscopies Were Free. But the 鈥楽urgical Trays鈥 Came With $600 Price Tags.
Health providers may bill however they choose 鈥 including in ways that could leave patients with unexpected bills for 鈥渇ree鈥 care. Routine preventive care saddled an Illinois couple with his-and-her bills for 鈥渟urgical trays.鈥
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When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill
For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.
By Darius Tahir -
Out for Blood? For Routine Lab Work, the Hospital Billed Her $2,400
Convenient as it may be, beware of getting your blood drawn at a hospital. The cost could be much higher than at an independent lab, and your insurance might not cover it all.
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Quick Genetic Test Offers Hope for Sick, Undiagnosed Kids. But Few Insurers Offer to Pay.
A new, rapid genetic test shows promise in increasing diagnoses and improving treatment for some children with rare genetic conditions. Many insurers won鈥檛 cover it, but Florida's Medicaid program is among those that see benefits 鈥 and, potentially, savings.
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Journalists Discuss Abortion Lawsuits and the Pros and Cons of Health Care Sharing Plans
黑料吃瓜网 News and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here鈥檚 a collection of their appearances.
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Patients Squeezed in Fight Over Who Gets to Bill for Pricey Infusion Drugs
To drive down costs, insurers are bypassing hospital system pharmacies and delivering high-priced infusion drugs, including some used in chemotherapy, via third-party pharmacies. Smarting from losing out on billing for those drugs, hospitals and clinics are trying to convince states to limit this practice, known as "white bagging."
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At Least 1.7M Americans Use Health Sharing Arrangements, Despite Lack of Protections
A new report boosts the estimated number of people enrolled in plans whose members 鈥 usually brought together by shared religious beliefs 鈥 pay one another鈥檚 health costs.
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Health Care Coalition Jockeys Over Medi-Cal Spending, Eyes Ballot Initiative
California Healthline has learned that a coalition of doctors, hospitals, insurers, and community clinics want to lock in a tax on health insurance companies to draw in extra Medicaid funding. It also wants to make the tax permanent.
By Angela Hart and Samantha Young