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"disqusTitle": "Obamacare Small Business Rules Take Effect in January -- and They're Complicated",
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"content": "\u003cp>Obamacare challenges aren’t over for businesses.\u003c/p>\n\u003cp>Starting in January, companies employing 50 to 100 workers face complicated and seemingly contradictory new rules that will affect what kind of insurance they offer and how much they and their workers will pay for it.\u003c/p>\n\u003cp>Wouldn’t you know it, one rule defines them as large businesses and another as small businesses.\u003c/p>\n\u003caside class=\"pullquote alignright\">'These guys are great truck drivers and farm workers, but not human resources guys. Now they’re forced with paying a ton of money to outsource this or do it themselves.' \u003ccite> Adam Rochon, insurance agent \u003c/cite>\u003c/aside>\n\u003cp>“The Affordable Care Act has many different definitions of small business. They’re inconsistent with one another,” says David Chase, California director of the \u003ca href=\"http://www.smallbusinessmajority.org/\" target=\"_blank\">Small Business Majority\u003c/a> advocacy organization.\u003c/p>\n\u003cp>Many of the affected businesses are family-run establishments that don’t have human resources departments, says \u003ca href=\"https://wfis.wellsfargo.com/aboutus/bios/pages/lilianasalazar.aspx\" target=\"_blank\">Liliana Salazar\u003c/a>, a senior vice president at Wells Fargo Insurance who advises employers on their benefits packages.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Many are completely oblivious to what they’re facing,” she says.\u003c/p>\n\u003cp>Adam Rochon, an insurance agent in the Central Valley city of Exeter, confirms employers’ frustrations. Many of his small business clients are farmers and owners of blue-collar companies who are “scared and frustrated.”\u003c/p>\n\u003cp>“These guys are great truck drivers and farm workers, but not human resources guys,” he says. “Now they’re forced with paying a ton of money to outsource this or do it themselves.”\u003c/p>\n\u003cp>Unfortunately, the cost of not complying could also be dear.\u003c/p>\n\u003cp>\u003cstrong>Q: I am a business owner with 78 full-time workers. Is there anything I need to know about health insurance changes next year?\u003c/strong>\u003c/p>\n\u003cp>A: Oh yes.\u003c/p>\n\u003cp>I’m going to focus on two, and I’m going to simplify for your sanity – and mine.\u003c/p>\n\u003cp>If you think you might be subject to these changes, I highly recommend you seek expert guidance. More on that later.\u003c/p>\n\u003cp>\u003cstrong>EMPLOYER MANDATE\u003c/strong>\u003c/p>\n\u003cp>Obamacare’s \u003ca href=\"http://centerforhealthreporting.org/article/health-law-mandate-hits-employers-unevenly\" target=\"_blank\">employer mandate \u003c/a>requires “large” businesses to provide “affordable” health coverage to their employees or face financial penalties. (That’s affordable as defined by the law.)\u003c/p>\n\u003cp>Starting Jan. 1, the mandate will expand to include businesses with at least 50 full-time equivalent workers, compared with 100 this year.\u003c/p>\n\u003cp>In other words, businesses with 50 to 100 workers will be considered large and will be required to offer insurance to their employees.\u003c/p>\n\u003cp>This year, 89 percent of firms with between 50 and 99 workers offered benefits to at least some workers, \u003ca href=\"http://kff.org/report-section/ehbs-2015-section-two-health-benefits-offer-rates/\" target=\"_blank\">according to the nonprofit Kaiser Family Foundation\u003c/a> (KFF).\u003c/p>\n\u003caside class=\"pullquote align right\">'A small business can’t afford a penalty.'\u003ccite> Liliana Salazar, Wells Fargo Insurance\u003c/cite>\u003c/aside>\n\u003cp>Restaurants, retail establishments and construction firms are among the employers in this category that are least likely to offer insurance, says Larry Levitt, a senior vice president at KFF.\u003c/p>\n\u003cp>Next year, they’ll face a penalty if they don’t.\u003c/p>\n\u003cp>More specifically, a business will be dinged if it doesn’t offer insurance to at least 95 percent of its full-time employees and their children, or if the coverage it offers doesn’t meet Obamacare’s standards. (Businesses don’t necessarily have to provide coverage to spouses, Levitt says.)\u003c/p>\n\u003cp>Under the law, a full-time employee is someone who works an average of at least 30 hours a week.\u003c/p>\n\u003cp>The penalties kick in if at least one of the business’ employees signs up for a plan from a health insurance exchange such as Covered California and receives tax credits to reduce the cost of the plan.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/infographic/employer-responsibility-under-the-affordable-care-act/\" target=\"_blank\">The penalties\u003c/a> can easily climb into the tens of thousands of dollars.\u003c/p>\n\u003cp>“A small business can’t afford a penalty,” Salazar says.\u003c/p>\n\u003cp>Because this can be complicated, the federal government is giving businesses that are newly subject to the mandate until April 1, 2016 to comply, she says.\u003c/p>\n\u003cp>\u003cstrong>SMALL BUSINESS DEFINITION\u003c/strong>\u003c/p>\n\u003cp>In addition to the requirement that these business offer insurance, \u003ca href=\"http://healthaffairs.org/blog/2015/10/20/cms-allows-states-to-keep-original-aca-small-employer-definition-in-the-pace-act/\" target=\"_blank\">California is among a handful of states \u003c/a>that next year will change the definition of “small” business to include them.\u003c/p>\n\u003cp>This Obamacare-related change will define small businesses as those with up to 100 full-time equivalent employees, up from 50 now.\u003c/p>\n\u003cp>By being classified as small businesses instead of a large business, these employers must offer health insurance that complies with a different and expanded set of Obamacare rules.\u003c/p>\n\u003cp>As a result, most of these businesses will have to purchase new plans that meet the requirements.\u003c/p>\n\u003cp>“The insurance carriers and products are different,” Chase says. “The way they calculate the premiums is different.”\u003c/p>\n\u003cp>For instance, under the new rules, the health plans must contain standard designs – think of those bronze, silver, gold and platinum coverage tiers \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">offered by Covered California\u003c/a> – and cover specific medical benefits. They also limit how much more insurers can charge employers for older workers than younger ones.\u003c/p>\n\u003cp>“If you’ve got a young and healthy workforce, you might see a premium increase,” Levitt says. “If you’ve got an older, sicker workforce, you might see a premium decrease.”\u003c/p>\n\u003cp>Overall, Salazar predicts that both employers and workers will see higher premium costs.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California\u003c/a>, the state’s health insurance exchange, is opening its small business exchange to businesses in this category and has “experienced a noticeable surge in enrollment” in the past few months, says spokesman Larry Hicks.\u003c/p>\n\u003cp>\u003ca href=\"https://www.calchoice.com\" target=\"_blank\">CaliforniaChoice\u003c/a>, a private health insurance exchange for small businesses, also is opening to these employers and has seen a jump in enrollments, says CEO Ron Goldstein.\u003c/p>\n\u003cp>Finally, you’ll recall from the “employer mandate” section that businesses with under 50 full-time equivalent employees are not required to offer insurance to their employees. However, if they do, their plans also must meet Obamacare requirements for small businesses.\u003c/p>\n\u003cp>\u003cstrong>GET HELP\u003c/strong>\u003c/p>\n\u003cp>If you’re a business in this category, seek guidance. The details are incredibly complex.\u003c/p>\n\u003cp>• Reach out to your local or state chamber of commerce, which can help you figure out where you stand.\u003cbr>\n• Consider hiring an employee benefits consultant, who can advise you on how to comply with Obamacare requirements.\u003cbr>\n• A licensed insurance broker can help you find the right health plan for your business, and there’s no extra cost for the help.\u003c/p>\n\u003cp>\u003cstrong>CHANGE FOR ASK EMILY\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Starting in January, Ask Emily is moving to a new home with \u003ca href=\"http://www.khn.org\" target=\"_blank\">Kaiser Health News.\u003c/a> Please start directing your questions to \u003ca href=\"mailto:AskEmily@kff.org\" target=\"_blank\">AskEmily@kff.org\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Obamacare challenges aren’t over for businesses.\u003c/p>\n\u003cp>Starting in January, companies employing 50 to 100 workers face complicated and seemingly contradictory new rules that will affect what kind of insurance they offer and how much they and their workers will pay for it.\u003c/p>\n\u003cp>Wouldn’t you know it, one rule defines them as large businesses and another as small businesses.\u003c/p>\n\u003caside class=\"pullquote alignright\">'These guys are great truck drivers and farm workers, but not human resources guys. Now they’re forced with paying a ton of money to outsource this or do it themselves.' \u003ccite> Adam Rochon, insurance agent \u003c/cite>\u003c/aside>\n\u003cp>“The Affordable Care Act has many different definitions of small business. They’re inconsistent with one another,” says David Chase, California director of the \u003ca href=\"http://www.smallbusinessmajority.org/\" target=\"_blank\">Small Business Majority\u003c/a> advocacy organization.\u003c/p>\n\u003cp>Many of the affected businesses are family-run establishments that don’t have human resources departments, says \u003ca href=\"https://wfis.wellsfargo.com/aboutus/bios/pages/lilianasalazar.aspx\" target=\"_blank\">Liliana Salazar\u003c/a>, a senior vice president at Wells Fargo Insurance who advises employers on their benefits packages.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Many are completely oblivious to what they’re facing,” she says.\u003c/p>\n\u003cp>Adam Rochon, an insurance agent in the Central Valley city of Exeter, confirms employers’ frustrations. Many of his small business clients are farmers and owners of blue-collar companies who are “scared and frustrated.”\u003c/p>\n\u003cp>“These guys are great truck drivers and farm workers, but not human resources guys,” he says. “Now they’re forced with paying a ton of money to outsource this or do it themselves.”\u003c/p>\n\u003cp>Unfortunately, the cost of not complying could also be dear.\u003c/p>\n\u003cp>\u003cstrong>Q: I am a business owner with 78 full-time workers. Is there anything I need to know about health insurance changes next year?\u003c/strong>\u003c/p>\n\u003cp>A: Oh yes.\u003c/p>\n\u003cp>I’m going to focus on two, and I’m going to simplify for your sanity – and mine.\u003c/p>\n\u003cp>If you think you might be subject to these changes, I highly recommend you seek expert guidance. More on that later.\u003c/p>\n\u003cp>\u003cstrong>EMPLOYER MANDATE\u003c/strong>\u003c/p>\n\u003cp>Obamacare’s \u003ca href=\"http://centerforhealthreporting.org/article/health-law-mandate-hits-employers-unevenly\" target=\"_blank\">employer mandate \u003c/a>requires “large” businesses to provide “affordable” health coverage to their employees or face financial penalties. (That’s affordable as defined by the law.)\u003c/p>\n\u003cp>Starting Jan. 1, the mandate will expand to include businesses with at least 50 full-time equivalent workers, compared with 100 this year.\u003c/p>\n\u003cp>In other words, businesses with 50 to 100 workers will be considered large and will be required to offer insurance to their employees.\u003c/p>\n\u003cp>This year, 89 percent of firms with between 50 and 99 workers offered benefits to at least some workers, \u003ca href=\"http://kff.org/report-section/ehbs-2015-section-two-health-benefits-offer-rates/\" target=\"_blank\">according to the nonprofit Kaiser Family Foundation\u003c/a> (KFF).\u003c/p>\n\u003caside class=\"pullquote align right\">'A small business can’t afford a penalty.'\u003ccite> Liliana Salazar, Wells Fargo Insurance\u003c/cite>\u003c/aside>\n\u003cp>Restaurants, retail establishments and construction firms are among the employers in this category that are least likely to offer insurance, says Larry Levitt, a senior vice president at KFF.\u003c/p>\n\u003cp>Next year, they’ll face a penalty if they don’t.\u003c/p>\n\u003cp>More specifically, a business will be dinged if it doesn’t offer insurance to at least 95 percent of its full-time employees and their children, or if the coverage it offers doesn’t meet Obamacare’s standards. (Businesses don’t necessarily have to provide coverage to spouses, Levitt says.)\u003c/p>\n\u003cp>Under the law, a full-time employee is someone who works an average of at least 30 hours a week.\u003c/p>\n\u003cp>The penalties kick in if at least one of the business’ employees signs up for a plan from a health insurance exchange such as Covered California and receives tax credits to reduce the cost of the plan.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/infographic/employer-responsibility-under-the-affordable-care-act/\" target=\"_blank\">The penalties\u003c/a> can easily climb into the tens of thousands of dollars.\u003c/p>\n\u003cp>“A small business can’t afford a penalty,” Salazar says.\u003c/p>\n\u003cp>Because this can be complicated, the federal government is giving businesses that are newly subject to the mandate until April 1, 2016 to comply, she says.\u003c/p>\n\u003cp>\u003cstrong>SMALL BUSINESS DEFINITION\u003c/strong>\u003c/p>\n\u003cp>In addition to the requirement that these business offer insurance, \u003ca href=\"http://healthaffairs.org/blog/2015/10/20/cms-allows-states-to-keep-original-aca-small-employer-definition-in-the-pace-act/\" target=\"_blank\">California is among a handful of states \u003c/a>that next year will change the definition of “small” business to include them.\u003c/p>\n\u003cp>This Obamacare-related change will define small businesses as those with up to 100 full-time equivalent employees, up from 50 now.\u003c/p>\n\u003cp>By being classified as small businesses instead of a large business, these employers must offer health insurance that complies with a different and expanded set of Obamacare rules.\u003c/p>\n\u003cp>As a result, most of these businesses will have to purchase new plans that meet the requirements.\u003c/p>\n\u003cp>“The insurance carriers and products are different,” Chase says. “The way they calculate the premiums is different.”\u003c/p>\n\u003cp>For instance, under the new rules, the health plans must contain standard designs – think of those bronze, silver, gold and platinum coverage tiers \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">offered by Covered California\u003c/a> – and cover specific medical benefits. They also limit how much more insurers can charge employers for older workers than younger ones.\u003c/p>\n\u003cp>“If you’ve got a young and healthy workforce, you might see a premium increase,” Levitt says. “If you’ve got an older, sicker workforce, you might see a premium decrease.”\u003c/p>\n\u003cp>Overall, Salazar predicts that both employers and workers will see higher premium costs.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California\u003c/a>, the state’s health insurance exchange, is opening its small business exchange to businesses in this category and has “experienced a noticeable surge in enrollment” in the past few months, says spokesman Larry Hicks.\u003c/p>\n\u003cp>\u003ca href=\"https://www.calchoice.com\" target=\"_blank\">CaliforniaChoice\u003c/a>, a private health insurance exchange for small businesses, also is opening to these employers and has seen a jump in enrollments, says CEO Ron Goldstein.\u003c/p>\n\u003cp>Finally, you’ll recall from the “employer mandate” section that businesses with under 50 full-time equivalent employees are not required to offer insurance to their employees. However, if they do, their plans also must meet Obamacare requirements for small businesses.\u003c/p>\n\u003cp>\u003cstrong>GET HELP\u003c/strong>\u003c/p>\n\u003cp>If you’re a business in this category, seek guidance. The details are incredibly complex.\u003c/p>\n\u003cp>• Reach out to your local or state chamber of commerce, which can help you figure out where you stand.\u003cbr>\n• Consider hiring an employee benefits consultant, who can advise you on how to comply with Obamacare requirements.\u003cbr>\n• A licensed insurance broker can help you find the right health plan for your business, and there’s no extra cost for the help.\u003c/p>\n\u003cp>\u003cstrong>CHANGE FOR ASK EMILY\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Starting in January, Ask Emily is moving to a new home with \u003ca href=\"http://www.khn.org\" target=\"_blank\">Kaiser Health News.\u003c/a> Please start directing your questions to \u003ca href=\"mailto:AskEmily@kff.org\" target=\"_blank\">AskEmily@kff.org\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Kaiser Permanente, the California-based health care and insurance provider, says it will acquire another major insurer in Washington state, Group Health Cooperative.\u003c/p>\n\u003cp>The proposed deal announced Friday would add about 590,000 members to Kaiser, which already serves more than 10 million people in eight states and Washington, D.C., 7.8 million of them in California. Both insurers are nonprofits which feature integrated systems of health care where they provide insurance and health care providers in one system.\u003c/p>\n\u003cp>In a joint statement, the companies said the proceeds of the deal, about $1.8 billion, will fund a new, nonprofit foundation, \"with the goal of improving community health.\"\u003c/p>\n\u003cp>Officials said no immediate changes are planned in coverage and care for current Group Health members. The transaction is subject to approval by Group Health's voting membership and by regulators.\u003c/p>\n\u003cp>\"This agreement is a natural extension of our long, successful working relationship with Group Health and it provides us with the opportunity to expand access to high-quality, affordable care and coverage,\" Bernard J. Tyson, CEO of Kaiser Foundation Health Plan and Hospitals, said in a statement, and called the two organizations \"a natural fit.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"http://www.wsj.com/articles/kaiser-permanente-to-buy-major-insurer-in-washington-state-1449241200\" target=\"_blank\">Wall Street Journal \u003c/a>cited analysts who said the deal makes sense:\u003c/p>\n\u003cblockquote>\u003cp>“They are certainly aligned philosophically,” said Raj Bal, an insurance-industry consultant, who added that Kaiser could bring technology and other resources to the smaller insurer, while the combined operation will have significant scale in its region. ...\u003c/p>\n\u003cp>The Group Health acquisition will draw attention “as a potential bellwether for other deals like it” that Kaiser could make in the future, said Dave Osterndorf, a partner at Health Exchange Resources Inc., a consultancy.\u003c/p>\u003c/blockquote>\n\u003cp>Scott Armstrong, Group Health's president and CEO said that the deal was a \"unique opportunity to accelerate our growth and potential.\" Kaiser said it will invest in Group Health's facilities and technology.\u003c/p>\n\u003cp>The two plans have allowed the other's members to receive care if visiting the other plan's service area for almost two decades.\u003c/p>\n\u003cp>Kaiser Permanente is based in Oakland and had $56.4 billion in revenue last year. In addition to its California membership, the plan operates in Oregon, Hawaii, parts of southwest Washington, Colorado, Georgia, Virginia, Maryland and Washington, D.C.\u003c/p>\n\u003cp>Group Health is based in Seattle and had $3.7 billion in revenue last year. It operates mostly in Washington but also serves two counties in northern Idaho.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story includes reporting from the Associated Press.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Kaiser Permanente, the California-based health care and insurance provider, says it will acquire another major insurer in Washington state, Group Health Cooperative.