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Health Insurance Navigator

with Lisa Zamosky

WebMD helps readers understand their health insurance and the new health care reform law. The Affordable Care Act is bringing sweeping changes to American health care. Lisa Zamosky is here to help you navigate the health care maze and understand how these changes affect you.

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Thursday, May 17, 2012

High Medical Costs: The Devil is in the Details

By Lisa Zamosky

Stethoscope and Money

A few weeks ago I wrote about how many insurance companies have changed the way they reimburse out-of-network care. Instead of paying a percentage of the actual prices health care providers charge (called usual, customary, and reasonable (UCR) charges), many insurers have instead begun using Medicare rates to calculate how much of your out-of-network medical care they’ll pay for.

Medicare rates are considerably lower than UCR – as much as 50% less – which means consumers pay a higher percentage of the cost of their care.

A reader of this blog left a comment in response to that post asking for clarification about some of the details discussed. Given the huge financial impact this insurance industry change can have on how much a medical visit or treatment costs, I wanted to respond to his questions in another post.

Here’s what the reader, Brian, said:

I am confused. Is not most out-of-network still tied to an insurance plan? As such, the member’s [cost] responsibility is based on UCR and not billed charges. Therefore if plans move to the lower Medicare fee schedule, then that should equate to less cost to the member. What am I missing here?

Out-of-Network, Out of Luck

The answer to Brian’s first question Is not most out-of-network still tied to an insurance plan? – is no.

Only in-network doctors and hospitals have signed a contract with your insurance company agreeing to see members at the insurer’s rate of payment.

Out-of-network doctors and hospitals have no legal relationship with your insurer, and they can charge whatever they like for the medical services they provide.

There is a tie, however, between you and your insurer. If you have a plan that allows you to receive care from an out-of-network provider, your insurer will pay some amount of money — often 70% or 80% of the cost — to help you pay for those visits.

Defining What Counts as Customary

Let’s say you go to a doctor that isn’t contracted with your insurance company (so he’s out-of-network) to have a plantar wart removed from the bottom of your foot. And, let’s say that doctor charges you $10,000 for the procedure.

Your insurance company, per the terms of your health plan, has agreed to reimburse you 70% of the cost of your out-of-network doctor visits.

But $10,000 to remove a plantar wart is an outrageously high price, and far outside the range of what most doctors charge for this procedure.

To guard against outrageous charges, insurers must determine what a “reasonable” cost for each service is. It’s that amount – the amount deemed reasonable – that your insurer will use to define the true price of the visit and for which it will reimburse you 70%.

So, if the average cost to remove a plantar wart is $250, your insurer will reimburse $175, or 70% of what it counts as a reasonable charge.  The fact that your doctor submitted a bill for $10,000 to remove your wart becomes irrelevant to your insurance company. It’s not a real number in its eyes.

Secret Formula

Back to Brian’s question:

If plans move to the lower Medicare fee schedule, then that should equate to less cost to the member.

Unfortunately, that’s not the case. Insurers applying common Medicare rates instead of UCR charges actually results in lower costs for insurance companies and higher costs for members.

Let me illustrate the difference with a real-world example. On the Fair Health FH Medicare Compare web-based tool, I punched in a New York City zip code for a colonoscopy.

The out-of-network procedure is billed by doctors in that region at an average rate of $1,799.99. Let’s assume my insurer reimburses 70% for out-of-network care.

If UCR charges are applied, the procedure will cost me $540. If, instead, Medicare rates are used, the same procedure, billed at the same rate of $1,799.99, will cost me $1,558.98.

That means that by applying Medicare rates, rather than UCR, my insurance company just saved itself $1,018.98. And I just picked up an extra bill of the same amount.

Confusing by Design

The fact is that the details of our health plans can be incredibly confusing. That’s scary because the harder it is to understand what your insurance company really means when it says it will pay 70% of a doctor’s visit, the greater the likelihood that we get zapped with an unexpected bill.

I want to thank Brian for his questions and invite other readers to speak out about the aspects of insurance they find confusing.

