Some Medicaid Providers Borrow or Go Into Debt Amid ‘Unwinding’ Payment Disruptions
Used to operating with scarce resources, Montana Medicaid providers say gaps in state payments have left them struggling further.
Out-Of-Pocket Costs
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California’s Expanded Health Coverage for Immigrants Collides With Medicaid Reviews
A state policy to extend Medi-Cal to qualified Californians without legal residency is running up against a federal requirement to resume eligibility checks. The redetermination process is causing many Latinos, who make up a majority of Medi-Cal beneficiaries, to be disenrolled.
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When Copay Assistance Backfires on Patients
Drugmakers offer copay assistance programs to patients, but insurers are tapping into those funds, not counting the amounts toward patient deductibles. That leads to unexpected charges. But the practice is under growing scrutiny.
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If You’re Poor, Fertility Treatment Can Be Out of Reach
For low-income people who are on Medicaid or whose employer health plan is skimpy, help for infertility seems unattainable.
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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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New California Law Offers Fresh Protection From Steep Ambulance Bills
The law, which takes effect Jan. 1, prohibits out-of-network ground ambulance operators from billing patients more than they would pay for in-network rides. It also caps how much the uninsured must pay.
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Pfizer and Moderna Are Pushing the New Covid Booster. Should You Get It? The CDC Is About to Decide.
Chances are, if you aren’t older, chronically ill, or obese, you don’t need a forthcoming covid vaccine to stay out of the hospital. But it probably wouldn’t hurt.
By Arthur Allen -
His Anesthesia Provider Billed Medicare Late. He Got Sent to Collections for the $3,000 Tab.
Medicare was supposed to cover the entire cost of his procedure. But after the anesthesia provider failed to file its claims in a timely manner, it billed the patient instead.
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New Weight Loss Drugs Carry High Price Tags and Lots of Questions for Seniors
Although nearly 40% of Americans 60 and older are obese, Medicare doesn’t cover weight loss medications. Meanwhile, studies haven’t thoroughly examined new drugs’ impact on older adults.
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Once the New Over-the-Counter Birth Control Pill Is Available, What About Cost and Coverage?
The Food and Drug Administration’s approval is viewed as groundbreaking, but many details still must be figured out.
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With More People Giving Birth at Home, Montana Passed a Pair of Laws to Make It Easier
The state now requires Medicaid to cover midwife services and has expanded the list of prescription drugs midwives can administer.
By Keely Larson A $229,000 Medical Bill Goes to Court
Season 9, Episode 5Lisa French was told her surgery would cost $1,337. But the hospital sent her a bill for $229,000, then sued her. The case went all the way to the Colorado Supreme Court. The court’s ruling could have major implications for determining a “reasonable price” in health care.
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Eli Lilly Slashed Insulin Prices. This Starts a Race to the Bottom.
Eli Lilly's news that it plans to cut insulin costs for patients will help, not hinder, the recent efforts in California and by entrepreneurs such as Mark Cuban to offer lower-cost alternatives, drug pricing experts said.
By Bram Sable-Smith and Samantha Young -
After Capping Insulin Copays, Colorado Sets Its Sights on EpiPens
Colorado’s proposed legislation to cap the copay for the EpiPen is part of a nationwide trend as more states try to shield patients from skyrocketing drug prices.
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Era of ‘Free’ Covid Vaccines, Test Kits, and Treatments Is Ending. Who Will Pay the Tab Now?
Insurers, employers, and taxpayers will all be affected as drug manufacturers move these products to the commercial market.
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Readers and Tweeters Diagnose Greed and Chronic Pain Within US Health Care System
KHN gives readers a chance to comment on a recent batch of stories.
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Want a Clue on Health Care Costs in Advance? New Tools Take a Crack at It
Another effort to make upfront cost comparisons possible in an industry known for its opaqueness: an online tool for consumers to get some idea of what they may pay for medical care.
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What Germany’s Coal Miners Can Teach America About Medical Debt
Coal mining ended in Germany’s Saarland a decade ago, but the transition away from coal has been smoother than in West Virginia, which has more medical debt than any state in America.
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Employers Use Patient Assistance Programs to Offset Their Own Costs
Some insurers and employers are tapping into assistance programs meant for individual patients. The concern: Some costly drugs could be harder for patients to access.
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Medicare Plan Finder Likely Won’t Note New $35 Cap on Out-of-Pocket Insulin Costs
In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.
By Susan Jaffe