\u003c/p>\n\u003cp>The proposed deal announced Friday would add about 590,000 members to Kaiser, which already serves more than 10 million people in eight states and Washington, D.C., 7.8 million of them in California. Both insurers are nonprofits which feature integrated systems of health care where they provide insurance and health care providers in one system.\u003c/p>\n\u003cp>In a joint statement, the companies said the proceeds of the deal, about $1.8 billion, will fund a new, nonprofit foundation, \"with the goal of improving community health.\"\u003c/p>\n\u003cp>Officials said no immediate changes are planned in coverage and care for current Group Health members. The transaction is subject to approval by Group Health's voting membership and by regulators.\u003c/p>\n\u003cp>\"This agreement is a natural extension of our long, successful working relationship with Group Health and it provides us with the opportunity to expand access to high-quality, affordable care and coverage,\" Bernard J. Tyson, CEO of Kaiser Foundation Health Plan and Hospitals, said in a statement, and called the two organizations \"a natural fit.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://www.wsj.com/articles/kaiser-permanente-to-buy-major-insurer-in-washington-state-1449241200\" target=\"_blank\">Wall Street Journal \u003c/a>cited analysts who said the deal makes sense:\u003c/p>\n\u003cblockquote>\u003cp>“They are certainly aligned philosophically,” said Raj Bal, an insurance-industry consultant, who added that Kaiser could bring technology and other resources to the smaller insurer, while the combined operation will have significant scale in its region. ...\u003c/p>\n\u003cp>The Group Health acquisition will draw attention “as a potential bellwether for other deals like it” that Kaiser could make in the future, said Dave Osterndorf, a partner at Health Exchange Resources Inc., a consultancy.\u003c/p>\u003c/blockquote>\n\u003cp>Scott Armstrong, Group Health's president and CEO said that the deal was a \"unique opportunity to accelerate our growth and potential.\" Kaiser said it will invest in Group Health's facilities and technology.\u003c/p>\n\u003cp>The two plans have allowed the other's members to receive care if visiting the other plan's service area for almost two decades.\u003c/p>\n\u003cp>Kaiser Permanente is based in Oakland and had $56.4 billion in revenue last year. In addition to its California membership, the plan operates in Oregon, Hawaii, parts of southwest Washington, Colorado, Georgia, Virginia, Maryland and Washington, D.C.\u003c/p>\n\u003cp>Group Health is based in Seattle and had $3.7 billion in revenue last year. It operates mostly in Washington but also serves two counties in northern Idaho.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story includes reporting from the Associated Press.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Kate and Scott Savett were trying to be responsible when they needed some medical care. They live about an hour north of Philadelphia with their dog, Frankie. Scott, 43, is a chemist and designs software for labs; Kate, 37, works in life insurance.\u003c/p>\n\u003cp>They buy their health insurance through Scott's job, and to keep their premiums affordable, they chose a high-deductible plan. They understood from the beginning that this would mean shopping carefully when they needed care, because costs can vary a lot among doctors and hospitals.\u003c/p>\n\u003cp>For years the couple didn't use their insurance much — but that all changed this year.\u003c/p>\n\u003cfigure id=\"attachment_116326\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101.jpg\">\u003cimg class=\"wp-image-116326 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-400x300.jpg\" alt=\"Kate and Scott Savett, of Allentown, PA, at an event of the Greater Delaware Valley chapter of the National MS Society, in Philadelphia, PA.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kate and Scott Savett, of Allentown, Pennsylvania, at an event of the Greater Delaware Valley chapter of the National MS Society, in Philadelphia. \u003ccite>(Bastiaan Slabbers for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kate was diagnosed with multiple sclerosis in January. Doctors did a lot of tests and then follow-up tests. On top of that, Scott needed some imaging tests for a spinal issue.\u003c/p>\n\u003cp>Under their insurance plan, the two have to pay in full for the first $3,000 of their combined care. After that, they still have to pay 20 percent of the cost, until they reach a total of $8,000 in out-of-pocket expenses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That experience made them want to find the best care for the best deal. But how?\u003c/p>\n\u003cp>They investigated, using an online cost estimator offered through their insurance company.\u003c/p>\n\u003cp>Scott logs in to use the tool, and searches for the typical cost of MRI scans in his region. The online calculator tells him the average cost is $1,270; the lowest is $512 and the \"above average\" is $1,790.\u003c/p>\n\u003cp>The tool then produced a list of different providers and an estimate of how much they will specifically charge under the plan the Savetts have.\u003c/p>\n\u003cp>At first, this kind of information seemed great to the couple. But it quickly proved to be quite the headache.\u003c/p>\n\u003cp>A few days before Kate was scheduled to have her first MRI, she and Scott got a call from the radiology office, saying that the scan would cost them $2,400. They were shocked — the online calculator had told them it would only be about $500.\u003c/p>\n\u003cp>What's the source of the disconnect?\u003c/p>\n\u003cp>A hospital had bought the imaging center and raised the price.\u003c/p>\n\u003cp>[contextly_sidebar id=\"wCEqkhB9BfZ9A3fRaUew9qoV5lT8Q2Dl\"]There were misquotes on other procedures, too. The Savetts received some bills from health providers that were as much as $1,000 higher than the price the online calculator had led them to expect. Another time, they couldn't find any listings at all for a procedure one of them needed.\u003c/p>\n\u003cp>The two quickly plowed through their $3,000 deductible. Financial planning became increasingly difficult. They delayed buying a new water heater for their house.\u003c/p>\n\u003cp>\"It's hard for us to pull the trigger on that, knowing that another bill could be coming around the corner,\" Kate says.\u003c/p>\n\u003cp>It's unclear how common these inaccuracies with online estimators are, but the tools \u003cem>are\u003c/em> becoming more popular, as patients shoulder a bigger share of the cost of their medical care. Outside companies are developing the online calculators, and most insurers offer them.\u003c/p>\n\u003cp>\"Each one of them — whether it's Aetna, United, Cigna — they all have something,\" says \u003ca href=\"http://www.hci3.org/about_hci3/team/francois-de-brantes-ms-mba-executive-director\" target=\"_blank\">Francois de Brantes\u003c/a>, director of the Health Care Incentives Improvement Institute, a nonprofit based in Connecticut. De Brantes has been \u003ca href=\"http://www.catalyzepaymentreform.org/images/Accuracy.pdf\" target=\"_blank\">paying close attention\u003c/a> to price-transparency tools.\u003c/p>\n\u003cp>\"There's lots and lots of variability in the information that's provided to consumers,\" he says.\u003c/p>\n\u003cp>Some of the estimators reflect an aggregate range of possible costs; others are based on historic pricing, or claims data from varying sources. Many, he says, are limited in the type of procedures they include.\u003c/p>\n\u003cp>[contextly_sidebar id=\"zWQnsaE6HJNkAsxDX37CJ1nbtNWIcaEb\"]As for \u003ca href=\"http://www.uhc.com/individual-and-family/why-uhc/programs-tools/myhealthcare-cost-estimator\" target=\"_blank\">United Healthare's cost estimator\u003c/a> — the one the Savetts used — Craig Hankins, the insurer's vice president of consumer engagement products, gives it an 8 out of 10 in terms of accuracy.\u003c/p>\n\u003cp>\"Right now, I would say if we look at our tool, relative to others that are offered, I would say ours is average — if not above average — in terms of breadth of services as well as accuracy,\" Hankins says.\u003c/p>\n\u003cp>UHC's cost calculator is based on current information, he says, adding that it is in the insurer's interest to have the online tool work. If members get care at an acceptable cost, that saves everyone money.\u003c/p>\n\u003cp>But, he says, the tool has limits — it's hard to predict what a particular doctor will actually \u003cem>do\u003c/em> during an exam, treatment, or office visit, and how he or she will bill for it.\u003c/p>\n\u003cp>That gets at a deeper challenge with these online estimators, says David Newman, director of the nonprofit \u003ca href=\"http://www.healthcostinstitute.org/\" target=\"_blank\">Health Care Cost Institute\u003c/a>, in Washington, D.C. The way billing and reimbursement work in health care is extremely complicated, he says.\u003c/p>\n\u003cp>\"There are 8,000 procedure codes, tens of thousands of diagnostic codes, a million different providers, and hundreds of insurance companies,\" says Newman. Calculators are often based on one specific procedure, so they may not reflect all that happens and is billed for during a visit. In that way, he says, \"this is probably going to be as good as it gets.\"\u003c/p>\n\u003cp>But de Brantes thinks much more improvement is possible.\u003c/p>\n\u003cp>\"It's not that difficult. It really — technologically — is not that difficult at all,\" he says.\u003c/p>\n\u003cp>The information people like the Savetts are seeking exists in the health care system, de Brantes says, even if in some cases it is hidden behind contract agreements. The bigger problem, he says, is that there is no internal pressure to make the online calculator work as well as it could. Health care has thrived in an opaque environment where costs are hard to find.\u003c/p>\n\u003cp>But the needle is starting to move. Employers are demanding these tools for their employees. And several \u003ca href=\"http://www.npr.org/sections/health-shots/2014/11/05/360351551/how-much-is-that-mri-really-massachusetts-shines-a-light\" target=\"_blank\">states mandate\u003c/a> public reporting of \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/12/276001379/elusive-goal-a-transparent-price-list-for-health-care\" target=\"_blank\">price information\u003c/a>.\u003c/p>\n\u003cp>As for Scott and Kate Savett, the current climate has turned each of them into a new breed of health care consumer: a savvy one.\u003c/p>\n\u003cp>Scott says he knows they are approaching their $8,000 out-of- pocket cap for the year, which means insurance will soon cover the entire cost of their care. But he doesn't want to give in. He wants to see improvements.\u003c/p>\n\u003cp>\"I would rather crawl to that $8,000 cap than sprint to it,\" he says. \"I know we're going to get there this year, unfortunately, but to blow it all on an MRI that's excessively priced rubs me the wrong way.\"\u003c/p>\n\u003cp>A few weeks after we first talked, Savett received a bill for his MRI. Turns out, it's pretty close to what the estimator predicted it would be — $1,100. He says he will keep using the tool. But he sees it as an imperfect clue rather than a price tag.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with WHYY's \u003ca href=\"http://www.newsworks.org/index.php/thepulse\" target=\"_blank\">The Pulse\u003c/a> and \u003c/em>\u003ca href=\"http://www.kaiserhealthnews.org\" target=\"_blank\">Kaiser Health News\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Kate and Scott Savett were trying to be responsible when they needed some medical care. They live about an hour north of Philadelphia with their dog, Frankie. Scott, 43, is a chemist and designs software for labs; Kate, 37, works in life insurance.\u003c/p>\n\u003cp>They buy their health insurance through Scott's job, and to keep their premiums affordable, they chose a high-deductible plan. They understood from the beginning that this would mean shopping carefully when they needed care, because costs can vary a lot among doctors and hospitals.\u003c/p>\n\u003cp>For years the couple didn't use their insurance much — but that all changed this year.\u003c/p>\n\u003cfigure id=\"attachment_116326\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101.jpg\">\u003cimg class=\"wp-image-116326 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-400x300.jpg\" alt=\"Kate and Scott Savett, of Allentown, PA, at an event of the Greater Delaware Valley chapter of the National MS Society, in Philadelphia, PA.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kate and Scott Savett, of Allentown, Pennsylvania, at an event of the Greater Delaware Valley chapter of the National MS Society, in Philadelphia. \u003ccite>(Bastiaan Slabbers for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kate was diagnosed with multiple sclerosis in January. Doctors did a lot of tests and then follow-up tests. On top of that, Scott needed some imaging tests for a spinal issue.\u003c/p>\n\u003cp>Under their insurance plan, the two have to pay in full for the first $3,000 of their combined care. After that, they still have to pay 20 percent of the cost, until they reach a total of $8,000 in out-of-pocket expenses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That experience made them want to find the best care for the best deal. But how?\u003c/p>\n\u003cp>They investigated, using an online cost estimator offered through their insurance company.\u003c/p>\n\u003cp>Scott logs in to use the tool, and searches for the typical cost of MRI scans in his region. The online calculator tells him the average cost is $1,270; the lowest is $512 and the \"above average\" is $1,790.\u003c/p>\n\u003cp>The tool then produced a list of different providers and an estimate of how much they will specifically charge under the plan the Savetts have.\u003c/p>\n\u003cp>At first, this kind of information seemed great to the couple. But it quickly proved to be quite the headache.\u003c/p>\n\u003cp>A few days before Kate was scheduled to have her first MRI, she and Scott got a call from the radiology office, saying that the scan would cost them $2,400. They were shocked — the online calculator had told them it would only be about $500.\u003c/p>\n\u003cp>What's the source of the disconnect?\u003c/p>\n\u003cp>A hospital had bought the imaging center and raised the price.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>There were misquotes on other procedures, too. The Savetts received some bills from health providers that were as much as $1,000 higher than the price the online calculator had led them to expect. Another time, they couldn't find any listings at all for a procedure one of them needed.\u003c/p>\n\u003cp>The two quickly plowed through their $3,000 deductible. Financial planning became increasingly difficult. They delayed buying a new water heater for their house.\u003c/p>\n\u003cp>\"It's hard for us to pull the trigger on that, knowing that another bill could be coming around the corner,\" Kate says.\u003c/p>\n\u003cp>It's unclear how common these inaccuracies with online estimators are, but the tools \u003cem>are\u003c/em> becoming more popular, as patients shoulder a bigger share of the cost of their medical care. Outside companies are developing the online calculators, and most insurers offer them.\u003c/p>\n\u003cp>\"Each one of them — whether it's Aetna, United, Cigna — they all have something,\" says \u003ca href=\"http://www.hci3.org/about_hci3/team/francois-de-brantes-ms-mba-executive-director\" target=\"_blank\">Francois de Brantes\u003c/a>, director of the Health Care Incentives Improvement Institute, a nonprofit based in Connecticut. De Brantes has been \u003ca href=\"http://www.catalyzepaymentreform.org/images/Accuracy.pdf\" target=\"_blank\">paying close attention\u003c/a> to price-transparency tools.\u003c/p>\n\u003cp>\"There's lots and lots of variability in the information that's provided to consumers,\" he says.\u003c/p>\n\u003cp>Some of the estimators reflect an aggregate range of possible costs; others are based on historic pricing, or claims data from varying sources. Many, he says, are limited in the type of procedures they include.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>As for \u003ca href=\"http://www.uhc.com/individual-and-family/why-uhc/programs-tools/myhealthcare-cost-estimator\" target=\"_blank\">United Healthare's cost estimator\u003c/a> — the one the Savetts used — Craig Hankins, the insurer's vice president of consumer engagement products, gives it an 8 out of 10 in terms of accuracy.\u003c/p>\n\u003cp>\"Right now, I would say if we look at our tool, relative to others that are offered, I would say ours is average — if not above average — in terms of breadth of services as well as accuracy,\" Hankins says.\u003c/p>\n\u003cp>UHC's cost calculator is based on current information, he says, adding that it is in the insurer's interest to have the online tool work. If members get care at an acceptable cost, that saves everyone money.\u003c/p>\n\u003cp>But, he says, the tool has limits — it's hard to predict what a particular doctor will actually \u003cem>do\u003c/em> during an exam, treatment, or office visit, and how he or she will bill for it.\u003c/p>\n\u003cp>That gets at a deeper challenge with these online estimators, says David Newman, director of the nonprofit \u003ca href=\"http://www.healthcostinstitute.org/\" target=\"_blank\">Health Care Cost Institute\u003c/a>, in Washington, D.C. The way billing and reimbursement work in health care is extremely complicated, he says.\u003c/p>\n\u003cp>\"There are 8,000 procedure codes, tens of thousands of diagnostic codes, a million different providers, and hundreds of insurance companies,\" says Newman. Calculators are often based on one specific procedure, so they may not reflect all that happens and is billed for during a visit. In that way, he says, \"this is probably going to be as good as it gets.\"\u003c/p>\n\u003cp>But de Brantes thinks much more improvement is possible.\u003c/p>\n\u003cp>\"It's not that difficult. It really — technologically — is not that difficult at all,\" he says.\u003c/p>\n\u003cp>The information people like the Savetts are seeking exists in the health care system, de Brantes says, even if in some cases it is hidden behind contract agreements. The bigger problem, he says, is that there is no internal pressure to make the online calculator work as well as it could. Health care has thrived in an opaque environment where costs are hard to find.\u003c/p>\n\u003cp>But the needle is starting to move. Employers are demanding these tools for their employees. And several \u003ca href=\"http://www.npr.org/sections/health-shots/2014/11/05/360351551/how-much-is-that-mri-really-massachusetts-shines-a-light\" target=\"_blank\">states mandate\u003c/a> public reporting of \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/12/276001379/elusive-goal-a-transparent-price-list-for-health-care\" target=\"_blank\">price information\u003c/a>.\u003c/p>\n\u003cp>As for Scott and Kate Savett, the current climate has turned each of them into a new breed of health care consumer: a savvy one.\u003c/p>\n\u003cp>Scott says he knows they are approaching their $8,000 out-of- pocket cap for the year, which means insurance will soon cover the entire cost of their care. But he doesn't want to give in. He wants to see improvements.\u003c/p>\n\u003cp>\"I would rather crawl to that $8,000 cap than sprint to it,\" he says. \"I know we're going to get there this year, unfortunately, but to blow it all on an MRI that's excessively priced rubs me the wrong way.\"\u003c/p>\n\u003cp>A few weeks after we first talked, Savett received a bill for his MRI. Turns out, it's pretty close to what the estimator predicted it would be — $1,100. He says he will keep using the tool. But he sees it as an imperfect clue rather than a price tag.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with WHYY's \u003ca href=\"http://www.newsworks.org/index.php/thepulse\" target=\"_blank\">The Pulse\u003c/a> and \u003c/em>\u003ca href=\"http://www.kaiserhealthnews.org\" target=\"_blank\">Kaiser Health News\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003ca href=\"http://kff.org/medicare/state-indicator/total-medicare-beneficiaries/\" target=\"_blank\">More than 5 million Californians\u003c/a> get their health insurance from \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html\" target=\"_blank\">Medicare\u003c/a>, the federal health insurance program for people 65 and over, and for people under 65 who have certain disabilities.