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Kaiser Health News: Insurance, Coverage & Health Costs News


Insurance, Coverage & Costs

Thursday, November 19, 2015
Check Kaiser Health News online for the latest headlines

This email contains the latest from Kaiser Health News about insurance, coverage and health care costs. To view all KHN resources on these topics, visit the Insurance or Health Costs news pages.

‘Do The Math’ When Shopping For A Health Plan This Open Enrollment Season
Because of the complexity of insurance available through and state exchanges, and the broad variation in how prescription drugs are covered, experts encourage consumers to compare options to figure out which one best fits their needs.

When Something Goes Wrong At The Hospital, Who Pays?
Hospital practices vary when it comes to paying care costs for patients with bad outcomes. Sometimes, patients foot the bill.

New Health Plans Offer Discounts For Diabetes Care
Aetna is rolling out a special gold-level plan for 2016 that is aimed at providing better care for people with diabetes in the hopes of keeping them healthier — and their costs down. But it’s not clear the plans are a good buy.

Study Finds Marketplace Silver Plans Offer Poor Access To HIV Drugs
Only 16 percent of the popular plans cover all 10 of the most common drug regimens and charge less than $100 a month in consumer cost sharing, according to a report by Avalere Health.

Five Things Young Adults Should Know About Buying Health Insurance
Open enrollment under Obamacare started Nov. 1 if you’re uninsured, now’s the time to consider options.

Costs May Keep Low-Income Patients From Clinical Trials, Study Finds
Insurance generally covers routine costs patients encounter in a clinical trial, but the patients can still be responsible for co-payments and other expenses, such as lost wages and travel.

Survey: Low-Income Elderly Reject Calif. Managed Care Experiment For Fear Of Change
About 47 percent opt out of California’s “dual eligibles” program serving Medicare and Medicaid patients, in part because they fear losing their doctors, a survey finds. But once enrolled in the pilot program, most stay.

Health Law Increases Coverage Rates For Women Not Yet Pregnant
The Urban Institute and March of Dimes estimate 5.5 million women of childbearing age gained health insurance under the federal health law since 2013, but many still have unmet needs.

Updated Breast Cancer Screening Guidelines Unlikely To Affect Insurance Coverage
The American Cancer Society now recommends that women begin annual mammogram screenings at age 45 instead of age 40, and that providers reduce the frequency of screening to every two years after age 54.

No Ready-Made Rx For Rising Drug Costs
Lawmakers, insurers and others have floated proposals to combat the spike in prescription drug prices, but will any of them gain traction?

N.Y. Attorney General Reaches Agreement With Urgent Care Clinics In First ‘Surprise Medical Bill’ Action
The clinics have agreed to disclose more fully which health insurance plans consider them “in network.”

HHS: Remaining Uninsured Worry About Costs Of Coverage
The Obama administration expects 1 million more people to be enrolled in marketplace coverage by the end of 2016.

Medical Prices Higher In Areas Where Large Doctor Groups Dominate, Study Finds
Researchers report that prices for a dozen procedures and tests were 8 to 26 percent higher in counties with the highest level of physicians concentrated in large group practices.

Buyer Beware: A Mammogram’s Price Can Vary By Nearly $1,000, Study Finds
Researchers looked at women’s health services around the country and found stark disparities between cities but also within health care markets.

Chronically Ill Pay More in Obamacare Plans Than Employer Coverage
Patients on typical silver plans pay twice as much as workers with job-based insurance for prescription drugs each year, researchers find.

Adults With Insurance Often Still Have Unmet Dental Needs, Survey Finds
Dental care is the health service that people most frequently avoid because of cost, researchers at the Urban Institute found.

Newly Insured Treasure Medicaid, But Growing Pains Felt
People newly covered by the Affordable Care Act’s Medicaid expansion appreciate their insurance. But seeing specialists is still a hurdle for many.

Insurers Find Out-Of-Network Bills As Much As 1,400 Percent Higher
Insurers’ study points to the need for limits on out-of-network billing by doctors and hospitals. The American Medical Association calls the report “grossly misleading.”

Think Health Prices Are High Near You? Maybe Yes — And No
The Health Care Cost Institute’s analysis of billing claims from three of the biggest commercial insurers finds that health services can be expensive in some areas while bargains in others. The findings complicate an assumption about health care markets.

Employers Shift More Health Costs To Workers, Survey Finds
Even as premiums for employer-based insurance increased only moderately this year, deductibles rose faster than total spending.

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2015 Kaiser Health News. All rights reserved.

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