Category: out of pocket costs

Despite Restraints, Democrats’ Drug Pricing Plan Could Still Aid Consumers

A last-minute agreement among lawmakers restored a provision seeking to hold down rising costs of prescription medicines. Although details on which drugs will be targeted remain sketchy, the legislation would help patients buying insulin and cap Medicare beneficiaries’ out-of-pocket drug costs at $2,000 a year.

Jaw Surgery Takes a $27,119 Bite out of One Man’s Budget

A Seattle patient discovers the hard way that you can still hit a lifetime limit for certain types of care. And health plans can vary a lot from one job to the next, even if the insurer is the same.

Enough to Wreck Their Rest: $10,322 for a Sleep Study

The University of Miami Health System charges a truck driver six times what Medicare would pay for an overnight test.

KHN’s ‘What the Health?’: 2020 in Review — It Wasn’t All COVID

The coronavirus pandemic colored just about everything in 2020. But there was other health policy news that you either never heard or might have forgotten about: the Affordable Care Act going before the Supreme Court with its survival on the line; ditto for Medicaid work requirements. And a surprise ending to the “surprise bill” saga. Joanne Kenen of Politico, Anna Edney of Bloomberg News and Sarah Karlin-Smith of Pink Sheet join KHN’s Julie Rovner to discuss these issues and more.

Surprise! Congress Takes Steps to Curb Unexpected Medical Bills

A long-debated measure to stop doctors, hospitals and other health care providers from billing patients for charges not covered by their insurance will gain congressional approval as part of the sweeping government spending package.

During ACA Open Enrollment, Picking a Plan Invites New COVID Complications

COVID-19’s “long haulers” — patients with lingering effects of the disease — have joined the ranks of Americans with preexisting conditions. For those shopping for health coverage on the individual market, here’s help navigating an uncharted insurance landscape.

Surprise Federal Drug Rule Directs Insurers to Reveal What They Pay for Prescription Drugs

A provision the Trump administration tucked into its final rule on health plan price transparency requires telling consumers what they will pay out-of-pocket for drugs and showing them what the plan paid.

Savvy Patient Fought for the Price She Was Quoted − And Didn’t Give Up

A California woman thought the discount on her coinsurance before an operation sounded too good to be true. Turns out, she was right.

With No Legal Guardrails for Patients, Ambulances Drive Surprise Medical Billing

Studies show that at least half of ground ambulance rides across the nation leave patients with “surprise” medical bills. And a $300-a-mile ride is not unusual. Yet federal legislation to stem what’s known as balance billing has largely ignored ambulance costs.

Health Insurers Prosper As COVID-19 Deflates Demand For Elective Treatments

With most nonemergency procedures shelved for now, many health insurers are expected to see profits in the near term, but the longer view of how the coronavirus will affect them is far more complicated and could well impact what people pay for coverage next year.