\u003c/p>\n\u003cp>There’s a lot going on with Medicare right now. Premiums will rise next year for about one-third of its Part B enrollees. (I’ll help you decipher some of Medicare’s alphabet soup below.)\u003c/p>\n\u003cp>And premiums will increase for other Medicare coverage, such as some prescription drug plans.\u003c/p>\n\u003cp>“The standalone prescription drug plans will have the most dramatic changes next year,” says Margaret Reilly, program manager for a \u003ca href=\"http://www.hicapservices.net/new/html/contact_us.htm\" target=\"_blank\">Medicare counseling service\u003c/a> in Northern California.\u003c/p>\n\u003cp>Now through Dec. 7 is a critical time for many of you with Medicare because it’s open-enrollment season. I’ll provide some tips on what to look out for.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Premium Increases\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html\" target=\"_blank\">Part B \u003c/a>is known as the “medical insurance” portion of Medicare, and helps pay for outpatient medical care such as doctor visits, lab tests and durable medical equipment.\u003c/p>\n\u003cp>Next year, about 30 percent of Part B enrollees will pay $121.80 (or more) instead of $104.90.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/medicare/issue-brief/whats-in-store-for-medicares-part-b-premiums-and-deductible-in-2016-and-why/\" target=\"_blank\">Here’s who will pay the higher premiums\u003c/a>:\u003c/p>\n\u003cp>• People who are dually eligible for Medicare and Medicaid (called Medi-Cal in California). But Medicaid pays their premium – and the increase – on their behalf.\u003cbr>\n• Medicare beneficiaries who made more than $85,000 as an individual or $170,000 as a couple. This group also has to\u003ca href=\"https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html\" target=\"_blank\"> pay a surcharge \u003c/a>depending on their income. For example, an individual who made $200,000 would have to pay a total of $316.70 per month.\u003cbr>\n• New Medicare enrollees in 2016.\u003cbr>\n• Part B enrollees who are not receiving Social Security benefits.\u003c/p>\n\u003cp>\u003cstrong>Medicare Advantage and Part D Open Enrollment\u003c/strong>\u003c/p>\n\u003cp>If you have a Medicare Advantage or Part D plan, now’s the time to make changes through Dec. 7. First, a few definitions.\u003c/p>\n\u003cp>Unlike “\u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/original-medicare/how-original-medicare-works.html\" target=\"_blank\">Original Medicare\u003c/a>,” which is administered by the federal government, \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/how-medicare-advantage-plans-work.html\" target=\"_blank\">Medicare Advantage\u003c/a> plans are offered by private companies. Medicare pays them to cover your benefits. In addition to your monthly Medicare premium, you may need to pay a premium for your Medicare Advantage plan.\u003c/p>\n\u003cp>They usually include prescription drug coverage.\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicare.gov/sign-up-change-plans/get-drug-coverage/get-drug-coverage.html\" target=\"_blank\">Part D\u003c/a> plans allow you to add prescription drug benefits primarily to Original Medicare.\u003c/p>\n\u003cp>If you already have a Medicare Advantage or Part D plan and don’t want to explore other options for next year, it could cost you.\u003c/p>\n\u003cp>Consider that 22 of the 28 standalone Part D plans in California next year \u003ca href=\"http://www.cahealthadvocates.org/news/drugs/2015/review-coverage-options-2016-and-save.html\" target=\"_blank\">will have higher premiums\u003c/a>, says Elaine Wong Eakin, executive director of \u003ca href=\"http://www.cahealthadvocates.org/index.html\" target=\"_blank\">California Health Advocates\u003c/a>, a Medicare advocacy and education group.\u003c/p>\n\u003cp>The premium hikes range from 90 cents per month to – gulp – $98.70, she says. Five plans will have premium reductions and one stays the same.\u003c/p>\n\u003cp>To find out what’s happening to your plan’s premium, look at your “\u003ca href=\"https://www.medicare.gov/forms-help-and-resources/mail-about-medicare/plan-annual-notice-of-change.html\" target=\"_blank\">Annual Notice of Change\u003c/a>,” which you should have received in the mail earlier this fall. (If you didn’t receive it, call your plan.)\u003c/p>\n\u003cp>This document also should include the plan’s drug formulary, which can add or drop medications from year to year.\u003c/p>\n\u003cp>“If the drugs you take this year are not going to be on next year’s formulary, you want to know that,” Reilly says.\u003c/p>\n\u003cp>Unfortunately, the formularies can be difficult to navigate, she says, so you can also call 1-800-MEDICARE with a list of your medications, and a customer service rep can help you.\u003c/p>\n\u003cp>Another option is to go to the \u003ca href=\"https://www.medicare.gov\" target=\"_blank\">Medicare.gov \u003c/a>website. From the home page, click on the “\u003ca href=\"https://www.medicare.gov/find-a-plan/questions/home.aspx\" target=\"_blank\">Find health & drug plans\u003c/a>” link. You’ll be able to enter the names of your drugs, as well as the dosage and frequency. In return, you’ll be told which Part D plans cover your medications most economically, Reilly says.\u003c/p>\n\u003cp>\u003cstrong>Dental and Vision\u003c/strong>\u003c/p>\n\u003cp>Original Medicare \u003ca href=\"https://www.medicare.gov/what-medicare-covers/not-covered/item-and-services-not-covered-by-part-a-and-b.html\" target=\"_blank\">does not cover most dental care,\u003c/a> including dentures. It also doesn’t cover eye exams related to prescription glasses.\u003c/p>\n\u003cp>Some Medicare Advantage plans may offer limited vision and dental coverage, but it may cost you extra. Check with your plan.\u003c/p>\n\u003cp>If you want these benefits and have Original Medicare, or don’t get them from your Medicare Advantage plan, you’ll need to buy a standalone dental or vision plan.\u003c/p>\n\u003cp>And that can be expensive. “There are very limited options for people on Medicare,” says Jeff Album, a vice president at \u003ca href=\"https://www.deltadental.com/Public/index.jsp\" target=\"_blank\">Delta Dental\u003c/a>, California’s largest dental insurer.\u003c/p>\n\u003cp>Album offers some tips for Medicare beneficiaries looking for dental coverage:\u003c/p>\n\u003cp>• If you’re eligible for AARP, then you’re also eligible for the \u003ca href=\"https://www.deltadentalins.com/aarp/index.html\" target=\"_blank\">dental insurance products it sells \u003c/a>(including Delta Dental). Call 866-583-2085 for more information.\u003cbr>\n• \u003ca href=\"https://www.deltadentalins.com/plans_costco/\" target=\"_blank\">Costco\u003c/a> sells a Delta Dental plan to its members.\u003cbr>\n• You can search for dental insurance and discount dental plans on \u003ca href=\"http://www.dentalplans.com\" target=\"_blank\">Dentalplans.com\u003c/a>.\u003c/p>\n\u003cp>You can enroll in standalone dental plans any time of year, Album says, but you often have to commit to the plan for a year and/or face a one-year waiting period for some major services.\u003c/p>\n\u003cp>\u003cstrong>Part B Open Enrollment\u003c/strong>\u003c/p>\n\u003cp>Most people sign up for \u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-a/what-part-a-covers.html\" target=\"_blank\">Medicare Part A\u003c/a> (known as the “hospital insurance” portion) when they turn 65 because\u003ca href=\"https://www.medicare.gov/your-medicare-costs/part-a-costs/part-a-costs.html\" target=\"_blank\"> it’s usually free.\u003c/a>\u003c/p>\n\u003cp>But not everyone signs up for Part B right away because some may have job-based insurance. Others don’t want to pay the Part B premium.\u003c/p>\n\u003cp>If you’re over 65 and have job-based insurance, \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html\" target=\"_blank\">you can sign up for Part B\u003c/a> without penalty when you retire or otherwise lose your (or your spouse’s) employer-sponsored coverage. (There are \u003ca href=\"http://www.aarp.org/health/medicare-insurance/info-03-2011/ask-ms-medicare-question-94.html\" target=\"_blank\">some different rules\u003c/a> for people who work for small businesses with fewer than 20 employees.)\u003c/p>\n\u003cp>But if you didn’t have insurance and elected not to sign up at age 65, you get dinged for waiting. You have to pay a premium penalty for every year you delayed enrolling, you can only sign up for Part B from \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html\" target=\"_blank\">January through March each year\u003c/a>, and your coverage won’t be effective until July 1 that same year.\u003c/p>\n\u003cp>(By the way, there are l\u003ca href=\"https://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html\" target=\"_blank\">ate enrollment penalties for Part D \u003c/a>as well.)\u003c/p>\n\u003cp>The point is to discourage people from waiting until they’re sick to enroll.\u003c/p>\n\u003cp>“Sometimes people will say, ‘I don’t want to spend the money. I’m not sick’,” Reilly says. “But when they need it, they find out the effective date isn’t until July 1.”\u003c/p>\n\u003cp>Tom Freker, an insurance broker in Fountain Valley, came across two women this year who have cancer, but neither had signed up for Part B when they were originally eligible.\u003c/p>\n\u003cp>They plan on enrolling in January. While they wait for their coverage to kick in, he says, they’re trying to get as much of their cancer treatment covered by Part A as possible.\u003c/p>\n\u003cp>Unfortunately, they face major out-of-pocket expenses. “This is costly,” he warns. “It can be a real crusher.”\u003c/p>\n\u003cp>If you’re someone in this category who needs advice, or if you have other Medicare questions, there’s free, one-on-one Medicare counseling available through the Health Insurance Counseling and Advocacy Program, or HICAP. You can find HICAP offices in your county by visiting the \u003ca href=\"https://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html\" target=\"_blank\">California Health Advocates website \u003c/a> or call 800-434-0222.\u003c/p>\n\u003cp>HICAP appointments can be hard to get during open enrollment. You can also call 1-800-MEDICARE for help.\u003c/p>\n\u003cp>\u003cem>Questions for Emily:\u003ca href=\"http://AskEmily@usc.edu\" target=\"_blank\"> AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">The CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Every year, open enrollment runs from Oct. 15 to Dec. 7. Premiums are going up for many people. You could save money by shopping around.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"http://kff.org/medicare/state-indicator/total-medicare-beneficiaries/\" target=\"_blank\">More than 5 million Californians\u003c/a> get their health insurance from \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html\" target=\"_blank\">Medicare\u003c/a>, the federal health insurance program for people 65 and over, and for people under 65 who have certain disabilities.\u003c/p>\n\u003cp>There’s a lot going on with Medicare right now. Premiums will rise next year for about one-third of its Part B enrollees. (I’ll help you decipher some of Medicare’s alphabet soup below.)\u003c/p>\n\u003cp>And premiums will increase for other Medicare coverage, such as some prescription drug plans.\u003c/p>\n\u003cp>“The standalone prescription drug plans will have the most dramatic changes next year,” says Margaret Reilly, program manager for a \u003ca href=\"http://www.hicapservices.net/new/html/contact_us.htm\" target=\"_blank\">Medicare counseling service\u003c/a> in Northern California.\u003c/p>\n\u003cp>Now through Dec. 7 is a critical time for many of you with Medicare because it’s open-enrollment season. I’ll provide some tips on what to look out for.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Premium Increases\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html\" target=\"_blank\">Part B \u003c/a>is known as the “medical insurance” portion of Medicare, and helps pay for outpatient medical care such as doctor visits, lab tests and durable medical equipment.\u003c/p>\n\u003cp>Next year, about 30 percent of Part B enrollees will pay $121.80 (or more) instead of $104.90.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/medicare/issue-brief/whats-in-store-for-medicares-part-b-premiums-and-deductible-in-2016-and-why/\" target=\"_blank\">Here’s who will pay the higher premiums\u003c/a>:\u003c/p>\n\u003cp>• People who are dually eligible for Medicare and Medicaid (called Medi-Cal in California). But Medicaid pays their premium – and the increase – on their behalf.\u003cbr>\n• Medicare beneficiaries who made more than $85,000 as an individual or $170,000 as a couple. This group also has to\u003ca href=\"https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html\" target=\"_blank\"> pay a surcharge \u003c/a>depending on their income. For example, an individual who made $200,000 would have to pay a total of $316.70 per month.\u003cbr>\n• New Medicare enrollees in 2016.\u003cbr>\n• Part B enrollees who are not receiving Social Security benefits.\u003c/p>\n\u003cp>\u003cstrong>Medicare Advantage and Part D Open Enrollment\u003c/strong>\u003c/p>\n\u003cp>If you have a Medicare Advantage or Part D plan, now’s the time to make changes through Dec. 7. First, a few definitions.\u003c/p>\n\u003cp>Unlike “\u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/original-medicare/how-original-medicare-works.html\" target=\"_blank\">Original Medicare\u003c/a>,” which is administered by the federal government, \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/how-medicare-advantage-plans-work.html\" target=\"_blank\">Medicare Advantage\u003c/a> plans are offered by private companies. Medicare pays them to cover your benefits. In addition to your monthly Medicare premium, you may need to pay a premium for your Medicare Advantage plan.\u003c/p>\n\u003cp>They usually include prescription drug coverage.\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicare.gov/sign-up-change-plans/get-drug-coverage/get-drug-coverage.html\" target=\"_blank\">Part D\u003c/a> plans allow you to add prescription drug benefits primarily to Original Medicare.\u003c/p>\n\u003cp>If you already have a Medicare Advantage or Part D plan and don’t want to explore other options for next year, it could cost you.\u003c/p>\n\u003cp>Consider that 22 of the 28 standalone Part D plans in California next year \u003ca href=\"http://www.cahealthadvocates.org/news/drugs/2015/review-coverage-options-2016-and-save.html\" target=\"_blank\">will have higher premiums\u003c/a>, says Elaine Wong Eakin, executive director of \u003ca href=\"http://www.cahealthadvocates.org/index.html\" target=\"_blank\">California Health Advocates\u003c/a>, a Medicare advocacy and education group.\u003c/p>\n\u003cp>The premium hikes range from 90 cents per month to – gulp – $98.70, she says. Five plans will have premium reductions and one stays the same.\u003c/p>\n\u003cp>To find out what’s happening to your plan’s premium, look at your “\u003ca href=\"https://www.medicare.gov/forms-help-and-resources/mail-about-medicare/plan-annual-notice-of-change.html\" target=\"_blank\">Annual Notice of Change\u003c/a>,” which you should have received in the mail earlier this fall. (If you didn’t receive it, call your plan.)\u003c/p>\n\u003cp>This document also should include the plan’s drug formulary, which can add or drop medications from year to year.\u003c/p>\n\u003cp>“If the drugs you take this year are not going to be on next year’s formulary, you want to know that,” Reilly says.\u003c/p>\n\u003cp>Unfortunately, the formularies can be difficult to navigate, she says, so you can also call 1-800-MEDICARE with a list of your medications, and a customer service rep can help you.\u003c/p>\n\u003cp>Another option is to go to the \u003ca href=\"https://www.medicare.gov\" target=\"_blank\">Medicare.gov \u003c/a>website. From the home page, click on the “\u003ca href=\"https://www.medicare.gov/find-a-plan/questions/home.aspx\" target=\"_blank\">Find health & drug plans\u003c/a>” link. You’ll be able to enter the names of your drugs, as well as the dosage and frequency. In return, you’ll be told which Part D plans cover your medications most economically, Reilly says.\u003c/p>\n\u003cp>\u003cstrong>Dental and Vision\u003c/strong>\u003c/p>\n\u003cp>Original Medicare \u003ca href=\"https://www.medicare.gov/what-medicare-covers/not-covered/item-and-services-not-covered-by-part-a-and-b.html\" target=\"_blank\">does not cover most dental care,\u003c/a> including dentures. It also doesn’t cover eye exams related to prescription glasses.\u003c/p>\n\u003cp>Some Medicare Advantage plans may offer limited vision and dental coverage, but it may cost you extra. Check with your plan.\u003c/p>\n\u003cp>If you want these benefits and have Original Medicare, or don’t get them from your Medicare Advantage plan, you’ll need to buy a standalone dental or vision plan.\u003c/p>\n\u003cp>And that can be expensive. “There are very limited options for people on Medicare,” says Jeff Album, a vice president at \u003ca href=\"https://www.deltadental.com/Public/index.jsp\" target=\"_blank\">Delta Dental\u003c/a>, California’s largest dental insurer.\u003c/p>\n\u003cp>Album offers some tips for Medicare beneficiaries looking for dental coverage:\u003c/p>\n\u003cp>• If you’re eligible for AARP, then you’re also eligible for the \u003ca href=\"https://www.deltadentalins.com/aarp/index.html\" target=\"_blank\">dental insurance products it sells \u003c/a>(including Delta Dental). Call 866-583-2085 for more information.\u003cbr>\n• \u003ca href=\"https://www.deltadentalins.com/plans_costco/\" target=\"_blank\">Costco\u003c/a> sells a Delta Dental plan to its members.\u003cbr>\n• You can search for dental insurance and discount dental plans on \u003ca href=\"http://www.dentalplans.com\" target=\"_blank\">Dentalplans.com\u003c/a>.\u003c/p>\n\u003cp>You can enroll in standalone dental plans any time of year, Album says, but you often have to commit to the plan for a year and/or face a one-year waiting period for some major services.\u003c/p>\n\u003cp>\u003cstrong>Part B Open Enrollment\u003c/strong>\u003c/p>\n\u003cp>Most people sign up for \u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-a/what-part-a-covers.html\" target=\"_blank\">Medicare Part A\u003c/a> (known as the “hospital insurance” portion) when they turn 65 because\u003ca href=\"https://www.medicare.gov/your-medicare-costs/part-a-costs/part-a-costs.html\" target=\"_blank\"> it’s usually free.\u003c/a>\u003c/p>\n\u003cp>But not everyone signs up for Part B right away because some may have job-based insurance. Others don’t want to pay the Part B premium.\u003c/p>\n\u003cp>If you’re over 65 and have job-based insurance, \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html\" target=\"_blank\">you can sign up for Part B\u003c/a> without penalty when you retire or otherwise lose your (or your spouse’s) employer-sponsored coverage. (There are \u003ca href=\"http://www.aarp.org/health/medicare-insurance/info-03-2011/ask-ms-medicare-question-94.html\" target=\"_blank\">some different rules\u003c/a> for people who work for small businesses with fewer than 20 employees.)\u003c/p>\n\u003cp>But if you didn’t have insurance and elected not to sign up at age 65, you get dinged for waiting. You have to pay a premium penalty for every year you delayed enrolling, you can only sign up for Part B from \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html\" target=\"_blank\">January through March each year\u003c/a>, and your coverage won’t be effective until July 1 that same year.\u003c/p>\n\u003cp>(By the way, there are l\u003ca href=\"https://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html\" target=\"_blank\">ate enrollment penalties for Part D \u003c/a>as well.)\u003c/p>\n\u003cp>The point is to discourage people from waiting until they’re sick to enroll.\u003c/p>\n\u003cp>“Sometimes people will say, ‘I don’t want to spend the money. I’m not sick’,” Reilly says. “But when they need it, they find out the effective date isn’t until July 1.”\u003c/p>\n\u003cp>Tom Freker, an insurance broker in Fountain Valley, came across two women this year who have cancer, but neither had signed up for Part B when they were originally eligible.\u003c/p>\n\u003cp>They plan on enrolling in January. While they wait for their coverage to kick in, he says, they’re trying to get as much of their cancer treatment covered by Part A as possible.\u003c/p>\n\u003cp>Unfortunately, they face major out-of-pocket expenses. “This is costly,” he warns. “It can be a real crusher.”\u003c/p>\n\u003cp>If you’re someone in this category who needs advice, or if you have other Medicare questions, there’s free, one-on-one Medicare counseling available through the Health Insurance Counseling and Advocacy Program, or HICAP. You can find HICAP offices in your county by visiting the \u003ca href=\"https://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html\" target=\"_blank\">California Health Advocates website \u003c/a> or call 800-434-0222.\u003c/p>\n\u003cp>HICAP appointments can be hard to get during open enrollment. You can also call 1-800-MEDICARE for help.\u003c/p>\n\u003cp>\u003cem>Questions for Emily:\u003ca href=\"http://AskEmily@usc.edu\" target=\"_blank\"> AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">The CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Thousands Enroll in Covered California's New Adult Dental Insurance",