Did this help clarify the issue about how out-of-network costs are paid, or make it more confusing? Share your thoughts in the comment section below.

Photo: Thinkstock

Posted by: Lisa Zamosky at 7:07 am

Tuesday, May 15, 2012

Medicare Under 65 and Other Insurance Options

By Lisa Zamosky

Insurance Paperwork

From time-to-time, readers of this blog ask for feedback about their particular health care or insurance situation. Here’s one question recently submitted:

I have health insurance through COBRA, which costs me over $500 a month. My medical bills consume over half of my long-term disability benefits every month. My COBRA eligibility is ending soon and then I’ll be uninsured but not eligible for Medicaid. What now?

Medicare Coverage

You mention that you’re receiving long-term disability benefits. If you have a medical disability and have been receiving Social Security Disability Insurance (SSDI) for more than 24 months, you may be eligible for Medicare coverage.

Eligibility for Medicare kicks in during the month you receive your 25th SSDI check. You should be contacted automatically by Social Security and receive a Medicare card in the mail three months before you become eligible.

To talk with someone about your particular situation, you might try contacting your local Social Security regional office.

Know Your COBRA Rights

It’s important that you understand your rights under COBRA, particularly if it turns out that Medicare is not an option for you.

In addition to your right under federal law to continue your group health insurance for 18 months after leaving or losing a job, once you’ve exhausted your 18 months of COBRA benefits (in some cases COBRA can be extended for longer periods), federal law guarantees you an insurance plan on the private market.

Every state is required to offer at least one “guaranteed issue plan” (sometimes called HIPAA plans). In some states you can buy a plan from any insurer that sells policies to individuals. In others, particular health plans are designated.

Get in touch with your state’s department of insurance to learn how things operate where you live. Contact information can be found at the National Association of Insurance Commissioner’s website.

And be sure to get a certificate of “credible coverage” from your previous insurer, which is a document that proves to a new company that you had prior coverage. Without it, you can be turned down for a new plan.

Find Coverage You Can Afford

You say that you’re not eligible for Medicaid, and you may be right about that. Still, I would urge you to double check, as well as to make sure there are no other public programs offered in your state for which you’re eligible. You can do that by taking a quick, five-question eligibility quiz created by the Foundation for Health Coverage Education at www.CoverageForAll.org.

Also, it’s a good idea to work with an experienced insurance broker in your area. These folks can be enormously helpful to you in searching for a less expensive health plan that meets your needs.

You can find a licensed insurance agent in any state at the National Association of Health Underwriters website.

Photo: Photodisc

Posted by: Lisa Zamosky at 6:31 am

Thursday, May 10, 2012

Pay More, Get Less for U.S. Healthcare

By Lisa Zamosky

Healthcare Costs

The term “You get what you pay for” doesn’t hold water when it comes to the U.S. healthcare system, according to an updated analysis by the Commonwealth Fund.

Researchers found – or really reconfirmed what’s long been known – that the United States spends more on healthcare than 12 other industrialized countries without having better health to show for it (Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom).

On average, healthcare spending in 2009 was about $8,000 per person in the U.S. By comparison, Norway and Switzerland took up spots two and three in health care spending at just $5,000 per person.

Follow the Money

Where’s the extra money going?

It’s not being spent on more doctor visits or lengthy hospital stays. In 2009, Americans made fewer visits to the doctor than any other country except for Sweden.  And despite less time spent in the hospital, average hospitalization costs more than $18,000 in the U.S. compared with less than $10,000 in Sweden ($9,870), Australia ($8,350), New Zealand ($7,160), France ($5,204), and Germany ($5,072).

