Tuesday, April 24, 2018

A Happy Camper

Well, patient, anyway:

Recently, I've had two occasions to be treated by Dr Nava at Medix Urgent Care here in Warm & Cheerful Centerville (Ohio).

The first, a few months ago, was flu-related; that is, I had it, I finally gave in to The Better Half's "suggestions" and headed over. I had never been there before (to the best of my recollection, I've never been treated at any urgent care before) so I didn't know what to expect. After signing in, filling out the intake form and a scan of my ID and insurance card (I could have opted for cash, but chose not to), I had a short (maybe half-hour?) wait until I was seen. Dr Nava was warm and caring, and when I explained that my wife's Primary Care had diagnosed her with the flu less than 24 hours earlier, she knew the score. I collected up my Tammiflu scrip, and headed off to the pharmacy.

All-in, maybe an hour-and-a-half's time and I was back at home, in bed and recovering.

Last week, I developed a rather ugly stye on my eyelid. I really didn't want to seek medical attention for such a trifle, so I tried the warm compress thing. And the warm teabag thing. And the antibiotic ointment thing. When I found myself reaching for the x-acto knife I knew the time had come to return to Dr Nava (yes, we have a Primary Care, but I really wanted to just get this done and over with as quickly as possible). She recognized me from my flu adventure, and took a look at the stye. When she learned that I'd been with the hot/warm compresses for at least 4 days with no noticeable results, she suggested we try brute force, and then a prescription anti-biotic.

A few seconds later, stye is mostly gone, and I have the ointment, and instructions to continue the compresses for a little while to make sure it's truly all cleared up.

I really can't say enough good things about Medix Urgent Care or Dr Nava. Great care, great folks.

Monday, April 23, 2018

Medi(s)care heads' up

Identity theft has become an ever growing problem; most folks think it pertains primarily to credit cards and the like. But your Visa info isn't the only valuable item in your wallet: in an effort to stem the tide of health care fraud, the folks in DC have (finally) followed their own rules and changed the face of Medicare ID cards:

"Millions of people 65 or older will soon get new Medicare cards to prevent identity theft ... Social Security numbers aren’t being printed on the new cards. Instead, they will contain 11-digit personal identifiers with numbers and letters"

Which makes sense: previously, one's social security number doubles as one's Medicare ID (which became a big issue, too). As co-blogger Kelley poijnted out several years ago:

"According to the article, doctors do not need your social security number to bill. That is correct; however, we do need your social security number if you choose not to pay your bill and we have to turn you over to collections."

Yeah, those pesky doctors and wanting to get paid for services rendered. The point, though, was that folks were concerned about identity theft being helped along by having one's social security number on their Medicare card.

So here, at least, the government is addressing the issue, however late to the game it may be.

That's the good news.

The bad news is that nogoodniks have already begun to find ways to exploit this new development:

"But now con artists are cold calling seniors around the U.S. about the new cards ... trying to steal seniors’ Social Security numbers, bank account numbers and credit card information."

So what's the best way to fight these crooks?

Well, Indiana’s Senior Medicare Patrol program director Nancy Moore says "People need to know Medicare won't call you. They only operate via U.S. mail, but the scammers are very persistent."

Looks like "Just hang up" is the new "Just say no."

Friday, April 20, 2018

The MVNHS© Giveth, and the MVNHS© Taketh Away

A few weeks ago, we reported that the Much Vaunted National Health Service© had granted not-quite-two-years-old Alfie Evans a (temporary) reprieve:

"Alfie Evans’ Life Support Won’t be Switched Off, Delayed After Pope Francis Intervenes on His Behalf"

And it's critical to remember that his parents were willing to foot the entire health care bill themselves (likely with a little help from their friends).

Well, it seems that the poor toddler's time has, in fact, now run out:

"UK Supreme Court declines appeal from parents of ill toddler"

And so the plug will be pulled, and little Alfie will be gone (but certainly not forgotten by anyone with a heart).

Here's the thing: while reasonable folks could disagree about the utility of further treatment (he's "in a "semi-vegetative state" as the result of a degenerative neurological condition"), and it could further be argued that public health care dollars pounds would be wasted, in this case it's actually cost the MVNHS© more money to fight his being flown elsewhere for treatment at his parents' expense.

But hey: Free health "care."

