Health plans limit physical or occupational therapy sessions to as few as 20 a year, no matter the patient’s infirmities. The limits persist despite federal rules banning insurers from setting annual dollar limits on the care they will provide.
Category: Insurers
The Medicare Advantage Influence Machine
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
How Your In-Network Health Coverage Can Vanish Before You Know It
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of “qualifying life events.” But insurers’ contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
The Colonoscopies Were Free. But the ‘Surgical Trays’ Came With $600 Price Tags.
Health providers may bill however they choose — including in ways that could leave patients with unexpected bills for “free” care. Routine preventive care saddled an Illinois couple with his-and-her bills for “surgical trays.”
When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill
For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.
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.
Quick Genetic Test Offers Hope for Sick, Undiagnosed Kids. But Few Insurers Offer to Pay.
A new, rapid genetic test shows promise in increasing diagnoses and improving treatment for some children with rare genetic conditions. Many insurers won’t cover it, but Florida’s Medicaid program is among those that see benefits — and, potentially, savings.
Patients Squeezed in Fight Over Who Gets to Bill for Pricey Infusion Drugs
To drive down costs, insurers are bypassing hospital system pharmacies and delivering high-priced infusion drugs, including some used in chemotherapy, via third-party pharmacies. Smarting from losing out on billing for those drugs, hospitals and clinics are trying to convince states to limit this practice, known as “white bagging.”
Health Care Coalition Jockeys Over Medi-Cal Spending, Eyes Ballot Initiative
KFF Health News has learned that a coalition of doctors, hospitals, insurers, and community clinics want to lock in a tax on health insurance companies to draw in extra Medicaid funding. It also wants to make the tax permanent.
Judge’s Decision Would Make Some No-Cost Cancer Screenings a Thing of the Past
A U.S. District Court ruling overturned the section of the Affordable Care Act that makes preventive health services — from colonoscopies to diabetes screenings and more — available at no cost to consumers.