Other major drivers of cost in the U.S. the study found:

  • Prescription drugs – The 30 most commonly prescribed drugs cost one-third higher than in Canada and Germany, and more than double the prices in Australia, France, Netherlands, New Zealand, and the U.K.
  • Physician visits – Primary care doctor visits are highest in the U.S., as are hip replacements done by orthopedic surgeons, who are paid more for the procedure in the U.S. than in Australia, Canada, France, Germany, and the U.K.
  • Physician income – American doctors make more money than physicians practicing in any other country. Primary care doctors in the U.S. average $186,582 per year and orthopedic doctors $442,450.
  • Technology – The U.S. also spends more money on MRIs: $1,080 compared with $281 in France, as well as CT scans: $510 in the U.S. vs. $141 in France.
  • Obesity – One-third of the U.S. population is obese, a rate higher than any other country studied, and in 2008, obesity accounted for almost 10% of all medical spending.

More Money, Better Health?

Except for breast and colorectal cancers, where survival rates are highest in the U.S., our pricey system isn’t doing a better job of keeping us in good health. America’s rates of preventable deaths due to asthma and diabetes-related amputations, for example, are the worst among all other study countries.

In sum, researchers write: “Despite being more expensive, the quality of health care in the U.S. does not appear to be notably superior to other industrialized countries.”

What’s more, 4 in 10 adults skipped care in 2010 because of the high cost.

Are we wasting our health care dollars here in the U.S.? Put in your two cents by commenting below.

Photo: Creatas

Posted by: Lisa Zamosky at 11:00 am

Tuesday, May 8, 2012

When Healthcare Goes Social

By Lisa Zamosky

Woman Using Computer

Social media has crept its way into virtually all aspects of our lives. In 2005, only 5% of adults logged onto social networking sites. By 2011 that number has shot up to 50%, according to a new report by the Health Research Institute (HRI), an arm of consulting firm PwC.

Health care – although slower than other industries to jump on the social media bandwagon – is not immune to this trend, and all signs point to consumers, doctors, hospitals, and pharmaceutical companies continuing to use social media in various ways to gain and disseminate health information and connect with others.

Social Health

According to the HRI report, which is based on the result of a survey of more than 1,000 consumers and 124 healthcare executives, about one in three people use social media sites such as Facebook, YouTube, and Twitter, among other online forums, to find information about health care, track symptoms, and share their feelings about the doctors, health plans, and various treatments they receive.

According to the survey:

  • 42% of consumers have used social media to learn about other patients’ reviews of treatments or doctors
  • 25% have posted on a social media site about their own health experience
  • 20% have joined a health forum or community (think Patients Like Me or Inspire)

Social media is having an impact on how people get the care they need, too; 45% claim that information found through social media would affect their decisions to seek a second opinion. More than 40% said the way in which they approached the treatment of a chronic condition, their diet, and exercise habits could all be influenced by information they gained via social media.

Not surprisingly, the health-related information most trusted by consumers is posted by health care providers.

And young people ages 18 to 24 are most likely to log on to social media sites when it comes to learning about or managing their health. Baby boomers ages 45 to 64 are the least likely.

The Downside of Connection

A greater connection and access to health care services and information is a good thing. But there can be a downside: the more information you share online, the more information about you is available to not only those with which you choose to share, but also to those you don’t.

According to the report, “healthcare organizations are starting to think about how to harness social media data and integrate it with other information to complete their view of the patient.” How will that information ultimately be used?

Privacy and security are among the top concerns for people sharing their health information through social media, the HRI report found, with many consumers worried about their personal health information being hacked and leaked, and in some cases being used in ways that could have an impact on their health insurance coverage.

What do you say?

Is there a bigger upside to the use of social media in health care or does the threat to privacy loom too large for you to engage online?

Have you ever joined a health community or used reviews you’ve found online to determine whether or not you should see a certain doctor or proceed with a particular treatment?

Be social: Share your experiences in the comments section below.

And if you’re in the market for a health care community, see this earlier post on what to look for on health-related social networking sites.

Photo: iStockphoto

Posted by: Lisa Zamosky at 9:48 am

Thursday, May 3, 2012

6 Things to Know About Long-Term Care Insurance

By Lisa Zamosky

Nest Egg

If you’re concerned about saving enough money for retirement, planning for your possible long-term medical needs is a must. But according to Susan Garland, editor of the recently released Kiplinger’s Retirement Report, “People are tending to overlook long-term health care. The numbers are so astounding that I don’t think people know how to deal with it,” she says.

