Category Archives: Insurance

Time to get ready for health insurance sign up


Take a few easy steps now to get ready for November 1

Get ready

First time applying through the Health Insurance Marketplace? Learn more about applying here.

  • Get a quick overview with 5 Health Insurance tips.
  • Use our checklist to gather everything you’ll need to apply.
  • Learn about key dates and deadlines to make sure you’re covered.

Already have a 2015 Marketplace health plan? Learn more about staying covered here.

  • Learn the 5 steps to staying covered.

Note: Plans and prices for 2016 will be available by late October.

The Team


Buyer Beware: a mammogram’s price can vary by nearly $1,000, study finds


Doctor views mammograms

By Jordan Rau

Thinking about getting a mammogram in the Dallas-Fort Worth area? You might check carefully because the cost can vary from $50 to as much as $1,045.

How about an initial routine gynecological exam? Around Phoenix, those prices can range from $72 to $388.

According to an analysis released Wednesday, it can pay to shop around for women’s health care, with mammograms and other routine services often costing far more in one office than in another. Continue reading


You can shift your health savings accounts to get a better deal


Twenty-dollar bill in a pill bottleMichelle Andrews answers your health insurance questions:

This week, readers wrote in with questions about health savings accounts and the “Cadillac tax.” Adding grandchildren to a health plan cropped up too.


Q. Last year, my wife and I opened a health savings account. Since then, my account has been moved twice, and we have no choice as to who manages it. We can’t shop around for someone with lower fees. I think that is a big flaw in the system. Why can’t I choose to have my HSA with the same company I have my brokerage account?

A. You may be able to do just that. Any contributions you make or your employer makes to a health savings account belong to you, and you can transfer the funds to a different HSA with another HSA provider that offers lower fees or better services if you wish, say Treasury Department officials. If you want to move the money to the company where you have your brokerage account, you can, provided that company offers health savings accounts. Continue reading


VM begins posting online ratings, patient comments about clinic providers


Virginia Mason VM ThumbSeattle’s Virginia Mason Medical Center has begun posting online star ratings for, and patients’ comments about, its clinic physicians and providers.

The ratings (up to five stars) and comments are based on patient satisfaction surveys and appear with providers’ biographies on the Virginia Mason website,

Screen Shot 2015-10-05 at 2.38.22 PM

Click on image to see the ratings and comments

To find a specific provider, type his or her name in the “Search” field at the top of the homepage. Click here to see an example.

In satisfaction surveys, patients rate physicians and other providers (i.e., physician assistants, advanced registered nurse practitioners) as Very Poor, Poor, Fair, Good or Very Good on these topics:

  • Friendliness/courtesy of the provider
  • Explanations the care provider gave you about your problem/condition
  • Concern the care provider showed for your questions or worries
  • Care provider’s efforts to include you in decisions about your treatment
  • Degree to which the provider talked with you, using words you could understand
  • Amount of time the care provider spent with you
  • Your confidence in the provider
  • Likelihood of your recommending this care provider to others

Ratings and patients’ comments are verified by Press Ganey Associates, an independent company that conducts ongoing satisfaction surveys.

The Virginia Mason Patient Relations and Service Department also uses information from the satisfaction surveys to identify and address issues of importance to patients and their families.

Virginia Mason is among a few health systems across the U.S. that post ratings for, and patient comments about, its providers on the Internet. Others include Cleveland Clinic, University of Utah Healthcare, Stanford Healthcare and University of Pittsburgh Medical Center.

Virginia Mason has launched several other similar initiatives include: implementing the Patient Cost Estimator, which offers comprehensive estimates of out-of-pocket costs for numerous medical exams and procedures; posting online the estimated prices of the 100 most common outpatient surgical procedures; and enabling Virginia Mason patients to see clinical notes about their care on the secure, online patient portal, called


Do workplace wellness programs lead to overtesting?


A researcher works with a rack of test tubesBy Julie Appleby

As health insurance open season heats up for businesses across the country, many employees will discover that participating in their company’s wellness program includes rolling up their sleeves for blood tests.

