‘An Arm and a Leg’: She Fights Health Insurers for Fun — And Wins
Law professor Jackie Fox looks at health insurance policies like any other contract, and she has spent 30 years making sound legal arguments to help patients get the care they need.
Insurance
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Post-Pandemic, What’s a Phone Call From Your Physician Worth?
Medicare billing codes for audio-only follow-up check-ins lead to new reimbursement battles.
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A Tale of Two Medicaid Expansions: Oklahoma Jumps In, While Missouri Lags
Voters in Missouri and Oklahoma approved Medicaid expansion to begin in 2021. But while Oklahoma has enrolled over 200,000 people so far, Missouri has enrolled fewer than 20,000. Why are two such similar states handling the public insurance rollout so differently?
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‘An Arm and a Leg’: How to Avoid the Worst Health Insurance
Listen to a journalist's first-person horror story on shopping for health insurance — and learn how to avoid the pitfalls.
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‘An Arm and a Leg’: The Insurance Warrior’s Battle Plan
Health care — and how much it costs — is scary. But knowledge is power. Take a master class in winning insurance appeals. In the case of Matthew Lientz, taking on his insurance also meant going up against his employer.
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Stranded by the Pandemic, He Had Only Travel Insurance. It Left Him With a $38,000 Bill.
Although it’s possible to buy travel insurance that provides some health coverage, the devil is in the fine print. Obama-era laws that prevent refusal of payment for preexisting conditions don’t apply to travel insurance.
By Arthur Allen -
Patients Get Stranded Out of Network as Insurer-Hospital Contract Talks Fall Apart
As hospital systems and insurers adjust to the pandemic, their contract negotiations grow increasingly fraught. Contracts for in-network care are ending without a new deal, leaving patients suddenly with out-of-network bills or scrambling to find new in-network providers.
By Andy Miller -
Missouri’s Thin Dental Safety Net Stretched Amid Medicaid Expansion
An estimated 275,000 Missouri adults can get dental insurance now as the state has expanded who is eligible for Medicaid. But with so few dentists participating in the program, the state’s already-backlogged dental clinics are facing a glut of new clients.
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Your Out-of-Pocket Health Care Costs Need Not Be a Mystery
A new California law requires health insurance companies to notify consumers how much remains on their deductibles and how close they are to their annual out-of-pocket spending limits.
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KHN’s ‘What the Health?’: Why Health Care Is So Expensive, Chapter $22K
Congress is making slow progress toward completing its ambitious social spending bill, although its Thanksgiving deadline looks optimistic. Meanwhile, a new survey finds the average cost of an employer-provided family plan has risen to more than $22,000. That’s about the cost of a new Toyota Corolla. Alice Miranda Ollstein of Politico, Anna Edney of Bloomberg News and Rebecca Adams of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Rebecca Love, a nurse academic and entrepreneur, about the impending crisis in nursing.
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Researcher: Medicare Advantage Plans Costing Billions More Than They Should
Some insurers pocketed ‘eye-popping’ overpayments, billing records show.
By Fred Schulte -
Medicare’s Open Enrollment Is Open Season for Scammers
Medicare officials say complaints are rising from seniors lured into private plans with misleading information or enrolled without their consent. In response, officials have threatened to penalize the private companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.
By Susan Jaffe -
As Workers Struggle With Pandemic’s Impact, Employers Expand Mental Health Benefits
Many job-based health plans broadened their mental health and substance use coverage to make sure workers had the support they needed this year as pandemic stress lingered, the annual KFF survey finds. Also, the proportion of employers offering health insurance to their workers remained steady, and increases for premiums and out-of-pocket health expenses were moderate.
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Medicare Enrollment Blitz Doesn’t Include Options to Move Into Medigap
TV ads and mailings targeting seniors tout Medicare Advantage plans this time of year, but millions choosing traditional Medicare make a costly and difficult decision about Medigap coverage, which gets much less attention.
By Harris Meyer -
New Health Plans Offer Twists on Existing Options, With a Dose of ‘Buyer Beware’
Fueled by consumer frustration with high premiums and deductibles, two new offerings promise a means for consumers to take control of their health care costs. But experts say they pose risks.
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California Law Aims to Strengthen Access to Mental Health Services
The law doesn’t take effect until July, but its passage should force insurers to expand their rosters of therapists. Here’s how you can challenge your health plan’s mental health services until then.
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If Congress Adds Dental Coverage to Medicare, Should All Seniors Get It?
Health equity advocates see a once-in-a-generation opportunity to provide a dental benefit to millions of older Americans as Congress considers expanding Medicare services. But complicating that push is a debate over how many of the more than 60 million Medicare recipients should receive dental coverage.
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What’s Scarier Than Covid? Halloween Health Haikus
A huge thank you to our readers who participated in our third annual KHN Halloween Haiku Contest. Based on a review by our expert panel of judges, we unmask the winner and serve a sampling of finalists.
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Medicare Punishes 2,499 Hospitals for High Readmissions
The federal government’s hospital penalty program finishes its first decade by lowering payments to nearly half the nation’s hospitals for readmitting too many Medicare patients within a month. Penalties, though often small, are credited with helping reduce the number of patients returning for another Medicare stay within 30 days.
By Jordan Rau -
How Billing Turns a Routine Birth Into a High-Cost Emergency
“Obstetrical emergency departments” are a new feature in some hospitals that can inflate medical bills for even the easiest, healthiest births. Just ask the parents of Baby Gus.