In 2011, nursing home care cost over $87,000 a year. Yikes!

I spoke with Garland last week about long-term care insurance and its place in retirement planning. She identified six things consumers should know when it comes to covering their health care costs as they age.

1. Beware the changing industry

According to Garland, a number of big insurance companies, including MetLife and Prudential, have stopped selling long-term care plans in the last few years. The companies underestimated the number of people who would eventually file claims, Garland says, making these products less lucrative.

If you have an existing policy with a company that’s stopped selling long-term care, your claims will continue to be paid.

If you’re just entering the market for a long-term care plan, Garland advises people to “stick to major insurers like Genworth, John Hancock, and Mass Mutual Life,” which have been around for a long time and are unlikely to leave the market in years to come.

2. Hang on to what you have

Most major insurers have raised rates for current long-term care policy holders in recent years, making these already expensive products even harder to afford. In response, many people consider dumping their plans. That’s a mistake, Garland says. Dropping your plan now means years of wasted premiums paid with no benefits to show for it.

3. Lower your costs

Instead of dropping your existing long-term care insurance plan, look for ways to lower its cost. Garland suggests asking your insurer for options to keep your premiums where they are. One of the best ways to do that is to cut back on your plan’s benefit period.

For most people, for example, a lifetime benefit is a big waste of money – the average length of stay in a nursing home is about three years. “Instead of a lifetime benefit, maybe cut it back to three to five years to keep the premium down,” Garland advises.

4. Consider other products

Insurers offer other products that may prove to be a better deal and more appropriate for your health care needs. Married couples, for example, should consider a “shared benefit” plan.

“A three-year shared-benefit policy provides a pool of six years of coverage to divvy up between spouses,” the Kiplinger’s Retirement Report says. So, if one spouse needs five years of care and the other needs only needs one, you’re covered.  Shared plans are a bit more expensive than two separate plans – about 15% more – but they may go a longer way.

The report also highlights hybrid plans, which combine a long-term care insurance policy with either life insurance or deferred annuity. The idea is that you can use the benefit for long-term care or as a death benefit that pays to your heirs.

Garland also suggests looking into longevity insurance. These products require a small investment of money, usually at around age 65, for a large payout at the age of 85. The payout can be used for long-term care or any other expenses you have at the time.

5. Plan for inflation

Since long-term care is purchased often decades before you use, you need to make sure you’re plan keeps pace with inflation. “The gold standard has been 5% per year,” Garland says.  

6. Look for a good agent

Generally, you’ll want to think about buying a long-term care product sometime in your mid-50s, Garland says. But the landscape can be tough to navigate on your own, so it’s a good idea to work with an agent specializing in long-term care insurance.

To find an experienced agent and more information about long-term care insurance, visit the website of the American Association of Long-Term Care Insurance.

Photo: iStockphoto

Posted by: Lisa Zamosky at 9:04 am

Monday, April 30, 2012

Insurance Rebates on the Way

By Lisa Zamosky

Rebate

Last month, I reported on a part of the health reform law that requires insurers to send rebates to customers if they fail to spend at least 80% to 85% of the premium money they collect on medical services, as opposed to executive salaries or marketing.

Last week, the Kaiser Family Foundation came out with a report outlining the current best estimate of just how much money insurers will be sending back. In total, the Foundation reports that 215 insurance plans providing coverage to about 3.4 million people will rebate $1.3 billion this August.

Here’s how the rebates break down by market:

  • $426 million will be returned to people who buy insurance on their own on the individual market
  • $377 million goes back to those insured in small group plans
  • $541 million will be returned to the large group market – large employers that provide insurance to their workers

Line Your Pockets

What might this mean for you personally?

If you buy your own insurance (meaning you don’t get it through your job), and your insurer collected more in premiums than the law allows, an average refund of $127 per person across the country is expected. And depending on where you live, the refund could be higher.