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"content": "\u003cp>Thousands of California adults are signing up for dental insurance \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/dental-coverage\" target=\"_blank\">offered for the first time\u003c/a> by Covered California, the state's Obamacare marketplace, officials said Wednesday.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This is really going to help a lot of people improve their health.'\u003cbr>\n\u003ccite> Dr. Ariane Terlet, Berkeley dentist and trustee, California Dental Association\u003c/cite>\u003c/aside>\n\u003cp>About 33,000 adults have signed up for the dental plans, including about 6,000 who also are signing up for health insurance on the marketplace for the first time, said Peter Lee, Covered California’s executive director.\u003c/p>\n\u003cp>While dental coverage for children under age 19 is considered an essential benefit under the Affordable Care Act and is included in their health insurance plans, that’s not the case for adults. Most of the nation’s state-run health exchanges now offer separate dental plans serving adults and the federally run exchange, healthcare.gov, also offers adult dental coverage.\u003c/p>\n\u003cp>Covered California is the second to last among the state-run exchanges to offer dental coverage for adults, said Jeff Album, a Delta Dental executive. Now only Washington state does not offer it.\u003c/p>\n\u003cp>In California, adults must purchase a health plan on Covered California to be able to purchase an “add-on” dental policy, and they’ll pay monthly premiums ranging from $11 to $65, Lee said. These premiums are not subsidized like Covered California’s health premiums for lower-income people, but the dental plans can’t turn anyone away because of pre-existing conditions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The dental plans are optional, and there’s no tax penalty for not enrolling in them.\u003c/p>\n\u003cp>Open enrollment for Covered California health and dental plans started Nov. 1 and ends Jan. 31, and people who sign up by Dec. 15 can have their benefits start on Jan. 1. Lee said Wednesday that 34,000 new consumers had selected a health insurance plan through the exchange since open enrollment began.\u003c/p>\n\u003cp>About 1.3 million Californians, including about 66,000 ages 18 or younger, already \u003ca href=\"http://hbex.coveredca.com/data-research/\" target=\"_blank\">had health insurance\u003c/a> through the exchange before open enrollment started.\u003c/p>\n\u003cp>Five insurers are offering dental plans on Covered California:\u003c/p>\n\u003cul>\n\u003cli>Access Dental Plan\u003c/li>\n\u003cli>Anthem Blue Cross of California\u003c/li>\n\u003cli>Delta Dental of California\u003c/li>\n\u003cli>Dental Health Services\u003c/li>\n\u003cli>Premier Access\u003c/li>\n\u003c/ul>\n\u003cp>The majority of people signed up so far -- 23,000 of 33,000 overall -- have chosen Delta Dental, Album said.\u003c/p>\n\u003cp>All of the plans will offer free preventive and diagnostic dental services for both adults and children. Consumers can choose from dental health maintenance organizations, which typically cost less but have more restricted networks of dentists, or dental preferred provider organizations, which offer more choice but higher out-of-pocket costs.\u003c/p>\n\u003caside class=\"pullquote alignright\">Covered California's open enrollment runs through Jan. 31\u003c/aside>\n\u003cp>A note to parents: You do not have to enroll your children in a family dental plan, because children's dental coverage is already included in their health plan. Still, some parents choose to do so to gain extra coverage.\u003c/p>\n\u003cp>Dr. Ariane Terlet, a Berkeley dentist who serves as chief dental officer for Oakland-based La Clinica de la Raza and as a trustee for the California Dental Association, said that people without dental insurance are four times more likely not to get preventive care. Many Californians have found it difficult to buy dental coverage on the individual market, she added, and the new availability of Covered California’s dental plans expands access to care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There isn’t a week that goes by where people don’t ask me what dental coverage is available for individuals,” Terlet said. “Having insurance is a critical step to improving dental care. This is really going to help a lot of people improve their health.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Thousands of California adults are signing up for dental insurance \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/dental-coverage\" target=\"_blank\">offered for the first time\u003c/a> by Covered California, the state's Obamacare marketplace, officials said Wednesday.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This is really going to help a lot of people improve their health.'\u003cbr>\n\u003ccite> Dr. Ariane Terlet, Berkeley dentist and trustee, California Dental Association\u003c/cite>\u003c/aside>\n\u003cp>About 33,000 adults have signed up for the dental plans, including about 6,000 who also are signing up for health insurance on the marketplace for the first time, said Peter Lee, Covered California’s executive director.\u003c/p>\n\u003cp>While dental coverage for children under age 19 is considered an essential benefit under the Affordable Care Act and is included in their health insurance plans, that’s not the case for adults. Most of the nation’s state-run health exchanges now offer separate dental plans serving adults and the federally run exchange, healthcare.gov, also offers adult dental coverage.\u003c/p>\n\u003cp>Covered California is the second to last among the state-run exchanges to offer dental coverage for adults, said Jeff Album, a Delta Dental executive. Now only Washington state does not offer it.\u003c/p>\n\u003cp>In California, adults must purchase a health plan on Covered California to be able to purchase an “add-on” dental policy, and they’ll pay monthly premiums ranging from $11 to $65, Lee said. These premiums are not subsidized like Covered California’s health premiums for lower-income people, but the dental plans can’t turn anyone away because of pre-existing conditions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The dental plans are optional, and there’s no tax penalty for not enrolling in them.\u003c/p>\n\u003cp>Open enrollment for Covered California health and dental plans started Nov. 1 and ends Jan. 31, and people who sign up by Dec. 15 can have their benefits start on Jan. 1. Lee said Wednesday that 34,000 new consumers had selected a health insurance plan through the exchange since open enrollment began.\u003c/p>\n\u003cp>About 1.3 million Californians, including about 66,000 ages 18 or younger, already \u003ca href=\"http://hbex.coveredca.com/data-research/\" target=\"_blank\">had health insurance\u003c/a> through the exchange before open enrollment started.\u003c/p>\n\u003cp>Five insurers are offering dental plans on Covered California:\u003c/p>\n\u003cul>\n\u003cli>Access Dental Plan\u003c/li>\n\u003cli>Anthem Blue Cross of California\u003c/li>\n\u003cli>Delta Dental of California\u003c/li>\n\u003cli>Dental Health Services\u003c/li>\n\u003cli>Premier Access\u003c/li>\n\u003c/ul>\n\u003cp>The majority of people signed up so far -- 23,000 of 33,000 overall -- have chosen Delta Dental, Album said.\u003c/p>\n\u003cp>All of the plans will offer free preventive and diagnostic dental services for both adults and children. Consumers can choose from dental health maintenance organizations, which typically cost less but have more restricted networks of dentists, or dental preferred provider organizations, which offer more choice but higher out-of-pocket costs.\u003c/p>\n\u003caside class=\"pullquote alignright\">Covered California's open enrollment runs through Jan. 31\u003c/aside>\n\u003cp>A note to parents: You do not have to enroll your children in a family dental plan, because children's dental coverage is already included in their health plan. Still, some parents choose to do so to gain extra coverage.\u003c/p>\n\u003cp>Dr. Ariane Terlet, a Berkeley dentist who serves as chief dental officer for Oakland-based La Clinica de la Raza and as a trustee for the California Dental Association, said that people without dental insurance are four times more likely not to get preventive care. Many Californians have found it difficult to buy dental coverage on the individual market, she added, and the new availability of Covered California’s dental plans expands access to care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There isn’t a week that goes by where people don’t ask me what dental coverage is available for individuals,” Terlet said. “Having insurance is a critical step to improving dental care. This is really going to help a lot of people improve their health.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "2 Million on Medi-Cal Face Different Appeals Process",
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"content": "\u003cp>Ben Fallstead, 28, was diagnosed several years ago with \u003ca href=\"http://www.cdc.gov/parasites/babesiosis/gen_info/faqs.html\" target=\"_blank\">babesiosis\u003c/a>, a tick-borne disease that left him exhausted, wracked with fevers and chronic joint pain and unable to hold a job.\u003c/p>\n\u003cp>After going through several antibiotics, his specialist prescribed one that brought him some relief.\u003c/p>\n\u003cp>“I was just getting to the point where I felt semi-normal,” he says.\u003c/p>\n\u003cp>But early last year, his managed care Medi-Cal plan told him it would not refill the medication, saying that it doesn’t support the long-term use of antibiotics, he says.\u003c/p>\n\u003cp>Since then, the Lake County man has been fighting his plan’s decision, waiting months for judges who aren’t medical experts to determine his medical fate.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Fallstead is among roughly 2 million Medi-Cal recipients who must use a different medical appeals process than most others on Medi-Cal. \u003ca href=\"http://www.dhcs.ca.gov/Services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\">Medi-Cal \u003c/a>is the state’s version of the federal Medicaid program that provides health insurance to low-income residents.\u003c/p>\n\u003cp>These Californians live in 22 counties, from Orange County to the Central Coast and rural Northern California. Unlike about 8 million other Medi-Cal enrollees in managed care, most of them can’t appeal their case to an independent physician.\u003c/p>\n\u003cp>Advocates, patients and some lawmakers say this has delayed critical treatments and is simply unfair.\u003c/p>\n\u003cp>“There should be uniformity in the protections of all Medi-Cal recipients,” says state Sen. Bill Monning, a Democrat whose district covers three affected counties: Monterey, Santa Cruz and San Luis Obispo.\u003c/p>\n\u003cp>Today, I’ll explain this inconsistency and offer advice to those people it affects.\u003c/p>\n\u003cp>\u003cb>Q: I live in Orange County and have Medi-Cal. I’m in the middle of cancer treatment but my health plan is making me get reapproved before I can continue. What are my options? \u003c/b>\u003c/p>\n\u003cp>A: If your medical plan makes a decision that you disagree with, such as not covering the medication or therapy your doctor has ordered, you usually start by appealing with the plan itself.\u003c/p>\n\u003cp>If the plan won’t budge, you move to the second level of appeals. This is where the difference lies.\u003c/p>\n\u003cp>The vast majority of managed care Medi-Cal recipients are in plans regulated by the state \u003ca href=\"https://www.dmhc.ca.gov/\" target=\"_blank\">Department of Managed Health Care\u003c/a>. They have access to something called an \u003ca href=\"https://www.dmhc.ca.gov/FileaComplaint/IndependentMedicalReview(IMR).aspx#.VjpX0mSrTw4\" target=\"_blank\">Independent Medical Review \u003c/a>(IMR), which allows them to appeal their plan’s decision to an independent physician (or physicians) who are experts in the conditions being reviewed.\u003c/p>\n\u003cul>\n\u003cli>If your health issue is urgent, you can request an expedited IMR to be conducted within a week.\u003c/li>\n\u003cli>If it is not urgent, it is usually decided within 30 days.\u003c/li>\n\u003c/ul>\n\u003cp>But Orange County managed care Medi-Cal recipients receive coverage through a plan called a \u003ca href=\"http://www.healthconsumer.org/092914-ManagedCareinCaliforniaSeries-3-COHSMediCalPlans.pdf\" target=\"_blank\">County Organized Health System \u003c/a>(COHS).\u003c/p>\n\u003cp>There are six COHS plans, including \u003ca href=\"https://www.caloptima.org/\" target=\"_blank\">CalOptima\u003c/a> in Orange County and \u003ca href=\"http://www.partnershiphp.org/Pages/PHC.aspx\" target=\"_blank\">Partnership HealthPlan\u003c/a>, which covers 14 Northern California counties. If you’re in one of these counties, your local COHS plan is the only Medi-Cal plan available to you.\u003c/p>\n\u003cp>These publicly operated plans were exempted from certain requirements more than 30 years ago when they were much smaller entities.\u003c/p>\n\u003cp>That means you don’t have access to an IMR for your second layer of appeals. You must request a state fair hearing and plead your case before an administrative law judge who usually is not a medical expert.\u003c/p>\n\u003cul>\n\u003cli>The cases must be decided within 90 days after the Medi-Cal recipient requests a hearing, says Michael Weston, spokesman for the state \u003ca href=\"http://www.cdss.ca.gov/cdssweb/default.htm\" target=\"_blank\">Department of Social Services\u003c/a>, which conducts the hearings.\u003c/li>\n\u003cli>An enrollee whose health is in danger from delay may request an expedited hearing. If a judge agrees, a hearing will be scheduled within 10 days of the request and a decision rendered within five days after all evidence has been submitted, Weston says.\u003c/li>\n\u003c/ul>\n\u003cp>(There is an exception. \u003ca href=\"https://www.hpsm.org/\" target=\"_blank\">The Health Plan of San Mateo\u003c/a>, a COHS plan, has voluntarily agreed to be regulated by the Department of Managed Health Care, so its enrollees can request an IMR.)\u003c/p>\n\u003cp>Fallstead has requested two state fair hearings in the past two years. Both took longer than 90 days to resolve.\u003c/p>\n\u003cp>“I feel like they’re denying me medication,” he says. “It feels like I’m not a person to them.”\u003c/p>\n\u003cp>Liza Thantranon,\u003ca href=\"http://lsnc.info/\" target=\"_blank\"> Legal Services of Northern California\u003c/a>’s managing attorney for health, says she deals with this problem every day.\u003c/p>\n\u003cp>Her clients who have access to IMRs usually are able to resolve their cases within a month, she says. However, the majority of her COHS clients who request state fair hearings wait more than 90 days for a decision, some as long as six to eight months.\u003c/p>\n\u003cp>“In the middle, you have administrative law judges trying to evaluate which doctor is right,” Thantranon says. “They don’t know what the science is.”\u003c/p>\n\u003cp>Weston counters that the judges are trained to make “factual findings based on evidence, including the medical evidence provided by the plan and the doctor.”\u003c/p>\n\u003cp>The plans say they’re not against regulation, but over-regulation. They’re already regulated twice, by the federal and state governments, says Bob Freeman, CEO of \u003ca href=\"https://www.cencalhealth.org/\" target=\"_blank\">CenCal Health\u003c/a>, the COHS plan that covers about 165,000 Medi-Cal enrollees in San Luis Obispo and Santa Barbara Counties.\u003c/p>\n\u003cp>Adding this additional layer of regulation would require them to pay about $4 million collectively in fees each year to the Department of Managed Health Care, he says.\u003c/p>\n\u003cp>“Where’s the value to the taxpayer in that?” Freeman asks. “That money could go somewhere else.”\u003c/p>\n\u003cp>For those of you who are in a COHS plan, here are some tips on the appeal process:\u003c/p>\n\u003cul>\n\u003cli>If your plan denies the initial internal appeal, ask it to review its decision. At the same time, immediately request a state fair hearing. You can always withdraw from the hearing later if you’re able to resolve the problem directly with your health plan.\u003c/li>\n\u003cli>Request a state fair hearing by calling 855-795-0634 or email your request to \u003ca href=\"shdcsu@dss.ca.gov\" target=\"_blank\">shdcsu@dss.ca.gov\u003c/a>.\u003c/li>\n\u003cli>Before your hearing, gather medical evidence to bolster your case. “Ask your doctors to write letters of support,” Thantranon says. Your doctor can also participate in the hearing by phone, Weston says.\u003c/li>\n\u003cli>Get help from health care advocacy groups. The Health Consumer Alliance is a good place to start: \u003ca href=\"http://healthconsumer.org/\" target=\"_blank\">healthconsumer.org \u003c/a>and 888-804-3536.\u003c/li>\n\u003cli>If you’re unhappy with the state fair hearing decision, you may be able to request a rehearing or take your case to civil court, Weston says. You also can contact the \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/MMCDOfficeoftheOmbudsman.aspx\" target=\"_blank\">Medi-Cal Managed Care Office of the Ombudsman\u003c/a> at 888-452-8609 or \u003ca href=\"MMCDOmbudsmanOffice@dhcs.ca.gov\" target=\"_blank\">MMCDOmbudsmanOffice@dhcs.ca.gov\u003c/a>.\u003c/li>\n\u003c/ul>\n\u003cp>\u003ci>Questions for Emily: \u003c/i>\u003ci>\u003ca href=\"http://AskEmily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/i>\u003c/p>\n\u003cp>\u003cem>Read \u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">previous Ask Emily columns.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>The \u003ca href=\"http://www.centerforhealthreporting.org/\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu/\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org/\" target=\"_blank\">California HealthCare Foundation\u003c/a>\u003c/i>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Ben Fallstead, 28, was diagnosed several years ago with \u003ca href=\"http://www.cdc.gov/parasites/babesiosis/gen_info/faqs.html\" target=\"_blank\">babesiosis\u003c/a>, a tick-borne disease that left him exhausted, wracked with fevers and chronic joint pain and unable to hold a job.\u003c/p>\n\u003cp>After going through several antibiotics, his specialist prescribed one that brought him some relief.\u003c/p>\n\u003cp>“I was just getting to the point where I felt semi-normal,” he says.\u003c/p>\n\u003cp>But early last year, his managed care Medi-Cal plan told him it would not refill the medication, saying that it doesn’t support the long-term use of antibiotics, he says.\u003c/p>\n\u003cp>Since then, the Lake County man has been fighting his plan’s decision, waiting months for judges who aren’t medical experts to determine his medical fate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Fallstead is among roughly 2 million Medi-Cal recipients who must use a different medical appeals process than most others on Medi-Cal. \u003ca href=\"http://www.dhcs.ca.gov/Services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\">Medi-Cal \u003c/a>is the state’s version of the federal Medicaid program that provides health insurance to low-income residents.