The Affordable Care Act (ACA; aka Obamacare) Health Insurance Marketplace begins its fifth Open Enrollment period today. American healthcare consumers can sign up on the federal insurance exchange at healthcare.gov or through their state marketplaces. This year, there is increased confusion and anxiety surrounding Open Enrollment due to changes (and attempted changes) made to the ACA under the Trump administration. Previous years Open Enrollment period ran 90 days after November 1 until the end of January but has been cut to 45 days this year unless you qualify for the Special Enrollment Period, extending the enrollment period by an […]
Tag: Uninsured
What is a Clawback & How it’s Affecting Your Prescription Copays
Americans may be surprised to learn that they could be paying more for their medications with their insurance copay instead of the cash price available to those without insurance. A study published last week found that Pharmacy Benefit Managers (PBMs) undermine claims that negotiated “rebates” with pharmaceutical companies are passed on to consumers. This follows a federal lawsuit filed over the summer after a California woman paid a $164 copay on a medication that can be purchased for $92 from the same pharmacy by anyone not using insurance. This practice is known as “clawback” and is instituted by PBMs who […]
Children’s Health Insurance Program (CHIP) Expires
Congress has allowed the Children’s Health Insurance Program (CHIP), which insures 9 million children in the United States, to expire. The program provided coverage for children in families making under 200% Federal Poverty Level (FPL) as well as to pregnant women. CHIP played a huge part in decreasing the rate of uninsured children from 14% in 1997 to 4.5% in 2015. By taking no action to renew the program before September 30, 2017 the U.S. Congress allowed the program to lose future funding, putting millions of American children at risk of major health complications from ordinarily treatable conditions. CHIP covers […]
Understanding Health Insurance
by Richard Sagall, M.D. Insurance is really a simple concept. But few people, and even fewer politicians, seem to understand how insurance works and why so many of the promises we hear are impossible. Here are the basic concepts of insurance: Number 1 – You Never Win with Insurance – You always lose with insurance. Think about what happens when you have health insurance. Outcome 1 – You get sick, perhaps really sick, and you suffer while ill. You may experience long-term or even permanent disability from your illness. Or, in the worst case, you die. Your health insurance helps […]
National Health Center Week
This week is National Health Center Week. As health care has become more and more expensive, the need for low-cost health care has increased. Many people living in more rural parts of the country have a very limited number of options to see a doctor, and depending on their insurance status the number of available “in-network” doctors is even lower. Many people do not regularly see their doctor, only seeking help when a more serious condition arises. It can be a scary situation to be uninsured and have an unforeseen medical problem come up. This week is meant to celebrate […]