Here’s where the biggest refunds will go:

  • Alaska – $305
  • Maryland – $294
  • Pennsylvania – $243
  • Idaho – $241
  • Mississippi – $236

If you live in New Mexico or Vermont, you can look forward to a new pack of gum this summer, courtesy of your insurer – the average refund in both states is about $1 per person. Try not to spend it all in one place!

Folks in Hawaii, Maine and Washington DC won’t see any refund. But overall, more than one in three people who buy their own insurance are expected to get a rebate.

Folks insured in the small group market (think small businesses) will see an average rebate of $76 per enrollee. And about 19% of large employers will get some money back – roughly $14 per enrollee.

Deal or No Deal?

A $1.3 billion refund sounds like a lot of money, and it is. But in the end, most of us are worried about whether or not health insurance is a product we can afford. When you look at the dollar amount of the refunds on an individual basis, that big rebate number seems decidedly less impressive.

Kathy, a reader of this blog, posted a comment the last time I wrote about insurer rebates that I think brings the issue back down to reality for most people:

“Out of pocket medical [insurance] cost me $18,000 over the last two years because of exclusions to coverage, insurance premiums, and co-payments. If my refund is $100 to $300, it will be nice, but won’t begin to replace savings or help with care I need now when I can no longer afford such insurance.”

Her thoughts were echoed in a blog written by health policy expert, Bob Laszewski. In it, he says that insurers’ first quarter earnings reports revealed that “health insurance prices are expected to rise by an average of 6% to 6.5% during the next year—well above inflation and well above wage rates. And, typically, individual and small group price increases significantly exceed a company’s average cost increases.”

He asks the question: “Does a $200 rebate on a $13,000 [annual] premium make health insurance any more affordable?”

I’m curious, readers, to hear how you would answer. Please share your thoughts in the comments section below.

Photo: Ingram Publishing

Posted by: Lisa Zamosky at 12:22 pm

Thursday, April 26, 2012

Good Insurance is Hard to Find

By Lisa Zamosky

Insurance Forms

In the United States, most people still get their health insurance at work. But that’s slowly changing, according to a new piece of research conducted by the Employee Benefit Research Institute (EBRI).

In a growing trend, fewer people today than in years past have access to employer-based coverage.

During the 13 years between 1997 and 2010, the percentage of workers offered health benefits by their employer dropped by 2.6%, according to the EBRI study. That may not sound like much, but add to that the 66% of part-time workers employed by a company that offered coverage in 2010 who weren’t eligible because they didn’t work enough hours – that’s up about 16% from 1997. Plus, just shy of 30% of people offered insurance at work had to turn it down because they couldn’t afford it.

Trouble Finding Coverage on Your Own

The EBRI study comes on the heels of another recently conducted by the Commonwealth Fund.

The Commonwealth study found that in 2011, one in four adults –about 48.2 million people –  between the ages of 19 and 64 spent some part of 2011 uninsured; nearly 70% of those folks went without coverage for a year or more. A change in or loss of a job was the most common reason cited for the lack of insurance.

Not surprisingly, the study found that the individual insurance market provided no comfort for people looking for coverage on their own.

According to the report, 73% had some kind of difficulty buying health insurance for a number of reasons, including being turned away or charged more because of a pre-existing medical condition, or because finding an affordable policy was a near impossibility.

And gaps in health insurance tended to lead to gaps in health care. A lack of insurance reduces the likelihood of having a regular doctor and increases the tendency to skip preventive screenings, such as cholesterol checks and mammograms, the study found.

Help Finding Coverage

There’s no doubt that finding affordable health insurance, or any insurance at all if you have a medical condition, can be extremely difficult, if not impossible. Yet, there’s also research to support the fact that many people eligible for various types of coverage aren’t aware of it and needlessly go uninsured.

For that reason, I urge anyone without health insurance to learn about the public and private insurance options available within your state, which you can do by taking a five-question quiz at the Foundation for Health Coverage Education’s website. You can also check Healthcare.gov for insurance options and to compare plans side-by-side.