Half of large employers offering health benefits have wellness programs that ask workers to submit to medical tests, often dubbed “biometrics,” that can involve a trip to a doctor’s office, lab or workplace health fair.

Will the screening exams actually improve health, or merely add to a culture of over-testing that is helping drive up the cost of health care?

While aimed at uncovering potential health risks early to head off serious and costly problems, the programs that involve those biometrics are also controversial. Will the screening exams actually improve health, or merely add to a culture of over-testing that is helping drive up the cost of health care?

So far, research is mixed on whether these programs truly save employers money. The Rand Corp. says most don’t, with the exception of programs targeted at managing specific diseases, such as diabetes. Still, Rand found that programs can help spur employees to quit smoking, get more exercise and lose a bit of weight. Continue reading


Newly insured treasure Medicaid, but growing pains felt


By Sara Varney

SAN DIEGO — The Affordable Care Act unleashed a building boom of community health centers across the country. At a cost of $11 billion, more than 950 health centers have opened and thousands have expanded or modernized.

In San Diego, new clinics have popped up on school campuses and busy street corners. Cramped storefront clinics have been replaced with gleaming, three-story medical centers with family medicine, radiology and physical therapy on site. They are outfitted to care for new immigrants in dozens of languages from Spanish to Somali.

The community health centers are the country’s largest primary care system for low-income patients, now working to absorb a tsunami of new Medicaid enrollees.

At age 58, after several worrisome decades without health insurance, Lori Simpson is finally getting treatment for her dangerously high blood pressure, a serious thyroid disorder and, after years of double vision that had made it difficult for her to work and care for her grandchildren, surgery for her eyes.

“I have nine medications that I get every month, and mine comes to a little over two hundred dollars,” Simpson said. Prescription medications for her husband, a diabetic, cost $400 a month. “We don’t pay anything, it’s all covered. It’s just amazing.”

Simpson goes to the Family Health Centers of San Diego, which saw an increase of 24,000 patients, almost overnight, after the Medicaid expansion began in January 2014. Dr. Chris Gordon, the center’s assistant medical director, said it was a rush primary care clinics have been waiting for ever since President Barack Obama signed the health law in 2010.

“We’ve anticipated this for years and have been planning for it,” Gordon said. “We have capacity to take on patients. These are patients that haven’t had access before because they just didn’t have the financial means to get in. And now all of a sudden, they actually get to come in, get to spend time with somebody and get to feel like they’re heard.” Continue reading


Even with insurance many adults can’t afford dental care


500px-Cavities_evolution_1.svgAdults With Insurance Often Still Have Unmet Dental Needs, Survey Finds

By Michelle Andrews

Dental care ranked number one among health care services that people with insurance say they’re skimping on because of cost, a new survey found.

One in five adults reported that they had unmet dental care needs because they couldn’t afford necessary care, according to the brief by researchers at the Urban Institute’s Health Policy Center.

People said they were more likely to go without dental care than prescription drugs, medical care, doctor or specialist care, and medical tests. Continue reading


Workplace wellness programs put employee privacy at risk


wellness-sig-2By Jay Hancock

Houston workers who checked the fine print said they weren’t sure whether they were joining an employee wellness program or a marketing scheme.

Last fall the city of Houston required employees to tell an online wellness company about their disease history, drug and seat-belt use, blood pressure and other delicate information.

Whether or not your health information stays private is anything but clear, an examination by Kaiser Health News shows.

The company, hired to improve worker health and lower medical costs, could pass the data to “third party vendors acting on our behalf,” according to an authorization form. The information might be posted in areas “that are reviewable to the public.” It might also be “subject to re-disclosure” and “no longer protected by privacy law.”

Employees could refuse to give permission or opt not to take the screen, called a health risk assessment — but only if they paid an extra $300 a year for medical coverage.

“We don’t mind giving our information to our health care providers,” said Ray Hunt, president of the Houston Police Officers’ Union, which objected so strongly along with other employees that the city switched to a different program. “But we don’t want to give it to a vendor that has carte blanche to give that information to anybody they want to.”

Millions of people find themselves in the same position as that of the Houston cops. As more employers grasp wellness as the latest promised solution to soaring health costs, they’re pressuring workers to give unfamiliar companies detailed data about the most sensitive parts of their lives.


