KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Patients Cope With Navigating The Health Care System

The Associated Press: Americans who lose employer coverage between now and 2014, when much of the health overhaul kicks in, "may find buying insurance on their own unaffordable." But for those without coverage and who can't afford to buy it "there are ways to cope."

Among these methods is having a primary physician and having regular appointments with that doctor. "People who have a primary care doctor when they lose their insurance should tell their physician about the change in status and ask if there is any flexibility on fees. Many physicians will offer a sliding scale or reduced payments to maintain the relationship." Places to get primary care include community health centers, which are partially funded by the federal government. Kids may also qualify for state coverage through the Children's Health Insurance Program.

There's also help for affording prescription drugs - by using samples or free and low-cost prescription programs - and for affording hospital bills by writing out payment plans for care received in emergency rooms. "Negotiating with the hospital is exactly what the insurance companies do. Insurers may pay only $3,000 for a procedure that a hospital will routinely bill an uninsured individual $9,000." Patients should ask to be given the same rate as insurers (7/6).

Meanwhile, in Colorado, a woman who underpaid her premium by one penny was recently told her benefits would be terminated, The Colorado Springs Gazette reports. The woman is fighting leukemia. After she lost her job, she took a COBRA subsidy to continue her former employer's insurance and "[b]ecause Carrington had not yet received a bill showing what her payment would be with the discount, she whipped out a calculator, figured out that she owed $165.15 a month and sent a check for that amount to Discovery Benefits." But it turned out her actual bill was $165.16, "and last week, she received a letter from the company telling her she was short on her premium and her coverage could not be continued. The letter, however, did not tell her how much she owed. She called Discovery Benefits and was aghast when she heard the amount." Eventually, the insurer learned the woman was correct in her calculations and wrote the penny off, extending coverage to her (Cotter, 7/6).

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