It’s also a good idea to work with an experienced agent who understands the insurance market where you live (which you can do at no cost). You can find one at the National Assn. of Health Underwriters website.

Finally, if you have a pre-existing health condition and have been uninsured for at least six months, it’s worth checking to see if you can afford one of the government-run Pre-Existing Condition Insurance Plans (PCIPs) available in each state. Details can be found on the government’s website.

Tell me what’s going on with you: Have you lost work-based health insurance? If so, how have you handled it?

Photo: iStockphoto

Posted by: Lisa Zamosky at 3:53 pm

Tuesday, April 24, 2012

Avoid Sticker Shock Before Going Out-of-Network

By Lisa Zamosky

Insurance Bill

Getting medical care from a provider that is not in your health insurer’s network comes with a price. And now due to a change in the way many insurance companies calculate how much they’ll pay for out-of-network medical services, the cost of that care is even higher.

Historically, says Robin Gelburd, president of the independent nonprofit, Fair Health, insurers paid a percentage of usual, customary, and reasonable (UCR) charges, which reflect the actual prices health care providers charge. However, over the past year, many insurers have instead begun using Medicare rates, which are considerably lower than UCR, to determine how much of your out-of-network medical care they’ll cover. This has come as a shock to many consumers who have been hit with bills that are significantly higher than what they expected.

New Tools for New Rules

In an effort to create price transparency and arm consumers with information they can use to protect their wallets, Fair Health recently launched FH Medicare Compare, a free, web-based tool that provides information about out-of-pocket costs for medical procedures, based on the Medicare fee schedule. UCR reimbursement rates are available on the site as well, and you can compare the difference between the two for the same medical service.

To use the tool, you’ll first want to learn the method your insurer uses to reimburse out-of-network services. You can do that by checking with your benefits or Human Resources department if you get you insurance at work, or simply by calling the customer service number on the back of your insurance card.

But once you know which method your insurer uses, you’ll need to put that information into context. Medicare-based formulas are usually 110% to 140% of Medicare fees, whereas an insurer may pay 80% of UCR. It’s common, Gelburd says, for consumers to think 140% is a better deal for them than 80%. “That’s a starting point and that’s where people start falling off the cliff and making assumptions that they are going to be very generously reimbursed for out-of-network care,” she says.

A search on the organization’s site for a colonoscopy with a biopsy, anesthesia, and pathology, for example, resulted in an estimated out-of-pocket cost of $631.78 when UCR standards were applied. When the Medicare-based formula was applied to the same procedure, the out-of-pocket costs were estimated at $1319.77.

FH Medicare Compare also helps people avoid other unexpected costs by providing out-of-network estimates for more than 30 common procedures, along with additional services often performed at the same time, such as a biopsy or anesthesia.

New Tools, Old Rules

Despite the growing need for consumers to understand the cost of their health care, many doctors still can’t – or won’t – disclose prices up front. I was recently told by a doctor’s office, in fact, that even a ball park figure for a common medical procedure could not be provided in advance of the doctor examining me. To combat this kind of resistance, Gelburd offers the following tips:

  • Negotiate: Print an estimate from FH Medicare Compare and bring it to your doctor to use for price negotiation
  • Get technical: Forgot to print before leaving home? Ask staff to pull the site up on their office computer to see the fair price in real-time
  • Appeal: “Some people are using our data to support reimbursement appeals if they feel they’ve been shortchanged on reimbursement,” Gelburd says.

On the site, you can also find guides offering suggestions for questions to ask both your provider and your health plan before you go for care.

Now it’s your turn to share: Have you gone out-of-network for care and been shocked by cost of your bill? Sound off in the comments section below.

Posted by: Lisa Zamosky at 1:11 pm

Thursday, April 19, 2012

Five Ways to Save on Prescription Drugs

By Lisa Zamosky

Prescription Medications

According to a recent survey by the Centers for Disease Control and Prevention, one out of five American families struggles to pay its medical bills, which include the cost of prescription drugs.

Savvy shopping can help you save money on medications. Here are five tips for cutting your prescription drug bills.

