Insurer Denied Coverage Five Times For Boy’s Treatment At Special Hospital Before It Finally Relented
The hospital was one of only three centers in the country that specialized in treating the boy's rare condition, but the insurer kept telling the family to find care closer to home. While the company eventually relented, the family was left wondering why it has become so hard to get needed care. Other health care costs news focuses on a public insurance option and the actual cost of a flu shot.
Five Health Insurance Denials For Sick 4-Year-Old Boy
Jax has a rare disease called metachromatic leukodystrophy that could rob him of the ability to walk, sit and hold up his own head within the next year. Children with the disease typically die between the ages of 2 and 10. ...The insurer sent the family letters denying requests for coverage five times. The insurer said the hospital was out-of-network, and Jax should get care closer to home. Those familiar with the disease, however, say the Pittsburgh hospital is one of only three centers in the country that specialize in treating children with Jax’s condition. (Schencker, 11/18)
Colorado Officials Have Finalized Their Proposal For A Public Health Insurance Option. Here’s What We Still Don’t Know About It.
Colorado regulators last week unveiled their final proposal for a public health insurance option, a program that would, in theory, provide a more affordable choice for people who buy coverage on their own. ... The final proposal, along with its appendices, weighs in at several hundred pages, but there are still a few big issues that need to be decided. It will be up to the state legislature to sketch in those details .... Here’s a look at some of the questions that are still TBD. (Ingold, 11/18)
Kaiser Health News:
The Startlingly High Cost Of The ‘Free’ Flu Shot
In the Byzantine world of health care pricing, most people wouldn’t expect that the ubiquitous flu shot could be a prime example of how the system’s lack of transparency can lead to disparate costs. The Affordable Care Act requires health insurers to cover all federally recommended vaccines at no charge to patients, including flu immunizations. Although people with insurance pay nothing when they get their shot, many don’t realize that their insurers foot the bill — and that those companies will recoup their costs eventually. (Galewitz, 11/19)