But whether or not that information stays private is anything but clear, an examination by Kaiser Health News shows. Continue reading


7 questions to ask your employer about wellness privacy


Question markBy Jay Hancock and Julie Appleby

If your company hasn’t launched a wellness program, this might be the year.

As benefits enrollment for 2016 approaches, more employers than ever are expected to nudge workers toward plans that screen them for risks, monitor their activity and encourage them to take the right pills, food and exercise.

Q. What information will my employer see?
Q. How many other companies see my wellness data?

This involves a huge collection of health data outside the established medical system, not only by wellness vendors such as RedbrickAudax and Vitality but also by companies offering gym services, smartphone apps and devices that track steps and heartbeats. Such partners pass worker results to the wellness providers.

Standards to keep such information confidential have developed more slowly than the industry. That raises risks it could be abused for workplace discrimination, credit screening or marketing, consumer advocates say.

Here’s what to ask about your company’s plan. Continue reading


Does Clinton have the Rx for rising health costs?


Twenty-dollar bill in medicine bottleBy Julie Rovner

While the Republicans running for president are united in their desire to repeal the federal health law, Democrat Hillary Rodham Clinton is fashioning her own health care agenda to tackle out-of-pocket costs – but industry experts question whether her proposals would solve the problem.

In addition to defending the  Affordable Care Act, Clinton released two separate proposals this week. One would seek to protect people with insurance from having to pay thousands of dollars in addition to their premiums for prescription drugs; the other would set overall limits on out-of-pocket health spending for those with insurance.

“When Americans get sick, high costs shouldn’t prevent them from getting better,” said Clinton in a statement provided by the campaign. “My plan would take a number of steps to ease the burden of medical expenses and protect health care consumers.”

Plan would let people see a doctor at least three times a year without having to first satisfy their deductible and create a tax credit for those whose out-of-pocket spending is more than  5% of their income.

The drug plan would, among other things, cap payments for covered prescriptions at $250 per month and let the government negotiate prices for the Medicare program. The overall health spending plan would let people see a doctor at least three times a year without having to first satisfy their deductible and create a new tax credit for those whose out-of-pocket spending is more than  5 percent of their annual income.

But while surveys show that health costs, and particularly drug costs, are a top concern for many voters, it’s not at all clear that Clinton’s proposals – some of which have been  mentioned for decades – would provide an actual cure. Continue reading


Payment changes for health exchange plans


Do you get health insurance through Washington Healthplanfinder?
Payment changes started Sept. 24

From the Office of the Insurance Commissioner

Coverage is hereStarting Sept. 24, 2015, if you have been buying an individual or family health plan through Washington Healthplanfinder, you must now pay your premium directly to your health insurer or dental insurer.

Any financial help – such as tax credits or cost-sharing reductions you’re receiving – won’t be affected by this change

Tips for an easy transition

  • Pay your insurance company directly by Sept. 23 at 4:59 p.m. for your October coverage.
  • Look for information in early October from your insurance company about your November premium payment deadline.
  • If you have health and dental insurance provided by two different companies, remember to make a payment to each insurance company.Remember: 

After canceling auto pay with Washington Healthplanfinder, be sure to set up your premium payment with your insurance company right away! Contact your insurance company to see what payment methods they offer.

If you have auto pay or automatic funds transfer set up through your bank, you’ll need to contact your bank to redirect your monthly payments to your insurance company before Sept. 24, 2015.

For more information


Obama administration will target hard-to-reach uninsured in next enrollment period


ACA health reform logoBy Mary Agnes Carey

The health law’s upcoming enrollment period may be its toughest yet, with federal officials promising a vigorous outreach campaign to enroll millions of eligible yet hard-to-reach Americans who have yet to sign up for health insurance.

“Those who are still uninsured are going to be a bigger challenge,” Department of Health and Human Services Secretary Sylvia Mathews Burwell said Tuesday in remarks to the Howard University College of Medicine.

This year’s enrollment campaign will be harder in part because officials will be pursuing those who have declined to sign up for health insurance during the two previous enrollment seasons.  Continue reading