Memo to Health Insurers: Pay Attention to Us

Memo to Health Insurers: Pay Attention to UThe text came from our 20 year old. His girlfriend had gone to her doctor to get the implantable birth control, Nexplanon, which (as every parent of a teenager might be happy to know) is nearly foolproof for 3 years. Needless to say, we were thrilled.

The problem?

It cost $1,500 and insurance wasn’t paying.

The Explanation of Benefits that Was Anything But

Impossible, I said (after all, there’s not much I know about but health insurance and the Affordable Care Act [ACA] are two). The ACA requires that most health insurers/employers provide all FDA-approved contraception with no out-of-pocket cost.

It took several back and forths between the girlfriend, her father, and me, including copies of the statement from the insurance company, before I figured it out. She was only seeing the insurance company statement, called an explanation of benefits (EOB), showing what was billed and what was paid. She didn’t owe a thing.

And therein likes one of the many problems with health insurance today. It’s unnecessarily complicated and confusing. After all, how many mere mortals … Continue Reading

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ACA Affordable Care Act FDA healthcare costs patient-centered care reprodutive rights

Plan B: Another Double Standard

For what appears to be the first time in history, the head of the Health and Human Services Department has overturned a decision by the FDA. Was this regarding a drug that was so potentially dangerous it could kill or permanently maim people? A drug for which we have little clinical trial evidence or history? A drug that is produced in appallingly unsafe conditions?

No. It is a drug–actually, a single pill–for which we have years of safety and efficacy data, that is exceedingly safe and easy to use, and, get this — doesn’t even require a prescription from a doctor–if you’re 17 and older.

What it does is require is that the patients buying it be at least 17 years of age and head to the back of drugstores to give their names and identification to a pharmacist before receiving it. Oh, and if the pharmacist doesn’t want to provide it, he/she doesn’t have to. And it does require a prescription for those 16 and younger.

It’s Plan B, aka “emergency contraception.” All its manufacturer was asking was that we stop requiring that women who need it — those who had unprotected sex, missed a couple of birth control … Continue Reading

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double standard FDA HHS Plan B reprodutive rights Sebalius