\u003c/p>\n\u003cp>These Californians live in 22 counties, from Orange County to the Central Coast and rural Northern California. Unlike about 8 million other Medi-Cal enrollees in managed care, most of them can’t appeal their case to an independent physician.\u003c/p>\n\u003cp>Advocates, patients and some lawmakers say this has delayed critical treatments and is simply unfair.\u003c/p>\n\u003cp>“There should be uniformity in the protections of all Medi-Cal recipients,” says state Sen. Bill Monning, a Democrat whose district covers three affected counties: Monterey, Santa Cruz and San Luis Obispo.\u003c/p>\n\u003cp>Today, I’ll explain this inconsistency and offer advice to those people it affects.\u003c/p>\n\u003cp>\u003cb>Q: I live in Orange County and have Medi-Cal. I’m in the middle of cancer treatment but my health plan is making me get reapproved before I can continue. What are my options? \u003c/b>\u003c/p>\n\u003cp>A: If your medical plan makes a decision that you disagree with, such as not covering the medication or therapy your doctor has ordered, you usually start by appealing with the plan itself.\u003c/p>\n\u003cp>If the plan won’t budge, you move to the second level of appeals. This is where the difference lies.\u003c/p>\n\u003cp>The vast majority of managed care Medi-Cal recipients are in plans regulated by the state \u003ca href=\"https://www.dmhc.ca.gov/\" target=\"_blank\">Department of Managed Health Care\u003c/a>. They have access to something called an \u003ca href=\"https://www.dmhc.ca.gov/FileaComplaint/IndependentMedicalReview(IMR).aspx#.VjpX0mSrTw4\" target=\"_blank\">Independent Medical Review \u003c/a>(IMR), which allows them to appeal their plan’s decision to an independent physician (or physicians) who are experts in the conditions being reviewed.\u003c/p>\n\u003cul>\n\u003cli>If your health issue is urgent, you can request an expedited IMR to be conducted within a week.\u003c/li>\n\u003cli>If it is not urgent, it is usually decided within 30 days.\u003c/li>\n\u003c/ul>\n\u003cp>But Orange County managed care Medi-Cal recipients receive coverage through a plan called a \u003ca href=\"http://www.healthconsumer.org/092914-ManagedCareinCaliforniaSeries-3-COHSMediCalPlans.pdf\" target=\"_blank\">County Organized Health System \u003c/a>(COHS).\u003c/p>\n\u003cp>There are six COHS plans, including \u003ca href=\"https://www.caloptima.org/\" target=\"_blank\">CalOptima\u003c/a> in Orange County and \u003ca href=\"http://www.partnershiphp.org/Pages/PHC.aspx\" target=\"_blank\">Partnership HealthPlan\u003c/a>, which covers 14 Northern California counties. If you’re in one of these counties, your local COHS plan is the only Medi-Cal plan available to you.\u003c/p>\n\u003cp>These publicly operated plans were exempted from certain requirements more than 30 years ago when they were much smaller entities.\u003c/p>\n\u003cp>That means you don’t have access to an IMR for your second layer of appeals. You must request a state fair hearing and plead your case before an administrative law judge who usually is not a medical expert.\u003c/p>\n\u003cul>\n\u003cli>The cases must be decided within 90 days after the Medi-Cal recipient requests a hearing, says Michael Weston, spokesman for the state \u003ca href=\"http://www.cdss.ca.gov/cdssweb/default.htm\" target=\"_blank\">Department of Social Services\u003c/a>, which conducts the hearings.\u003c/li>\n\u003cli>An enrollee whose health is in danger from delay may request an expedited hearing. If a judge agrees, a hearing will be scheduled within 10 days of the request and a decision rendered within five days after all evidence has been submitted, Weston says.\u003c/li>\n\u003c/ul>\n\u003cp>(There is an exception. \u003ca href=\"https://www.hpsm.org/\" target=\"_blank\">The Health Plan of San Mateo\u003c/a>, a COHS plan, has voluntarily agreed to be regulated by the Department of Managed Health Care, so its enrollees can request an IMR.)\u003c/p>\n\u003cp>Fallstead has requested two state fair hearings in the past two years. Both took longer than 90 days to resolve.\u003c/p>\n\u003cp>“I feel like they’re denying me medication,” he says. “It feels like I’m not a person to them.”\u003c/p>\n\u003cp>Liza Thantranon,\u003ca href=\"http://lsnc.info/\" target=\"_blank\"> Legal Services of Northern California\u003c/a>’s managing attorney for health, says she deals with this problem every day.\u003c/p>\n\u003cp>Her clients who have access to IMRs usually are able to resolve their cases within a month, she says. However, the majority of her COHS clients who request state fair hearings wait more than 90 days for a decision, some as long as six to eight months.\u003c/p>\n\u003cp>“In the middle, you have administrative law judges trying to evaluate which doctor is right,” Thantranon says. “They don’t know what the science is.”\u003c/p>\n\u003cp>Weston counters that the judges are trained to make “factual findings based on evidence, including the medical evidence provided by the plan and the doctor.”\u003c/p>\n\u003cp>The plans say they’re not against regulation, but over-regulation. They’re already regulated twice, by the federal and state governments, says Bob Freeman, CEO of \u003ca href=\"https://www.cencalhealth.org/\" target=\"_blank\">CenCal Health\u003c/a>, the COHS plan that covers about 165,000 Medi-Cal enrollees in San Luis Obispo and Santa Barbara Counties.\u003c/p>\n\u003cp>Adding this additional layer of regulation would require them to pay about $4 million collectively in fees each year to the Department of Managed Health Care, he says.\u003c/p>\n\u003cp>“Where’s the value to the taxpayer in that?” Freeman asks. “That money could go somewhere else.”\u003c/p>\n\u003cp>For those of you who are in a COHS plan, here are some tips on the appeal process:\u003c/p>\n\u003cul>\n\u003cli>If your plan denies the initial internal appeal, ask it to review its decision. At the same time, immediately request a state fair hearing. You can always withdraw from the hearing later if you’re able to resolve the problem directly with your health plan.\u003c/li>\n\u003cli>Request a state fair hearing by calling 855-795-0634 or email your request to \u003ca href=\"shdcsu@dss.ca.gov\" target=\"_blank\">shdcsu@dss.ca.gov\u003c/a>.\u003c/li>\n\u003cli>Before your hearing, gather medical evidence to bolster your case. “Ask your doctors to write letters of support,” Thantranon says. Your doctor can also participate in the hearing by phone, Weston says.\u003c/li>\n\u003cli>Get help from health care advocacy groups. The Health Consumer Alliance is a good place to start: \u003ca href=\"http://healthconsumer.org/\" target=\"_blank\">healthconsumer.org \u003c/a>and 888-804-3536.\u003c/li>\n\u003cli>If you’re unhappy with the state fair hearing decision, you may be able to request a rehearing or take your case to civil court, Weston says. You also can contact the \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/MMCDOfficeoftheOmbudsman.aspx\" target=\"_blank\">Medi-Cal Managed Care Office of the Ombudsman\u003c/a> at 888-452-8609 or \u003ca href=\"MMCDOmbudsmanOffice@dhcs.ca.gov\" target=\"_blank\">MMCDOmbudsmanOffice@dhcs.ca.gov\u003c/a>.\u003c/li>\n\u003c/ul>\n\u003cp>\u003ci>Questions for Emily: \u003c/i>\u003ci>\u003ca href=\"http://AskEmily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/i>\u003c/p>\n\u003cp>\u003cem>Read \u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">previous Ask Emily columns.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>The \u003ca href=\"http://www.centerforhealthreporting.org/\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu/\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org/\" target=\"_blank\">California HealthCare Foundation\u003c/a>\u003c/i>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Cancer Patients on Medi-Cal Do Worse Than Those with Other Insurance",
"title": "Cancer Patients on Medi-Cal Do Worse Than Those with Other Insurance",
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"content": "\u003cp>Cancer patients with Medi-Cal are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a \u003ca href=\"https://www.ucdmc.ucdavis.edu/iphi/resources/1117737_CancerHI_100615.pdf\" target=\"_blank\">study\u003c/a> by UC Davis researchers. Medi-Cal is California's version of Medicaid, health insurance for people who are low income.\u003c/p>\n\u003caside class=\"pullquote alignright\">“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks.\"\u003cbr>\n\u003ccite>Christina Clarke, Cancer Prevention Institute of California\u003c/cite>\u003c/aside>\n\u003cp>While other \u003ca href=\"http://consumer.healthday.com/cancer-information-5/breast-cancer-news-94/medicaid-patients-get-worse-cancer-care-studies-contend-688451.html\" target=\"_blank\">studies\u003c/a> have linked Medicaid insurance status to worse cancer outcomes, the UC Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.\u003c/p>\n\u003cp>Understanding how well Medi-Cal serves cancer patients is crucial, experts say, because as much as 10 percent of Medi-Cal expenditures go to cancer care. And under the Affordable Care Act, the program has grown to cover more than 12 million Californians – nearly a third of the state’s population.\u003c/p>\n\u003cp>“What’s striking is how similar the findings were for Medi-Cal members and the uninsured,” said Dr. Kenneth Kizer, director of the UC Davis’ Institute for Population Health Improvement, which conducted the study. “If we weren’t spending billions of Medi-Cal dollars on cancer care perhaps that would not be surprising, but you’d think that the outcomes might be better when you’re spending that much money.”\u003c/p>\n\u003cp>The UC Davis researchers used \u003ca href=\"http://www.ccrcal.org/\" target=\"_blank\">California Cancer Registry\u003c/a> data to study the experiences of approximately 700,000 Californians diagnosed with breast, colon, rectal, lung, and prostate cancer between 2004 and 2012. They tracked how early these patients were diagnosed, their quality of treatment and their five-year relative survival rates according to their type of insurance. The types were Medi-Cal, Medicare, dual Medi-Cal/Medicare (for lowest-income seniors), private insurance, Department of Defense (DOD) insurance and Department of Veterans Affairs (VA) insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Among the findings:\u003c/p>\n\u003cul>\n\u003cli>Medi-Cal patients were diagnosed with advanced (stage IV) prostate cancer more than three times as often as patients with private insurance or DOD coverage.\u003c/li>\n\u003cli>Medi-Cal patients with breast, colon or rectal cancer were more likely to be diagnosed at an advanced stage and to have worse five-year survival rates than people with other types of insurance.\u003c/li>\n\u003cli>Low-income seniors covered by Medicare and Medi-Cal, known as “dual-eligible patients,” were the least likely to receive recommended treatment for breast and colon cancer.\u003c/li>\n\u003cli>VA patients waited the longest to be treated for breast, colon, rectal, lung and prostate cancers, but their outcomes compared favorably to patients with other types of health insurance and they were generally more likely to receive recommended treatment.\u003c/li>\n\u003c/ul>\n\u003cp>What researchers still don’t know, Kizer said, is the reason for these disparities. It’s possible that Medi-Cal patients drop on and off the rolls, missing preventive screenings that could help detect cancers earlier. \u003ca href=\"http://khn.org/news/state-auditor-slams-californias-oversight-of-medi-cal-plans-used-by-9-million/\" target=\"_blank\">Audits\u003c/a> and studies also have shown that some of the state’s Medi-Cal patients have difficulty getting access to doctors and specialists.\u003c/p>\n\u003cp>Researchers also can’t explain why Medi-Cal patients are less likely than patients with other kinds of insurance to receive recommended treatment after they are diagnosed. And they also don’t know whether cancer patients fare better or worse in Medi-Cal managed care programs, which now cover most of the Medi-Cal population.\u003c/p>\n\u003cp>“It’s not acceptable to have these variations” based on insurance coverage, particularly regarding breast and colon cancers for which preventive screenings are well-established and effective, said Christina Clarke, a research scientist at the Cancer Prevention Institute of California and a consulting associate professor at the Stanford University School of Medicine. She was not involved in the study.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks. That’s the tragic thing here,” Clarke said. “There’s a body count and we’d like to figure out a better way to insure that all Californians are getting the recommended screening for these deadly cancers and treatment according to guidelines. We have a lot of work to do.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Cancer patients with Medi-Cal are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a \u003ca href=\"https://www.ucdmc.ucdavis.edu/iphi/resources/1117737_CancerHI_100615.pdf\" target=\"_blank\">study\u003c/a> by UC Davis researchers. Medi-Cal is California's version of Medicaid, health insurance for people who are low income.\u003c/p>\n\u003caside class=\"pullquote alignright\">“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks.\"\u003cbr>\n\u003ccite>Christina Clarke, Cancer Prevention Institute of California\u003c/cite>\u003c/aside>\n\u003cp>While other \u003ca href=\"http://consumer.healthday.com/cancer-information-5/breast-cancer-news-94/medicaid-patients-get-worse-cancer-care-studies-contend-688451.html\" target=\"_blank\">studies\u003c/a> have linked Medicaid insurance status to worse cancer outcomes, the UC Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.\u003c/p>\n\u003cp>Understanding how well Medi-Cal serves cancer patients is crucial, experts say, because as much as 10 percent of Medi-Cal expenditures go to cancer care. And under the Affordable Care Act, the program has grown to cover more than 12 million Californians – nearly a third of the state’s population.\u003c/p>\n\u003cp>“What’s striking is how similar the findings were for Medi-Cal members and the uninsured,” said Dr. Kenneth Kizer, director of the UC Davis’ Institute for Population Health Improvement, which conducted the study. “If we weren’t spending billions of Medi-Cal dollars on cancer care perhaps that would not be surprising, but you’d think that the outcomes might be better when you’re spending that much money.”\u003c/p>\n\u003cp>The UC Davis researchers used \u003ca href=\"http://www.ccrcal.org/\" target=\"_blank\">California Cancer Registry\u003c/a> data to study the experiences of approximately 700,000 Californians diagnosed with breast, colon, rectal, lung, and prostate cancer between 2004 and 2012. They tracked how early these patients were diagnosed, their quality of treatment and their five-year relative survival rates according to their type of insurance. The types were Medi-Cal, Medicare, dual Medi-Cal/Medicare (for lowest-income seniors), private insurance, Department of Defense (DOD) insurance and Department of Veterans Affairs (VA) insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Among the findings:\u003c/p>\n\u003cul>\n\u003cli>Medi-Cal patients were diagnosed with advanced (stage IV) prostate cancer more than three times as often as patients with private insurance or DOD coverage.\u003c/li>\n\u003cli>Medi-Cal patients with breast, colon or rectal cancer were more likely to be diagnosed at an advanced stage and to have worse five-year survival rates than people with other types of insurance.\u003c/li>\n\u003cli>Low-income seniors covered by Medicare and Medi-Cal, known as “dual-eligible patients,” were the least likely to receive recommended treatment for breast and colon cancer.\u003c/li>\n\u003cli>VA patients waited the longest to be treated for breast, colon, rectal, lung and prostate cancers, but their outcomes compared favorably to patients with other types of health insurance and they were generally more likely to receive recommended treatment.\u003c/li>\n\u003c/ul>\n\u003cp>What researchers still don’t know, Kizer said, is the reason for these disparities. It’s possible that Medi-Cal patients drop on and off the rolls, missing preventive screenings that could help detect cancers earlier. \u003ca href=\"http://khn.org/news/state-auditor-slams-californias-oversight-of-medi-cal-plans-used-by-9-million/\" target=\"_blank\">Audits\u003c/a> and studies also have shown that some of the state’s Medi-Cal patients have difficulty getting access to doctors and specialists.\u003c/p>\n\u003cp>Researchers also can’t explain why Medi-Cal patients are less likely than patients with other kinds of insurance to receive recommended treatment after they are diagnosed. And they also don’t know whether cancer patients fare better or worse in Medi-Cal managed care programs, which now cover most of the Medi-Cal population.\u003c/p>\n\u003cp>“It’s not acceptable to have these variations” based on insurance coverage, particularly regarding breast and colon cancers for which preventive screenings are well-established and effective, said Christina Clarke, a research scientist at the Cancer Prevention Institute of California and a consulting associate professor at the Stanford University School of Medicine. She was not involved in the study.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks. That’s the tragic thing here,” Clarke said. “There’s a body count and we’d like to figure out a better way to insure that all Californians are getting the recommended screening for these deadly cancers and treatment according to guidelines. We have a lot of work to do.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Covered California Targets African Americans, Latinos In Obamacare Open Enrollment",