Case Study: Life plus LTCi

So, working on an interesting case for a long-time client. Doris is in her early 60's, has an existing Universal Life policy but is looking at replacing it with a new plan that would include both life and long term care coverage (please don't ask why she's replacing a perfectly good UL plan; she apparently has her reasons).

After some discussion, we've narrowed things down to 2 (well, technically 3) options. All include $250,000 of life insurance and $5,000/month of long term care benefits:

Option 1: Term life + Stand-alone Long Term Care (LTCi) plan

15 Year term + LTCi = $4,551/year, or
20 Year term + LTCi = $5,189/year

The stand-alone LTCi plan offers 3% inflation protection and is Partnership-compliant; benefits payable for up to 48 months.

Option 2: Hybrid Guaranteed Universal Life/LTCi has a 50 month benefit period, and is built on an indemnity chassis (no receipts or invoices to submit past the initial claim form). On the other hand, it has no inflation protection and is not Partnership-compliant. On the gripping hand, the life insurance pays someone if there's no long term care claim (to her age 120!). The annual premium for this plan is $5,000 (Thanks to commenter Scott O who pointed out this omission - Mea culpa!)

There are a few other details, of course, but that's the gist.

So which option will she pick? I have no idea, but would be interested in our readers' prognostications (and feel free to explain why in the comments section below):

Thursday, April 19, 2018

Spring has Sprung!

And so has this month's Health Wonk Review, with a wonderfully fresh variety of posts on health care wonkery.

Louise Norris hosts, offering items ranging from "rumblings at CMS" (yay Silver plans) to the horrendous opioid crisis, not to mention the state of Medicaid (oops, mentioned!).

Do head on over for a great bouquet of interesting topics.

Wednesday, April 18, 2018

Tort reform, MVNHS©-style?

As previously noted, government-run health care schemes like the Much Vaunted National Health System©  have never really managed to rein in health care costs:

"It's kind of funny that their data actually shows real socialized medicine (UK NHS) has annualized cost growth higher than that in the US."

But co-blogger Mike tells us that they're at least trying (for certain values of "try"):

"Health leaders have written to Justice Secretary David Gauke urging him to reform the payout system for negligence claims against the NHS."

Seems that all those (costly) mistakes (such as leaving patients "dying prematurely in corridors") have begun to add up. A pound here, a pound there, and pretty soon you're talking real money:



[click to embiggen]

Yikes!

Monday, April 16, 2018

HHS makes its move

Via email from our friends at Cornerstone regarding next year's individual health insurance market:

The Bureauweenies in DC
© have published their "Notice of Benefit and Payment Parameters for 2019," which includes another reprieve for Transitional ("Grandmothered") plans for another year, as well as info on:
• Qualified Health Plan (QHP) Certification Standards
• Exemptions
• Risk Adjustment
• Advance Premium Tax Credit (APTC) Program Integrity
• Special Enrollment Periods (SEPs)
• Medical Loss Ratio
Among other items. There's also additional guidance on those underwhelming SHOP plans (oh, goody).

Interested (or insomnia-stricken) readers may click here for the not-so-gory details.

Friday, April 13, 2018

Rich Man, Poor Man

It was the best of times, it was the worst of times.

Benjamin Hynden had an abdominal pain and made an appointment to see his doctor. During the examination his doctor suggested a CT scan to look for abnormalities.

The radiologist didn’t see anything wrong on the images, and Ardesia didn’t recommend any treatment.
A few weeks later, Hynden, who has a high-deductible health insurance policy with Cigna, got a bill for $268. He paid it and moved on. -
KHN

Three months later the pain returned. This time Dr Ardesia wasn't available so he saw a nurse practitioner. The NP, fearing possible appendicitis, told Benjamin to have a CT scan at the hospital.

The triage nurse told him the problem wasn’t his appendix, but she suggested he stick around for some additional tests — including another CT scan — just to be safe.
 “It was the exact same machine. It was the exact same test,” Hynden said.
The results were also the same as the October scan: Hynden was sent home without a definitive diagnosis.

But what happened next was a complete shock.

Total Bill: $10,174.75, including $8,897 for a CT scan of the abdomen

Things such as this happen every day. So how can you protect yourself?

Follow this link for the rest of the story.

It was the age of wisdom . . . .

#CTScan #MedicalPriceGouging  #Medicare  #ProviderNetworks