1. Pay attention to your formulary

If you have health insurance, it’s important to check whether the medications you need are on your carrier’s formulary — the list of drugs it covers. The list can change from year-to-year so don’t assume that if your medication was covered in the past it still will be.

To prevent sticker shock at the pharmacy, take the list with you on your next visit to the doctor so that, if possible, he or she can prescribe a medication that will be less costly for you.

2. Go Generic

Many top-selling prescription drugs are losing their patents over the next few years. In time, that means generics will make their way to the market and compete for your business.

The difference in cost between generic and name-brand medications can be quite significant. Talk with your doctor about whether the medication you need is available in generic form and if he or she believes it could be as effective for you as the name-brand drug.

3. Shop Around

Prescription drug prices vary widely among pharmacies. If you purchase your medications locally, it pays to compare costs at a few local drugstores.

Large discount stores, such as Wal-Mart and Target, for example, sell a 30-day supply of generic prescriptions for just $4 (the program doesn’t apply to brand-name drugs), and a 90-day supply for roughly $10.00. Sometimes just mentioning that another pharmacy nearby is offering the same drug at a lower cost may encourage your favorite drugstore to match the price and keep your business.

It’s also a good idea to see if getting your medication by mail-order will lower your costs.

4. Go Online

According to Consumer Reports, buying prescription drugs through online pharmacies can save consumers 35% or more off the regular price of medications.

As I discussed in this previous post, however, it’s very important to be cautious about where you shop because online scams are common. Look for websites that are verified by the National Association of Boards of Pharmacy, which issues a Verified Internet Pharmacy Practice Site (VIPPS) to websites that have been vetted.

Here are some well-known sites with the VIPPS seal:

5. Ask for Help

Many of the big pharmaceutical companies offer programs to make the medications they manufacture available to patients at either no or low cost. Sites such as rxassist.org, pparx.org and benefitscheckuprx.org can help you to locate programs.

Have you found ways to cut down on your medication costs? If so, share your experience.

Photo: iStockphoto

Posted by: Lisa Zamosky at 8:35 am

Tuesday, April 17, 2012

How to Raise Money to Pay for Your Medical Care

By Lisa Zamosky

Donation

Here are some sobering statistics about medical expenses: In the U.S., more than 62% of all personal bankruptcies filed are the result of medical expenses. What’s more, 78% of people who file bankruptcy have medical insurance. Most are middle class and have gone to college. Two-thirds are homeowners.

The moral of this story: Having health insurance in America doesn’t provide guaranteed protection against devastating financial effects. If you don’t have health insurance and you get sick, the situation can be even more dire.

A New Way of Paying for Care

As a way of dealing with incredibly high medical costs, people are finding creative ways of covering their expenses.

In the past few years, crowd-funding – a method of online fundraising commonly used by business start-ups and charity organizations– has made its way into health care.

A number of websites now make it possible for patients and their families to create a personalized web page from which to launch their fundraising campaign.  Online, people can donate money to help them pay for the cost of care.

The general process works like this: You create a page on the site of your choice, set a fundraising goal, and then promote your page with email or social media outlets, such as Facebook or Twitter. You can upload pictures and videos and write a full description of the patient’s situation. On some sites, friends and family can also post words of support for patients.

You establish a fundraising goal and a date by which the funds are to be raised. The goal is displayed on your page so you and your visitors can keep track of how much money has been raised and how much further you have to go to hit your target.

It’s free to create a page, but some sites charge a processing fee – typically a percentage of the money raised (5% – 9% seems common).

People have used crowd-funding to pay for all types of medical care – cancer treatment, various types of surgery, life support, recovery from an accident, and dental care.

Sites for Funding

If you’re in need of money to pay for medical treatment, here are a few crowd-funding sites to explore:

Have you used a crowd-funding site to raise money for medical expenses? If so, how successful was your campaign? What was the experience like? Please share your experience, plus any sites not mentioned but worth checking out, in the comments section below.

Photo: iStockphoto

Posted by: Lisa Zamosky at 10:49 am

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