Take a few easy steps now to get ready for November 1
First time applying through the Health Insurance Marketplace? Learn more about applying here.
Already have a 2015 Marketplace health plan? Learn more about staying covered here.
Note: Plans and prices for 2016 will be available by late October.
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
Michelle 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
Seattle’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, VirginiaMason.org.
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 MyVirginiaMason.org.
By 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?
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
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
Adults 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
By Michael Ollove
If Arizona gets its way, its able-bodied, low-income adults will face the toughest requirements in the country to receive health care coverage through Medicaid.
Most of the those Medicaid recipients, and new applicants, would have to have a job, be looking for one or be in job training to qualify for the joint federal-state program for the poor.
They would have to contribute their own money to health savings accounts, which they could tap into only if they met work requirements or engaged in certain types of healthy behavior, such as completing wellness physical exams or participating in smoking cessation classes. And most recipients would be limited to just five years of coverage as adults.
Despite its conservative bent, Arizona already has expanded Medicaid under the Affordable Care Act. In October, however, Republican Gov. Doug Ducey will ask the federal agency that oversees Medicaid to approve changes in the state’s program that are designed to promote healthy behavior in a traditionally unhealthy population, while encouraging people to become less economically dependent on the state. Continue reading
By 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.
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
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?
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
By 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.
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
Do you get health insurance through Washington Healthplanfinder?
Payment changes started Sept. 24
Starting 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
By 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