"title": "Covered California Targets African Americans, Latinos In Obamacare Open Enrollment",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>Covered California still faces major challenges in enrolling African-Americans and Latinos as the state’s health insurance exchange launched its third open enrollment period Sunday.\u003c/p>\n\u003cp>“We know we’ve come up short in who’s enrolled today,” Covered California Executive Director Peter Lee said at a recent media briefing on the exchange’s marketing and outreach plans. “Of those who are still uninsured, we want to make sure we reach them.”\u003c/p>\n\u003caside class=\"pullquote alignright\">“We know we’ve come up short in who’s enrolled today.\"\u003cbr>\n\u003ccite>Peter Lee, Covered California Executive Director \u003c/cite>\u003c/aside>\n\u003cp>About 2.4 percent of the exchange’s approximately 1.3 million enrollees are African-American, only about half of the blacks considered eligible for subsidies because of their income. Another 30 percent are Latino; 37 percent are considered eligible for subsidies, according to \u003ca href=\"http://hbex.coveredca.com/data-research/library/Active-Membership-Slides.pdf\" target=\"_blank\">Covered California data\u003c/a>.\u003c/p>\n\u003cp>In contrast, enrollment of whites and Asians has exceeded eligibility projections, meaning that Covered California was better able to reach those groups. The state’s enrollment data is not exact, because more than a quarter of enrollees decline to state their race.\u003c/p>\n\u003cp>[contextly_sidebar id=\"i6jYaraDnQfXmte5cZ5eZKWtJ7cBm8iG\"]While many more California Latinos and African-Americans have become insured since the passage of the Affordable Care Act, including through the state’s Medi-Cal expansion and employer-based insurance, Covered California’s experience echoes that of other states trying to ensure that their minority populations get the health coverage they need, said Larry Levitt, senior vice president at the Kaiser Family Foundation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>About 55 percent of the nation’s remaining 32.3 million uninsured under age 65 \u003ca href=\"http://kff.org/disparities-policy/issue-brief/estimates-of-eligibility-for-aca-coverage-among-the-uninsured-by-race-and-ethnicity/\" target=\"_blank\">are people of color\u003c/a>, including 34 percent who identify as Hispanic/Latino and 14 percent who identify as black, according to Kaiser Family Foundation data.\u003c/p>\n\u003cp>In California, about \u003ca href=\"http://www.coveredca.com/news/pdfs/CoveredCA-CaliforniansKnowledgeoftheACA.pdf\" target=\"_blank\">2.2 million\u003c/a> Californians remain uninsured but are eligible for Medi-Cal or Covered California insurance plans, Lee said. They are more likely to be Latino and African-American, and younger and slightly more affluent than current enrollees, who may have qualified for subsidies or Medi-Cal, the state’s version of Medicaid.\u003c/p>\n\u003cp>Covered California has earmarked about \u003ca href=\"http://hbex.coveredca.com/financial-reports/PDFs/FINAL%20JUNE%202015-16%20Covered%20CA%20Budget%20Summary_KL.pdf\" target=\"_blank\">$50 million\u003c/a> for marketing and another $13 million for navigators -- trained counselors who help people learn about and sign up for coverage. The exchange unveiled \u003ca href=\"http://news.coveredca.com/2015/10/covered-california-launches-open.html\" target=\"_blank\">its new advertising campaign\u003c/a> Friday, including ads specifically targeted to Latinos and African-Americans. Covered California’s open enrollment runs from Nov. 1 to Jan. 31, 2016.\u003c/p>\n\u003cp>Explanations for the disproportionately low enrollments of eligible African-Americans and Latinos vary. “We’ve got people who don’t trust the government,” said Dan Daniels, coastal area director of the NAACP California State Conference, who oversaw Affordable Care Act outreach in his region.\u003c/p>\n\u003cp>Daniels also cited attitudes among “young invincibles,” who are healthy enough to think they don’t need coverage and are willing to pay the mandatory penalty for not having health insurance. That penalty will rise in 2016 to \u003ca href=\"https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/\" target=\"_blank\">$695 per person\u003c/a> or 2.5 percent of income, whichever is higher.\u003c/p>\n\u003cp>[contextly_sidebar id=\"D6TWOWFjS0MLbUxYid2ZhI9XmIOKCRNT\"]Among some Latinos who are legal residents, there is fear that applying for health insurance through Covered California will jeopardize the immigration status of other family members, Levitt said.\u003c/p>\n\u003cp>And affordability remains a looming concern for higher-income people of color who may not be eligible for subsidies or Medi-Cal.\u003c/p>\n\u003cp>For example, Kemisha Roston, a 38-year-old contract lawyer from Riverside, said she makes too much money to qualify for those programs, but not enough to afford Covered California unsubsidized premiums – which top $300 per month — while she pays off student debt.\u003c/p>\n\u003cp>“I’m living check to check, because the market for attorneys is very saturated,” Roston said. “My health is pretty good right now, so I don’t need to go to the doctor. When I do, I go to free clinics or Planned Parenthood. I’m dismayed, because if something does happen and I don’t have health insurance, I could be wiped out.”\u003c/p>\n\u003cp>In addition, some community leaders and health advocates have criticized Covered California’s previous marketing and outreach efforts to both African-American and Latino communities as too generalized and impersonal. The exchange has spent more money on marketing and outreach than other exchanges, with less to show for it, said Hector De La Torre, executive director of the Transamerica Center for Health Studies.\u003c/p>\n\u003cp>[contextly_sidebar id=\"O1fT4KmbMVl23QPu7yIqqfTkXntKSW9w\"]“You have these challenges in these communities and it takes a lot more than a TV commercial to make them aware of what they need to do -– you can’t do that in 30 seconds,” De La Torre said, referring to the need to educate people about the basic value of health insurance. “That’s where Covered California has not done as much as it could in reaching out to these folks. It’s a face-to-face communication effort that needs to take place.”\u003c/p>\n\u003cp>Charla Franklin, community outreach liaison for Healthy African American Families, an advocacy group in Los Angeles, said Covered California did well in reaching out to California’s black churches and community groups to get the word out. But the advertising campaign in her area was “so bland it was ridiculous,” she said. The exchange really needed to better inform people about specific community events and places where people could get in-person help with the complicated and time-consuming online enrollment process, she said.\u003c/p>\n\u003cp>Lee has told reporters recently that Covered California is stepping up its ground game and changing its messaging. Consumer surveys have shown that potential enrollees need more education on how subsidies can lower their out-of-pocket costs, he said. The U.S. Department of Health and Human Services said it will pursue a similar \u003ca href=\"http://www.nytimes.com/2015/10/30/us/politics/obama-administration-campaign-will-publicize-health-care-subsidies.html?_r=1\" target=\"_blank\">strategy\u003c/a> of publicizing financial help available to many people.\u003c/p>\n\u003cp>“We cannot take it as a given that Californians understand that health care is more affordable because subsidies are available,” he said. “We’ll be getting back to basics.”\u003c/p>\n\u003cp>The exchange is also expanding its direct outreach efforts, more than doubling the number of Covered California storefronts where people can get help to enroll to 500, Lee said.\u003c/p>\n\u003cp>But while Lee promised “a more intense ground game,” he also cautioned against overly high expectations for the exchange’s third open enrollment season.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We have millions of Californians who’ve adopted a culture of coping. They don’t understand they have subsidies available to them and are making do. It’s going to be years to change to a culture of coverage.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Covered California still faces major challenges in enrolling African-Americans and Latinos as the state’s health insurance exchange launched its third open enrollment period Sunday.\u003c/p>\n\u003cp>“We know we’ve come up short in who’s enrolled today,” Covered California Executive Director Peter Lee said at a recent media briefing on the exchange’s marketing and outreach plans. “Of those who are still uninsured, we want to make sure we reach them.”\u003c/p>\n\u003caside class=\"pullquote alignright\">“We know we’ve come up short in who’s enrolled today.\"\u003cbr>\n\u003ccite>Peter Lee, Covered California Executive Director \u003c/cite>\u003c/aside>\n\u003cp>About 2.4 percent of the exchange’s approximately 1.3 million enrollees are African-American, only about half of the blacks considered eligible for subsidies because of their income. Another 30 percent are Latino; 37 percent are considered eligible for subsidies, according to \u003ca href=\"http://hbex.coveredca.com/data-research/library/Active-Membership-Slides.pdf\" target=\"_blank\">Covered California data\u003c/a>.\u003c/p>\n\u003cp>In contrast, enrollment of whites and Asians has exceeded eligibility projections, meaning that Covered California was better able to reach those groups. The state’s enrollment data is not exact, because more than a quarter of enrollees decline to state their race.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>While many more California Latinos and African-Americans have become insured since the passage of the Affordable Care Act, including through the state’s Medi-Cal expansion and employer-based insurance, Covered California’s experience echoes that of other states trying to ensure that their minority populations get the health coverage they need, said Larry Levitt, senior vice president at the Kaiser Family Foundation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>About 55 percent of the nation’s remaining 32.3 million uninsured under age 65 \u003ca href=\"http://kff.org/disparities-policy/issue-brief/estimates-of-eligibility-for-aca-coverage-among-the-uninsured-by-race-and-ethnicity/\" target=\"_blank\">are people of color\u003c/a>, including 34 percent who identify as Hispanic/Latino and 14 percent who identify as black, according to Kaiser Family Foundation data.\u003c/p>\n\u003cp>In California, about \u003ca href=\"http://www.coveredca.com/news/pdfs/CoveredCA-CaliforniansKnowledgeoftheACA.pdf\" target=\"_blank\">2.2 million\u003c/a> Californians remain uninsured but are eligible for Medi-Cal or Covered California insurance plans, Lee said. They are more likely to be Latino and African-American, and younger and slightly more affluent than current enrollees, who may have qualified for subsidies or Medi-Cal, the state’s version of Medicaid.\u003c/p>\n\u003cp>Covered California has earmarked about \u003ca href=\"http://hbex.coveredca.com/financial-reports/PDFs/FINAL%20JUNE%202015-16%20Covered%20CA%20Budget%20Summary_KL.pdf\" target=\"_blank\">$50 million\u003c/a> for marketing and another $13 million for navigators -- trained counselors who help people learn about and sign up for coverage. The exchange unveiled \u003ca href=\"http://news.coveredca.com/2015/10/covered-california-launches-open.html\" target=\"_blank\">its new advertising campaign\u003c/a> Friday, including ads specifically targeted to Latinos and African-Americans. Covered California’s open enrollment runs from Nov. 1 to Jan. 31, 2016.\u003c/p>\n\u003cp>Explanations for the disproportionately low enrollments of eligible African-Americans and Latinos vary. “We’ve got people who don’t trust the government,” said Dan Daniels, coastal area director of the NAACP California State Conference, who oversaw Affordable Care Act outreach in his region.\u003c/p>\n\u003cp>Daniels also cited attitudes among “young invincibles,” who are healthy enough to think they don’t need coverage and are willing to pay the mandatory penalty for not having health insurance. That penalty will rise in 2016 to \u003ca href=\"https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/\" target=\"_blank\">$695 per person\u003c/a> or 2.5 percent of income, whichever is higher.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Among some Latinos who are legal residents, there is fear that applying for health insurance through Covered California will jeopardize the immigration status of other family members, Levitt said.\u003c/p>\n\u003cp>And affordability remains a looming concern for higher-income people of color who may not be eligible for subsidies or Medi-Cal.\u003c/p>\n\u003cp>For example, Kemisha Roston, a 38-year-old contract lawyer from Riverside, said she makes too much money to qualify for those programs, but not enough to afford Covered California unsubsidized premiums – which top $300 per month — while she pays off student debt.\u003c/p>\n\u003cp>“I’m living check to check, because the market for attorneys is very saturated,” Roston said. “My health is pretty good right now, so I don’t need to go to the doctor. When I do, I go to free clinics or Planned Parenthood. I’m dismayed, because if something does happen and I don’t have health insurance, I could be wiped out.”\u003c/p>\n\u003cp>In addition, some community leaders and health advocates have criticized Covered California’s previous marketing and outreach efforts to both African-American and Latino communities as too generalized and impersonal. The exchange has spent more money on marketing and outreach than other exchanges, with less to show for it, said Hector De La Torre, executive director of the Transamerica Center for Health Studies.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“You have these challenges in these communities and it takes a lot more than a TV commercial to make them aware of what they need to do -– you can’t do that in 30 seconds,” De La Torre said, referring to the need to educate people about the basic value of health insurance. “That’s where Covered California has not done as much as it could in reaching out to these folks. It’s a face-to-face communication effort that needs to take place.”\u003c/p>\n\u003cp>Charla Franklin, community outreach liaison for Healthy African American Families, an advocacy group in Los Angeles, said Covered California did well in reaching out to California’s black churches and community groups to get the word out. But the advertising campaign in her area was “so bland it was ridiculous,” she said. The exchange really needed to better inform people about specific community events and places where people could get in-person help with the complicated and time-consuming online enrollment process, she said.\u003c/p>\n\u003cp>Lee has told reporters recently that Covered California is stepping up its ground game and changing its messaging. Consumer surveys have shown that potential enrollees need more education on how subsidies can lower their out-of-pocket costs, he said. The U.S. Department of Health and Human Services said it will pursue a similar \u003ca href=\"http://www.nytimes.com/2015/10/30/us/politics/obama-administration-campaign-will-publicize-health-care-subsidies.html?_r=1\" target=\"_blank\">strategy\u003c/a> of publicizing financial help available to many people.\u003c/p>\n\u003cp>“We cannot take it as a given that Californians understand that health care is more affordable because subsidies are available,” he said. “We’ll be getting back to basics.”\u003c/p>\n\u003cp>The exchange is also expanding its direct outreach efforts, more than doubling the number of Covered California storefronts where people can get help to enroll to 500, Lee said.\u003c/p>\n\u003cp>But while Lee promised “a more intense ground game,” he also cautioned against overly high expectations for the exchange’s third open enrollment season.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Anthem Blue Cross Will Repay $8.3 Million to 50,000 California Customers",
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"content": "\u003cp>Anthem Blue Cross has settled a class action lawsuit to refund $8.3 million to tens of thousands of its members and has \u003ca href=\"http://www.consumerwatchdog.org/resources/kassouf_taub_-_settlement_agreement.5.29.15_noe.pdf\" target=\"_blank\">agreed to forgo mid-year changes \u003c/a>to the deductible and out-of-pocket limits on its members' annual plans.\u003c/p>\n\u003cp>Anthem, California's second largest insurer, had raised annual deductibles, prescription drug deductibles and out-of-pocket limits for about 50,000 customers in mid-year in 2011, prompting two lawsuits alleging breach of contract.\u003c/p>\n\u003cp>One of those who sued was Eric Taub of Westlake Village. In 2011, he and his wife were paying Anthem a combined premium of about $2,400 each month and had individual deductibles of $1,500.\u003c/p>\n\u003cp>With the mid-year change, Taub and his wife saw their deductibles rise to $1,750.\u003c/p>\n\u003cp>\"It's like you're playing a game and you think you're at the goal, and they move the goal post another 10 yards,\" says Taub.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Anthem argued that its contracts allowed for mid-year increases, as long as it provided proper notice of the changes.\u003c/p>\n\u003cp>Taub's suit and another case were combined into one class action. After extensive negotiations, \u003ca href=\"http://www.consumerwatchdog.org/resources/kassouf_taub_-_settlement_agreement.5.29.15_noe.pdf\" target=\"_blank\">the two sides agreed to settle\u003c/a>. Anthem agreed to no longer make mid-year alterations to individual customers' plans, unless a change in law or regulation supports such modifications. As part of the deal, Anthem does not admit to wrongdoing.\u003c/p>\n\u003cp>\"Anthem should be commended for listening to the heartfelt concerns of its policyholders,\" Jerry Flanagan, lead attorney for plaintiffs' co-counsel Consumer Watchdog, said in a statement. \"This settlement gives consumers the peace-of-mind of knowing that their 'annual' out-of-pocket costs won't change in the middle of the year.\"\u003c/p>\n\u003cp>Anthem issued a statement saying it \"is pleased that all parties were able to come to an agreement.\"\u003c/p>\n\u003cp>The Anthem members who saw their costs rise due to the 2011 plan changes do not need to file a claim to receive their part of the $8.3 million refund. Checks will be mailed to them in December, according to Consumer Watchdog.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The settlement is tentative pending Los Angeles County Superior Court Judge Jane Johnson's final approval.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Anthem Blue Cross has settled a class action lawsuit to refund $8.3 million to tens of thousands of its members and has \u003ca href=\"http://www.consumerwatchdog.org/resources/kassouf_taub_-_settlement_agreement.5.29.15_noe.pdf\" target=\"_blank\">agreed to forgo mid-year changes \u003c/a>to the deductible and out-of-pocket limits on its members' annual plans.\u003c/p>\n\u003cp>Anthem, California's second largest insurer, had raised annual deductibles, prescription drug deductibles and out-of-pocket limits for about 50,000 customers in mid-year in 2011, prompting two lawsuits alleging breach of contract.\u003c/p>\n\u003cp>One of those who sued was Eric Taub of Westlake Village. In 2011, he and his wife were paying Anthem a combined premium of about $2,400 each month and had individual deductibles of $1,500.\u003c/p>\n\u003cp>With the mid-year change, Taub and his wife saw their deductibles rise to $1,750.\u003c/p>\n\u003cp>\"It's like you're playing a game and you think you're at the goal, and they move the goal post another 10 yards,\" says Taub.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Anthem argued that its contracts allowed for mid-year increases, as long as it provided proper notice of the changes.\u003c/p>\n\u003cp>Taub's suit and another case were combined into one class action. After extensive negotiations, \u003ca href=\"http://www.consumerwatchdog.org/resources/kassouf_taub_-_settlement_agreement.5.29.15_noe.pdf\" target=\"_blank\">the two sides agreed to settle\u003c/a>. Anthem agreed to no longer make mid-year alterations to individual customers' plans, unless a change in law or regulation supports such modifications. As part of the deal, Anthem does not admit to wrongdoing.\u003c/p>\n\u003cp>\"Anthem should be commended for listening to the heartfelt concerns of its policyholders,\" Jerry Flanagan, lead attorney for plaintiffs' co-counsel Consumer Watchdog, said in a statement. \"This settlement gives consumers the peace-of-mind of knowing that their 'annual' out-of-pocket costs won't change in the middle of the year.\"\u003c/p>\n\u003cp>Anthem issued a statement saying it \"is pleased that all parties were able to come to an agreement.\"\u003c/p>\n\u003cp>The Anthem members who saw their costs rise due to the 2011 plan changes do not need to file a claim to receive their part of the $8.3 million refund. Checks will be mailed to them in December, according to Consumer Watchdog.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The settlement is tentative pending Los Angeles County Superior Court Judge Jane Johnson's final approval.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>If you’re not already in the midst of picking your health coverage for next year, you soon may be.\u003c/p>\n\u003cp>If at all possible, please don’t base your decision solely on the cost of monthly premiums.\u003c/p>\n\u003cp>Let’s say you have asthma. Out of 10 major \u003ca href=\"https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/\" target=\"_blank\">Health Maintenance Organizations \u003c/a>(HMOs) recently ranked in California, three received a “poor” rating for asthma care, five were ranked “fair” and two got “excellent.”\u003c/p>\n\u003cp>You might want to know which is which.\u003c/p>\n\u003cp>“If you have substandard care … through your health plan, paying any amount of money is not a good trade-off,” says Beth Abbott, director of the state \u003ca href=\"http://www.opa.ca.gov/Pages/Home.aspx\" target=\"_blank\">Office of the Patient Advocate \u003c/a>(OPA), which provides the rankings. “People should consider the interaction of both cost and quality.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today I’ll point you to some resources that will help you compare plans on their care and patient satisfaction.\u003c/p>\n\u003cp>I also want to acknowledge again that while costs are definitely a critical component of your decision, don’t make premiums the only criterion.\u003c/p>\n\u003cp>\u003cstrong>Q: I have health insurance through my employer and open enrollment is coming up. It would make my life easier just to stay in the same plan I’m in. Is that a good idea?\u003c/strong>\u003c/p>\n\u003cp>A: Don’t automatically assume that the plan you’re in now will be the best plan for you next year.