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Health Insurance Tips
WE CAN HELP — Our health care experts are working to provide you with the resources you need to make the most of new health care consumer protections and tools.
Get The Best Deal On Health Insurance
Looking for health coverage? The Health Insurance Marketplace could save you time and money.
1. Check out options at the Health Insurance Marketplace. The plans include coverage for doctor visits, hospitalizations, maternity care, emergency room care, prescriptions and more.
Toll free: (800)318-2596 TTY: (855) 889-4325
2. Find out about financial help that’s available. At the Health Insurance Marketplace, you can find out if you qualify for financial assistance to lower your costs.
3. Use the Health Insurance Marketplace to compare plans side-by-side. The new marketplace lists your options on one website, and shows what each plan covers.
4. Take advantage of expert help in-person, online, or by phone. Specially trained people are available in communities across the country to help you apply and understand your options. Find them at LocalHelp.healthcare.gov.
5. Don’t take no for an answer. For coverage starting January 2014, insurance companies can no longer deny you due to a pre-existing condition.
6. Keep in touch. Check for updates on our website, and tell us about your experience. We want to hear what you think so we can spot trends and advocate for ongoing improvements. Contact us.
HEALTH CARE CONSUMER PROTECTIONS
If you have coverage, you already have protections under the health care law, such as:
- Children and young adults can stay on their parents’ plan until age 26
- Free preventive care, including check-ups and vaccinations
- Insurance companies can’t set a lifetime cap on what they’ll pay if you get sick
- Rebates if your insurance company spends less than 80% of premiums on care
Plus, new protections for coverage effective January 1, 2014 include:
- Insurers can’t deny anyone coverage for having a “pre-existing condition”
- No more annual caps on what your insurer will pay if you get sick
- Insurance companies can’t charge women more than men for coverage
While many Americans struggle to afford their prescription drugs, TexPIRG Education Fund’s survey of retail prices of commonly-prescribed medications found patients can save hundreds, even thousands of dollars in some cases by shopping around at pharmacies within their communities.
"Texans shouldn’t have to forgo life-saving medicines. But when they don't realize there are more affordable options at a different pharmacy, some have to do exactly that,” said Bay Scoggin, TexPIRG Education Fund’s Director. “Our medications don’t work any better when we pay more for them. We need a transparent prescription drug system that delivers value to patients at a reasonable price, instead of confusing and price-gouging them."
Retail prescription drug spending represents about 10 percent of the overall national health expenditures in America, while nearly 1 in 4 Americans struggle to afford their prescription drugs primarily because of inflated prices.
TexPIRG Education Fund’s report, The Real Price of Medications: A Survey of Pharmaceutical Prices, released today, reveals a wide variation in the retail pricing of prescription drugs by pharmacies large and small, urban and rural. The report looked at prices in Dallas, El Paso, and Gainesville.
People living in the United States have access to some of the best medical care in the world, from life-saving drugs to cutting-edge surgical techniques. But our system is deeply flawed, with spiraling costs forcing many Americans to spend more on care and often receiving poor quality care for all the extra money spent.
Retail prescription drug costs represent about 10% of the total national healthcare expenditure in America and are a public concern because of existing high prices, which often continue to climb. In fact, nearly 1 in 4 Americans on medication struggle to afford their prescription drugs - and that rises to more than 4 in 10 for individuals in worse health. Research on these high health care expenses (including prescription drug expenses) in comparison to other countries show that this difficult cost burden is driven primarily by inflated prices: not differences in the drugs used, our aging population, nor the amount of drugs prescribed.”
These high prices decimate the delivered value we get from medications. The main problem is this: although a patient may pay more for their life saving medicine, they are not getting any more health value for the extra money spent.
Research shows that high prices lead patients to engage in risky behaviors, including medication rationing or altering dosages without doctor’s consent. Nearly 17% of older adults exhibit this non-adherence behavior, the highest among 11 comparably wealthy countries. Physician treatment plans don’t work when patients can’t follow them, and research shows that medical treatment deviations account for major proportions of treatment failures and many hospital and nursing home admissions.
The picture is even more concerning when you consider that drug prices can vary greatly within cities, states and regions of the United States. Doctors may prescribe more expensive medication that is just as effective as other options, or patients may decide to forgo treatment, when more affordable options could be available at the pharmacy around the corner. Sometimes, the best treatment may be what the patient can consistently stick to, but with providers and patients unsure about prescription drug prices, that treatment decision becomes even more daunting.
King Bio Inc. issued the second significant voluntary recall since late July of their homeopathic drugs on Wednesday. Safety concerns over homeopathic drugs extend beyond King Bio as over the past several years, the FDA has issued recalls to several companies for a variety of health products from zinc-containing intranasal medicine to asthma drugs with toxic ingredients.
Tools & Resources
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