\u003c/p>\n\u003cp>Why? Doctors fall in and out of networks. Premiums, co-pays and deductibles often rise. And your plan might not provide the best care for your current medical needs.\u003c/p>\n\u003cp>Let’s start with some basics. For most people, open enrollment will be the only chance to buy or change your health insurance each year. But the time frame depends on where you get it:\u003c/p>\n\u003cul>\n\u003cli>If you have job-based insurance, you usually enroll for the coming year during the fall. Check with your human resources department for exact dates.\u003c/li>\n\u003cli>If you buy individual or family plans from the state health insurance exchange, \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California,\u003c/a> or the open market, open enrollment for 2016 starts Nov. 1 and ends Jan. 31, 2016. If you already have a Covered California plan and want to stick with it, you can start the renewal process now.\u003c/li>\n\u003cli>Open enrollment for Medicare recipients began Oct. 15 and ends Dec. 7. \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html\" target=\"_blank\">Medicare\u003c/a> is the federal health insurance program for people 65 and older and those with kidney failure and certain disabilities.\u003c/li>\n\u003cli>You can enroll in\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\"> Medi-Cal\u003c/a>, the state’s version of the federal Medicaid program for low-income residents, any time of year if you’re eligible.\u003c/li>\n\u003c/ul>\n\u003cp>The biggest chunk of insured Californians have private insurance, either purchased through their employer or from Covered California or the open market. I’m going to focus on them.\u003c/p>\n\u003cp>The OPA report cards (find them at www.opa.ca.gov) grade the health plans and doctor groups that serve more than 16 million Californians, most of whom get their insurance through work.\u003c/p>\n\u003cp>Recently updated for 2015-2016, they offer two categories of ratings.\u003c/p>\n\u003cul>\n\u003cli>Member satisfaction: Patients rank their health plans and doctor groups on customer service, ease (and speed) of obtaining care and other measures.\u003c/li>\n\u003cli>Clinical data: These rankings measure whether plans meet recommended care guidelines in a number of areas, including diabetes, maternity, heart and mental health care.\u003c/li>\n\u003c/ul>\n\u003cp>The plans differ dramatically on some measures. For instance, as with asthma, HMOs rank from poor to excellent when it comes to maternity care. Drill into the rankings to learn which plans do better at prenatal and post-birth visits than others.\u003c/p>\n\u003cp>Beyond rankings, if you click on a health plan’s name, you can inspect customer service options and hours, which can be critical if you’re dealing with a sick child in the middle of the night and need advice, Abbott says. Some are open 24/7, including weekends. Others only answer the phone from 8 a.m. to 5 p.m. on weekdays.\u003c/p>\n\u003cp>“Some don’t have an after-hours number you can call,” she says.\u003c/p>\n\u003cp>If you’re buying insurance from Covered California, the agency this year will offer some plan ratings based on enrollee experience and opinion, not clinical data. You can find those star ratings when you’re shopping for plans on its website: \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>If you’re looking for clinical data, use the OPA report cards as a proxy, Abbott suggests. But beware that insurers sell different plans to their job-based customers and Covered California enrollees. Doctor networks, price structure and other factors differ.\u003c/p>\n\u003cp>Now, back to cost.\u003c/p>\n\u003cp>Don’t ignore the amount of money you will owe when you actually receive care, such as the deductibles, co-pays and other out-of-pocket costs that can easily climb into the thousands of dollars. (A \u003ca href=\"https://www.healthcare.gov/glossary/deductible/\" target=\"_blank\">deductible\u003c/a>, for instance, is the amount you owe for covered health care services before your insurance starts to pay.)\u003c/p>\n\u003cp>In general, the health plans with the lowest premiums have the highest out-of-pocket costs.\u003c/p>\n\u003cp>In Covered California parlance, that’s a bronze plan. For 2016, an individual who buys a basic bronze plan will face a $6,000 deductible for medical costs and $500 for drugs, which equals the plan’s $6,500 out-of-pocket maximum. (Double those figures to get the family limits.)\u003c/p>\n\u003cp>People with job-based plans, too, are getting hit. A \u003ca href=\"http://kff.org/health-costs/press-release/employer-family-health-premiums-rise-4-percent-to-17545-in-2015-extending-a-decade-long-trend-of-relatively-moderate-increases/\" target=\"_blank\">recent Kaiser Family Foundation analysis \u003c/a>of workplace benefits found that both the share of workers with deductibles and the size of deductibles have spiked. Together, they account for a 67 percent increase in deductibles since 2010, dwarfing the rise in premiums, workers’ wages and general inflation.\u003c/p>\n\u003cp>If you’re considering a high-deductible plan because of its lower premium, do the math ahead of time and understand all of your financial obligations, says Lucien Wulsin, executive director of the \u003ca href=\"http://itup.org/\" target=\"_blank\">Insure the Uninsured Project,\u003c/a> which advocates for California’s uninsured population.\u003c/p>\n\u003cp>If you’re a Covered California customer in particular, Wulsin urges you to check if you’re eligible for \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">an “enhanced” silver plan\u003c/a> based on your income. These plans offer subsidies that lower your out-of-pocket costs, but you must choose the silver level to receive them.\u003c/p>\n\u003cp>“When people are choosing these plans, they have to have their eyes wide open,” he says. “You can say, ‘I’m healthy today,’ then have an accident tomorrow.”\u003c/p>\n\u003cp>In other words, how many of you have $6,500 lying around for your next unplanned visit to the ER?\u003c/p>\n\u003cp>\u003cem>Questions for Emily: \u003ca href=\"askemily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Click\u003c/em>\u003cem> \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">here\u003c/a>\u003cem> \u003c/em>\u003cem>to find\u003c/em>\u003cem> \u003c/em>\u003cem>previous Ask Emily columns.\u003c/em>\u003cem> \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>.\u003c/p>\n\n",
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"excerpt": "For California plans, consumers can look at quality of care and satisfaction. Think about the amount of the deductible, too. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you’re not already in the midst of picking your health coverage for next year, you soon may be.\u003c/p>\n\u003cp>If at all possible, please don’t base your decision solely on the cost of monthly premiums.\u003c/p>\n\u003cp>Let’s say you have asthma. Out of 10 major \u003ca href=\"https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/\" target=\"_blank\">Health Maintenance Organizations \u003c/a>(HMOs) recently ranked in California, three received a “poor” rating for asthma care, five were ranked “fair” and two got “excellent.”\u003c/p>\n\u003cp>You might want to know which is which.\u003c/p>\n\u003cp>“If you have substandard care … through your health plan, paying any amount of money is not a good trade-off,” says Beth Abbott, director of the state \u003ca href=\"http://www.opa.ca.gov/Pages/Home.aspx\" target=\"_blank\">Office of the Patient Advocate \u003c/a>(OPA), which provides the rankings. “People should consider the interaction of both cost and quality.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today I’ll point you to some resources that will help you compare plans on their care and patient satisfaction.\u003c/p>\n\u003cp>I also want to acknowledge again that while costs are definitely a critical component of your decision, don’t make premiums the only criterion.\u003c/p>\n\u003cp>\u003cstrong>Q: I have health insurance through my employer and open enrollment is coming up. It would make my life easier just to stay in the same plan I’m in. Is that a good idea?\u003c/strong>\u003c/p>\n\u003cp>A: Don’t automatically assume that the plan you’re in now will be the best plan for you next year.\u003c/p>\n\u003cp>Why? Doctors fall in and out of networks. Premiums, co-pays and deductibles often rise. And your plan might not provide the best care for your current medical needs.\u003c/p>\n\u003cp>Let’s start with some basics. For most people, open enrollment will be the only chance to buy or change your health insurance each year. But the time frame depends on where you get it:\u003c/p>\n\u003cul>\n\u003cli>If you have job-based insurance, you usually enroll for the coming year during the fall. Check with your human resources department for exact dates.\u003c/li>\n\u003cli>If you buy individual or family plans from the state health insurance exchange, \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California,\u003c/a> or the open market, open enrollment for 2016 starts Nov. 1 and ends Jan. 31, 2016. If you already have a Covered California plan and want to stick with it, you can start the renewal process now.\u003c/li>\n\u003cli>Open enrollment for Medicare recipients began Oct. 15 and ends Dec. 7. \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html\" target=\"_blank\">Medicare\u003c/a> is the federal health insurance program for people 65 and older and those with kidney failure and certain disabilities.\u003c/li>\n\u003cli>You can enroll in\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\"> Medi-Cal\u003c/a>, the state’s version of the federal Medicaid program for low-income residents, any time of year if you’re eligible.\u003c/li>\n\u003c/ul>\n\u003cp>The biggest chunk of insured Californians have private insurance, either purchased through their employer or from Covered California or the open market. I’m going to focus on them.\u003c/p>\n\u003cp>The OPA report cards (find them at www.opa.ca.gov) grade the health plans and doctor groups that serve more than 16 million Californians, most of whom get their insurance through work.\u003c/p>\n\u003cp>Recently updated for 2015-2016, they offer two categories of ratings.\u003c/p>\n\u003cul>\n\u003cli>Member satisfaction: Patients rank their health plans and doctor groups on customer service, ease (and speed) of obtaining care and other measures.\u003c/li>\n\u003cli>Clinical data: These rankings measure whether plans meet recommended care guidelines in a number of areas, including diabetes, maternity, heart and mental health care.\u003c/li>\n\u003c/ul>\n\u003cp>The plans differ dramatically on some measures. For instance, as with asthma, HMOs rank from poor to excellent when it comes to maternity care. Drill into the rankings to learn which plans do better at prenatal and post-birth visits than others.\u003c/p>\n\u003cp>Beyond rankings, if you click on a health plan’s name, you can inspect customer service options and hours, which can be critical if you’re dealing with a sick child in the middle of the night and need advice, Abbott says. Some are open 24/7, including weekends. Others only answer the phone from 8 a.m. to 5 p.m. on weekdays.\u003c/p>\n\u003cp>“Some don’t have an after-hours number you can call,” she says.\u003c/p>\n\u003cp>If you’re buying insurance from Covered California, the agency this year will offer some plan ratings based on enrollee experience and opinion, not clinical data. You can find those star ratings when you’re shopping for plans on its website: \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>If you’re looking for clinical data, use the OPA report cards as a proxy, Abbott suggests. But beware that insurers sell different plans to their job-based customers and Covered California enrollees. Doctor networks, price structure and other factors differ.\u003c/p>\n\u003cp>Now, back to cost.\u003c/p>\n\u003cp>Don’t ignore the amount of money you will owe when you actually receive care, such as the deductibles, co-pays and other out-of-pocket costs that can easily climb into the thousands of dollars. (A \u003ca href=\"https://www.healthcare.gov/glossary/deductible/\" target=\"_blank\">deductible\u003c/a>, for instance, is the amount you owe for covered health care services before your insurance starts to pay.)\u003c/p>\n\u003cp>In general, the health plans with the lowest premiums have the highest out-of-pocket costs.\u003c/p>\n\u003cp>In Covered California parlance, that’s a bronze plan. For 2016, an individual who buys a basic bronze plan will face a $6,000 deductible for medical costs and $500 for drugs, which equals the plan’s $6,500 out-of-pocket maximum. (Double those figures to get the family limits.)\u003c/p>\n\u003cp>People with job-based plans, too, are getting hit. A \u003ca href=\"http://kff.org/health-costs/press-release/employer-family-health-premiums-rise-4-percent-to-17545-in-2015-extending-a-decade-long-trend-of-relatively-moderate-increases/\" target=\"_blank\">recent Kaiser Family Foundation analysis \u003c/a>of workplace benefits found that both the share of workers with deductibles and the size of deductibles have spiked. Together, they account for a 67 percent increase in deductibles since 2010, dwarfing the rise in premiums, workers’ wages and general inflation.\u003c/p>\n\u003cp>If you’re considering a high-deductible plan because of its lower premium, do the math ahead of time and understand all of your financial obligations, says Lucien Wulsin, executive director of the \u003ca href=\"http://itup.org/\" target=\"_blank\">Insure the Uninsured Project,\u003c/a> which advocates for California’s uninsured population.\u003c/p>\n\u003cp>If you’re a Covered California customer in particular, Wulsin urges you to check if you’re eligible for \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">an “enhanced” silver plan\u003c/a> based on your income. These plans offer subsidies that lower your out-of-pocket costs, but you must choose the silver level to receive them.\u003c/p>\n\u003cp>“When people are choosing these plans, they have to have their eyes wide open,” he says. “You can say, ‘I’m healthy today,’ then have an accident tomorrow.”\u003c/p>\n\u003cp>In other words, how many of you have $6,500 lying around for your next unplanned visit to the ER?\u003c/p>\n\u003cp>\u003cem>Questions for Emily: \u003ca href=\"askemily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Click\u003c/em>\u003cem> \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">here\u003c/a>\u003cem> \u003c/em>\u003cem>to find\u003c/em>\u003cem> \u003c/em>\u003cem>previous Ask Emily columns.\u003c/em>\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Yes, Shopping for Health Care is Hard, But Don't Give Up",
"title": "Yes, Shopping for Health Care is Hard, But Don't Give Up",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cp>\u003cem>Editor's note: this essay comes to us from our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a> partner, Jeanne Pinder, the founder of \u003ca href=\"https://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a>. Her mission is improving transparency in health prices by giving consumers more power by lifting the veil on the opaque world of health care prices.\u003c/em>\u003c/p>\n\u003cp>Yes, people are shopping for health care. Some are better at it than others, and some providers and payers (read: doctors and insurers) are better than others about revealing information. We're always interested to hear when people who haven't encountered these truths come up against the real world. So when Sarah Kliff, the well-respected health care writer for Vox.com, wrote about her experience \u003ca href=\"http://www.vox.com/2015/10/19/9567991/health-care-shopping-mri\" target=\"_blank\">trying to get a better price for an MRI\u003c/a>, I was really interested.\u003c/p>\n\u003cp>In her story Kliff said she had a fracture that hadn't healed properly. After she spent weeks in a walking cast and saw little improvement, her doctor recommended an MRI. Kliff scheduled an MRI at an academic center, then heard from her insurance company that they had a better choice that was less expensive. That's where she went.\u003c/p>\n\u003cp>[contextly_sidebar id=\"hGVGNvKrsTsPnj7fRdvTeNOueVtv99Gh\"]But when she returned to her doctor for the results, he said that it was hard to for him to get the MRI scan, because he wasn't familiar with the facility she went to. She waited for awhile as the offices straightened this out. Then the doctor told her that the quality of the MRI was a little blurry, and he wanted a better version (that could have been done at the expensive academic medical center where she was first sent!). Still, the scan was good enough for the doctor to diagnose a fracture.\u003c/p>\n\u003cp>In Sarah's story she concluded that shopping for health care is hard.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At \u003ca href=\"https://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a>, the company I founded, we've been studying and writing about this for years now, so I have a few observations.\u003c/p>\n\u003cp>My questions for Sarah:\u003c/p>\n\u003cul>\n\u003cli>Having been directed to a different MRI provider by the insurance company, did you ask the doctor if the quality at that provider is OK? This system is a mess, and we often hear of people being steered to a provider for reasons of money (the doctor's in-network, or the gastrointestinal doctor owns an interest in the GI center where she sends patients for a colonoscopy, etc) or for reasons of quality (this place has old machines; please don't go there).\u003c/li>\n\u003cli>Did you ask the same quality question of the insurance company that sent you to a different provider?\u003c/li>\n\u003cli>As a reporter, did you ask why there were no quality metrics posted publicly or made available in other ways? Quality metrics are in their infancy.\u003c/li>\n\u003c/ul>\n\u003cp>I also wonder if MRIs at the academic medical center where she was first sent ever has blurry scans.\u003c/p>\n\u003cp>I have a friend who works at a prestigious New York City hospital. When I asked him about the quality question, he laughed and said \"Every MRI that comes into [our hospital from another center] gets a sticker up in the corner that says, \"Poor quality. Must re-do,\" or words to that effect.\u003c/p>\n\u003cp>[contextly_sidebar id=\"PAvOhcs5QFWfXqbeuQwNRmx1NEHCybJ3\"]To his credit, he seemed shamefaced about this –- not gloating, but truly just acknowledging that this is common practice and that it’s ridiculous that every single MRI not performed at his hospital would be flawed.\u003c/p>\n\u003cp>Kliff said she’d saved her insurer money by going cheaper. But the insurer has power to save money itself: It contracts with both the expensive MRI provider and the inexpensive MRI provider. Why doesn’t it simply refuse to pay the higher rate? The answer, of course, depends on who you talk to: the expensive provider has market power; the expensive provider needs to get paid more because its care is better; the expensive provider needs to be compensated for uncompensated care, etc.\u003c/p>\n\u003cp>But the truth is: the money that Kliff saved her insurance company will not be finding its way back to her soon. High prices benefit many in the marketplace by creating an artificial view of pricing, and by scaring the pants off people. (“A $6,000 MRI? Wow, glad I have insurance, and glad they negotiated it down to $2,000! Whew!”)\u003c/p>\n\u003cp>For many people, having choice in where they go for health care is a foreign experience.\u003c/p>\n\u003cp>It's especially foreign for people who have not used much health care recently -- and also for younger people. They just haven't got as many health issues and may be more trusting than someone like me, who, at 61, has had her share of health care experiences.\u003c/p>\n\u003cp>Sarah's conclusion: \"My own health care experience is far from unique. But it was a helpful, first-person demonstration of how shopping for health care might not be a zero-sum game, and that even with basic services, there can be clear winners and losers.\"\u003c/p>\n\u003cp>My conclusion: Yes, it's hard. But we have to keep trying.\u003c/p>\n\u003cp>My advice to anyone who is trying to get good quality -- at a fair price:\u003c/p>\n\u003cul>\n\u003cli>Ask about quality.\u003cbr>\nIf they won't give you an answer, ask again.\u003cbr>\nAsk why not.\u003cbr>\nAsk who's making money off this.\u003c/li>\n\u003cli>Yes, the system makes it hard to get at the right answer. But that does not mean we should give up trying.\u003c/li>\n\u003c/ul>\n\u003cp>There are baby steps toward bringing more cost and quality transparency to health care. Here are some sites (in addition to PriceCheck or ClearHealthCosts):\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://healthcarebluebook.com/page_ConsumerFront.aspx\" target=\"_blank\">Healthcare Bluebook\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.cahealthcarecompare.org/search.jsp\" target=\"_blank\">California Healthcare Compare\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>People are saving money by asking questions about price. It won't always work perfectly, but I hear every day from people who have saved money by asking some questions and doing some research.\u003c/p>\n\n",
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"description": "Editor's note: this essay comes to us from our PriceCheck partner, Jeanne Pinder, the founder of ClearHealthCosts. Her mission is improving transparency in health prices by giving consumers more power by lifting the veil on the opaque world of health care prices. Yes, people are shopping for health care. Some are better at it than",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor's note: this essay comes to us from our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a> partner, Jeanne Pinder, the founder of \u003ca href=\"https://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a>. Her mission is improving transparency in health prices by giving consumers more power by lifting the veil on the opaque world of health care prices.\u003c/em>\u003c/p>\n\u003cp>Yes, people are shopping for health care. Some are better at it than others, and some providers and payers (read: doctors and insurers) are better than others about revealing information. We're always interested to hear when people who haven't encountered these truths come up against the real world. So when Sarah Kliff, the well-respected health care writer for Vox.com, wrote about her experience \u003ca href=\"http://www.vox.com/2015/10/19/9567991/health-care-shopping-mri\" target=\"_blank\">trying to get a better price for an MRI\u003c/a>, I was really interested.\u003c/p>\n\u003cp>In her story Kliff said she had a fracture that hadn't healed properly. After she spent weeks in a walking cast and saw little improvement, her doctor recommended an MRI. Kliff scheduled an MRI at an academic center, then heard from her insurance company that they had a better choice that was less expensive. That's where she went.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But when she returned to her doctor for the results, he said that it was hard to for him to get the MRI scan, because he wasn't familiar with the facility she went to. She waited for awhile as the offices straightened this out. Then the doctor told her that the quality of the MRI was a little blurry, and he wanted a better version (that could have been done at the expensive academic medical center where she was first sent!). Still, the scan was good enough for the doctor to diagnose a fracture.\u003c/p>\n\u003cp>In Sarah's story she concluded that shopping for health care is hard.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At \u003ca href=\"https://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a>, the company I founded, we've been studying and writing about this for years now, so I have a few observations.\u003c/p>\n\u003cp>My questions for Sarah:\u003c/p>\n\u003cul>\n\u003cli>Having been directed to a different MRI provider by the insurance company, did you ask the doctor if the quality at that provider is OK? This system is a mess, and we often hear of people being steered to a provider for reasons of money (the doctor's in-network, or the gastrointestinal doctor owns an interest in the GI center where she sends patients for a colonoscopy, etc) or for reasons of quality (this place has old machines; please don't go there).\u003c/li>\n\u003cli>Did you ask the same quality question of the insurance company that sent you to a different provider?\u003c/li>\n\u003cli>As a reporter, did you ask why there were no quality metrics posted publicly or made available in other ways? Quality metrics are in their infancy.\u003c/li>\n\u003c/ul>\n\u003cp>I also wonder if MRIs at the academic medical center where she was first sent ever has blurry scans.\u003c/p>\n\u003cp>I have a friend who works at a prestigious New York City hospital. When I asked him about the quality question, he laughed and said \"Every MRI that comes into [our hospital from another center] gets a sticker up in the corner that says, \"Poor quality. Must re-do,\" or words to that effect.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>To his credit, he seemed shamefaced about this –- not gloating, but truly just acknowledging that this is common practice and that it’s ridiculous that every single MRI not performed at his hospital would be flawed.\u003c/p>\n\u003cp>Kliff said she’d saved her insurer money by going cheaper. But the insurer has power to save money itself: It contracts with both the expensive MRI provider and the inexpensive MRI provider. Why doesn’t it simply refuse to pay the higher rate? The answer, of course, depends on who you talk to: the expensive provider has market power; the expensive provider needs to get paid more because its care is better; the expensive provider needs to be compensated for uncompensated care, etc.\u003c/p>\n\u003cp>But the truth is: the money that Kliff saved her insurance company will not be finding its way back to her soon. High prices benefit many in the marketplace by creating an artificial view of pricing, and by scaring the pants off people. (“A $6,000 MRI? Wow, glad I have insurance, and glad they negotiated it down to $2,000! Whew!”)\u003c/p>\n\u003cp>For many people, having choice in where they go for health care is a foreign experience.\u003c/p>\n\u003cp>It's especially foreign for people who have not used much health care recently -- and also for younger people. They just haven't got as many health issues and may be more trusting than someone like me, who, at 61, has had her share of health care experiences.\u003c/p>\n\u003cp>Sarah's conclusion: \"My own health care experience is far from unique. But it was a helpful, first-person demonstration of how shopping for health care might not be a zero-sum game, and that even with basic services, there can be clear winners and losers.\"\u003c/p>\n\u003cp>My conclusion: Yes, it's hard. But we have to keep trying.\u003c/p>\n\u003cp>My advice to anyone who is trying to get good quality -- at a fair price:\u003c/p>\n\u003cul>\n\u003cli>Ask about quality.\u003cbr>\nIf they won't give you an answer, ask again.\u003cbr>\nAsk why not.\u003cbr>\nAsk who's making money off this.\u003c/li>\n\u003cli>Yes, the system makes it hard to get at the right answer. But that does not mean we should give up trying.\u003c/li>\n\u003c/ul>\n\u003cp>There are baby steps toward bringing more cost and quality transparency to health care. Here are some sites (in addition to PriceCheck or ClearHealthCosts):\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://healthcarebluebook.com/page_ConsumerFront.aspx\" target=\"_blank\">Healthcare Bluebook\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.cahealthcarecompare.org/search.jsp\" target=\"_blank\">California Healthcare Compare\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>People are saving money by asking questions about price. It won't always work perfectly, but I hear every day from people who have saved money by asking some questions and doing some research.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Soon after moving to Utah this summer, Rainbow Sky Buck ended up at the hospital with a painful ear infection. There, Buck learned she no longer had access to the free health coverage she had in California as a former foster youth.\u003c/p>\n\u003cp>To pay for the care, Buck emptied out her bank account and borrowed money. “Luckily, I got my antibiotics and I am okay now,” she said. “But what is going to happen next time?”\u003c/p>\n\u003cp>Under the health law, young adults who age of out of the foster care system are eligible for free Medicaid coverage \u003ca href=\"http://khn.org/news/foster-children-california-adults-medicaid/\" target=\"_blank\">until they turn 26.\u003c/a> The provision was an attempt to give them the same opportunity as other young people who can stay on their parents’ insurance until their 26\u003csup>th\u003c/sup> birthday.\u003c/p>\n\u003cp>But these young adults are encountering a major barrier: They are only guaranteed coverage in the state where they were in foster care. States have the option of extending the benefit to all former foster youths, but only about a dozen have done so.\u003c/p>\n\u003cp>Now, advocates and policymakers are trying to change the law at the federal level, so former foster youths don’t lose access to Medicaid coverage no matter where they move.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"quDmgipf5B7js5fILKqbBJCNiiZBBixc\"]Reps. Karen Bass, D-Calif., and Jim McDermott, D-Wash., have proposed \u003ca href=\"http://bass.house.gov/press-release/reps-bass-mcdermott-introduce-legislation-ensure-former-foster-youth-can-keep-health\" target=\"_blank\">legislation\u003c/a> that would allow them to qualify for Medicaid, the government health program for low-income Americans, in any state. Sen. Bob Casey, D-Pa., has introduced a similar \u003ca href=\"http://www.casey.senate.gov/newsroom/releases/casey-introduces-bill-to-fix-glitch-that-could-kick-former-foster-youth-off-of-medicaid\" target=\"_blank\">bill\u003c/a> that he said would be a simple clarification of what Congress intended. Meanwhile, advocates are pushing the Centers for Medicare & Medicaid Services to change its interpretation of the original provision.\u003c/p>\n\u003cp>\u003ca href=\"http://firstfocus.org/\" target=\"_blank\">First Focus\u003c/a>, which advocates for foster youths, has been receiving calls from young people who had no idea that they would lose health insurance when they moved.\u003c/p>\n\u003cp>“We really do feel an urgency about this,” said Shadi Houshyar, vice president of child welfare policy at the organization. “So many people who have aged out have significant health needs and coverage is so important. There shouldn’t be an additional barrier.”\u003c/p>\n\u003cp>Former foster youths are more likely than their peers to have physical and mental health needs, experts say. Ongoing \u003ca href=\"http://www.chapinhall.org/research/report/midwest-evaluation-adult-functioning-former-foster-youth\" target=\"_blank\">research\u003c/a> in Illinois, Wisconsin and Iowa shows that 22 percent of former foster youths had been hospitalized at least once in the previous year and one-third had two or more emergency room visits.\u003c/p>\n\u003cp>Just like other young people, former foster youths move to different states for school, jobs or family, said Fatima Morales, policy and outreach associate for the advocacy group \u003ca href=\"http://www.childrennow.org/\" target=\"_blank\">Children Now\u003c/a>. Morales said they shouldn’t be penalized for doing so.\u003c/p>\n\u003cfigure id=\"attachment_94773\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM.png\">\u003cimg class=\"size-thumbnail wp-image-94773\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM-400x367.png\" alt=\"Lezlie Martinez, 19, holds her two-year-old son. She would like to move from California to Colorado where she says it would be cheaper to live, but she worries about losing her health coverage. \" width=\"400\" height=\"367\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM-400x367.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM.png 594w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lezlie Martinez, 19, holds her two-year-old son. She would like to move from California to Colorado where she says it would be cheaper to live, but she worries about losing her health coverage. \u003ccite>(Courtesy: Jordan Verdin )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Morales said her organization is trying to inform youths what they might face if they move. “They need to know how their health coverage might be impacted,” she said. “It’s just something that they need to weigh.”\u003c/p>\n\u003cp>Lezlie Martinez, 19, is weighing her options now. She is hoping to move from California to Colorado because she wants to live in a place with a lower cost of living. Her boyfriend is already there and she is looking for hospitality jobs to support herself and her 2-year-old son.\u003c/p>\n\u003cp>But she worries that she may be left uninsured and unable to pay for medical treatment for eczema, allergies and fibromyalgia. “It is causing foster youth to be stuck in the same state they were raised in,” said Martinez, who lives in Oceanside, Calif. “It is really stressing me out.”\u003c/p>\n\u003cp>Buck said she decided to move to Sandy City, Utah, because of the limited job prospects in the small northern California town of Crescent City. Before moving, she asked social workers about whether she would still qualify for free health coverage and was told that she would. Buck said she was shocked to learn otherwise.\u003c/p>\n\u003cp>She is no longer seeing a therapist for depression and said she is weaning herself off antidepressants because she can’t afford them. Buck said she also worries about getting another ear infection and not being able to afford treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It is just scary to think I am completely on my own,” said Buck, who recently got a job at an automotive shop but doesn’t get insurance from her employer. “I don’t want to leave, but this is almost forcing me to move back to California.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Soon after moving to Utah this summer, Rainbow Sky Buck ended up at the hospital with a painful ear infection. There, Buck learned she no longer had access to the free health coverage she had in California as a former foster youth.\u003c/p>\n\u003cp>To pay for the care, Buck emptied out her bank account and borrowed money. “Luckily, I got my antibiotics and I am okay now,” she said. “But what is going to happen next time?”\u003c/p>\n\u003cp>Under the health law, young adults who age of out of the foster care system are eligible for free Medicaid coverage \u003ca href=\"http://khn.org/news/foster-children-california-adults-medicaid/\" target=\"_blank\">until they turn 26.\u003c/a> The provision was an attempt to give them the same opportunity as other young people who can stay on their parents’ insurance until their 26\u003csup>th\u003c/sup> birthday.\u003c/p>\n\u003cp>But these young adults are encountering a major barrier: They are only guaranteed coverage in the state where they were in foster care. States have the option of extending the benefit to all former foster youths, but only about a dozen have done so.\u003c/p>\n\u003cp>Now, advocates and policymakers are trying to change the law at the federal level, so former foster youths don’t lose access to Medicaid coverage no matter where they move.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Reps. Karen Bass, D-Calif., and Jim McDermott, D-Wash., have proposed \u003ca href=\"http://bass.house.gov/press-release/reps-bass-mcdermott-introduce-legislation-ensure-former-foster-youth-can-keep-health\" target=\"_blank\">legislation\u003c/a> that would allow them to qualify for Medicaid, the government health program for low-income Americans, in any state. Sen. Bob Casey, D-Pa., has introduced a similar \u003ca href=\"http://www.casey.senate.gov/newsroom/releases/casey-introduces-bill-to-fix-glitch-that-could-kick-former-foster-youth-off-of-medicaid\" target=\"_blank\">bill\u003c/a> that he said would be a simple clarification of what Congress intended. Meanwhile, advocates are pushing the Centers for Medicare & Medicaid Services to change its interpretation of the original provision.\u003c/p>\n\u003cp>\u003ca href=\"http://firstfocus.org/\" target=\"_blank\">First Focus\u003c/a>, which advocates for foster youths, has been receiving calls from young people who had no idea that they would lose health insurance when they moved.\u003c/p>\n\u003cp>“We really do feel an urgency about this,” said Shadi Houshyar, vice president of child welfare policy at the organization. “So many people who have aged out have significant health needs and coverage is so important. There shouldn’t be an additional barrier.”\u003c/p>\n\u003cp>Former foster youths are more likely than their peers to have physical and mental health needs, experts say. Ongoing \u003ca href=\"http://www.chapinhall.org/research/report/midwest-evaluation-adult-functioning-former-foster-youth\" target=\"_blank\">research\u003c/a> in Illinois, Wisconsin and Iowa shows that 22 percent of former foster youths had been hospitalized at least once in the previous year and one-third had two or more emergency room visits.\u003c/p>\n\u003cp>Just like other young people, former foster youths move to different states for school, jobs or family, said Fatima Morales, policy and outreach associate for the advocacy group \u003ca href=\"http://www.childrennow.org/\" target=\"_blank\">Children Now\u003c/a>. Morales said they shouldn’t be penalized for doing so.\u003c/p>\n\u003cfigure id=\"attachment_94773\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM.png\">\u003cimg class=\"size-thumbnail wp-image-94773\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM-400x367.png\" alt=\"Lezlie Martinez, 19, holds her two-year-old son. She would like to move from California to Colorado where she says it would be cheaper to live, but she worries about losing her health coverage. \" width=\"400\" height=\"367\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM-400x367.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM.png 594w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lezlie Martinez, 19, holds her two-year-old son. She would like to move from California to Colorado where she says it would be cheaper to live, but she worries about losing her health coverage. \u003ccite>(Courtesy: Jordan Verdin )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Morales said her organization is trying to inform youths what they might face if they move. “They need to know how their health coverage might be impacted,” she said. “It’s just something that they need to weigh.”\u003c/p>\n\u003cp>Lezlie Martinez, 19, is weighing her options now. She is hoping to move from California to Colorado because she wants to live in a place with a lower cost of living. Her boyfriend is already there and she is looking for hospitality jobs to support herself and her 2-year-old son.\u003c/p>\n\u003cp>But she worries that she may be left uninsured and unable to pay for medical treatment for eczema, allergies and fibromyalgia. “It is causing foster youth to be stuck in the same state they were raised in,” said Martinez, who lives in Oceanside, Calif. “It is really stressing me out.”\u003c/p>\n\u003cp>Buck said she decided to move to Sandy City, Utah, because of the limited job prospects in the small northern California town of Crescent City. Before moving, she asked social workers about whether she would still qualify for free health coverage and was told that she would. Buck said she was shocked to learn otherwise.\u003c/p>\n\u003cp>She is no longer seeing a therapist for depression and said she is weaning herself off antidepressants because she can’t afford them. Buck said she also worries about getting another ear infection and not being able to afford treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It is just scary to think I am completely on my own,” said Buck, who recently got a job at an automotive shop but doesn’t get insurance from her employer. “I don’t want to leave, but this is almost forcing me to move back to California.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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"info": "",
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"tech-nation": {
"id": "tech-nation",
"title": "Tech Nation Radio Podcast",
"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
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"ted-radio-hour": {
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"title": "TED Radio Hour",
"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
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