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When he was diagnosed with two autoimmune diseases, Joel Hechler knew he’d be in for a battle. He didn’t realize maybe his toughest one would be with his insurance company.“I think they put the dollars ahead of a patient’s health,” Hechler said. “I don’t think they fully understand the impact the medicine will have on my long-term health and well-being."Hechler suffers from Crohn’s disease and ulcerative colitis, diseases that attack the lining of his digestive tract. Autoimmune conditions like his can’t be cured but, with the right medication, the symptoms can be controlled. Finding the right medicine can be hard for those suffering from autoimmune diseases. Even if there are scores of drugs on the market, some patients might only respond to one. In Joel’s case, his doctor thought he’d have a better chance trying a drug called Remicade.“I received a letter from my insurance company that denied the Remicade on the basis that I have to try a different drug before I can get to Remicade," Hechler said.Hechler's insurance company, Premera Blue Cross, wouldn’t approve the drug his doctor prescribed because they wanted him to try a cheaper one first.It’s part of a program that health insurers nationwide use called step therapy, requiring that patients try less-costly drugs before “stepping up” to more expensive ones — even if doctors believes the cheaper drug won’t work.Dr. Larry Adler is president of Huron Gastro in Ypsilanti, Michigan and says he spends virtually every day battling insurance companies over step therapy drugs.“They have to fail this medicine first before they get the new drug,” Adler said. “That doesn’t make any sense.”Adler says it's common for patients to get sicker while waiting for step therapy to run its course.In Hechler's case, it took six weeks of fighting with his insurer to convince them that the cheaper drug wouldn’t be effective. As he was waiting, he was getting worse.“It got to the point where I had to be admitted to the hospital,” Hechler said. "I was very, very sick.”Step therapies are used by insurers to try to control skyrocketing prescription medicine costs, says Glen Perry, Director of Pharmacy Contracting and Sales for Blue Cross Blue Shield of Michigan.“These drugs can cost up to 0,000 per year. These are not cheap medications,” Perry said.“It seems like you’re telling patients that, in many cases, your insurer knows what’s best for you, rather than your doctor,” Jones said.“We are trying to provide the most cost effective and safe medication use,” Perry said, adding that when a doctor and insurer disagree over a drug, they can usually resolve the case within a few days without putting a patient at serious risk.“A delay of one or two days I don’t think is really going to make that much of a difference for the medical outcome of the patient," he said.But for many patients, like Phyllis Toole, the delay is longer than a few days.Phyllis suffers from rheumatoid arthritis, a condition where her body attacks her joints. When her doctor wanted to put her on Orencia, her insurance company HAP said she needed to first try a less expensive drug, Humira.But Phyllis’ doctor was worried about possible side effects and thought Humira could be risky.After battling for months, Phyllis says the whole thing made her feel more like a number than a patient. With her doctor and insurer in a standoff, she was forced to rely on samples of the drug she got from her doctor. HAP never approved her prescription.“They’re playing doctor, is what it feels like,” Toole said. “They’re saying this is what you can have for the symptoms you have. It may make you sicker, but this is what you can have.”HAP issued the following statement to Scripps station WXYZ in Detroit: 3800
While officials in Puerto Rico placed the official death toll from last year's Hurricane Maria at 64, researchers from Harvard believe the death toll was actually in the thousands. According to Harvard's study, there were an estimated 4,645 deaths directly or indirectly tied to the hurricane, which struck the island in September. Harvard estimated a mortality rate of 14.3 deaths per 1.000 people from September 20 through December 31, 2017 in Puerto Rico. Harvard said in its study that it believes its estimate is rather conservative due to a "survivor bias."Harvard conducted the study by performing a random survey of 3,299 households in Puerto Rico. "In our survey, interruption of medical care was the primary cause of sustained high mortality rates in the months after the hurricane, a finding consistent with the widely reported disruption of health systems," the study says. "Growing numbers of persons have chronic diseases and use sophisticated pharmaceutical and mechanical support that is dependent on electricity. Chronically ill patients are particularly vulnerable to disruptions in basic utilities, which highlights the need for these patients, their communities, and their providers to have contingency plans during and after disasters."Part of why there the death toll might have been underreported is due to how hurricane-related deaths are counted. In order to have a death counted as storm related, bodies had looked at by a medical examiner, which required a body to be transported to San Juan, or the medical examiner to travel to remote locations. With a lack of electricity and blocked roads, some bodies were likely buried before the government could count fatalities. Maria is considered the third-costliest hurricane in US history. 1816
What to keep in mind with credit card bill payments (READ)Tips on handling your credit cards amid virus outbreak (READ)Help available for renters, homeowners struggling to pay for housing during pandemic (READ)3 ways credit cards can help you ride out a crisis (READ)SAN DIEGO (KGTV) -- Tens of thousands of people in California are being sued for not paying their credit card bills and other types of loan payments. The lawsuits are what's known as rule 3.740 collection cases."A lot of worrying after that, like oh my god, what am I going to do," said Chris Madden. "Stressed out now and just didn't need it."In February, Madden was served with a lawsuit from a debt collection company.During an interview with 10 News that month Madden said he needed to borrow money a few years ago to keep his car. He turned to a lender that could get him money quickly."I figured it was going to be a high-interest rate, like 22% or something," he said. "I started making the payments on it, and then I found out more about it."Madden admits he didn't do a great job getting all the details when he took the money, saying the interest rate wasn't clear. When he finally did look at the fine print, he saw the interest rate was 135%. Court documents show a ,000 loan turned into ,000 owed."They were threatening to take any assets that I have, garnish my wages," Madden said.Madden said he stopped paying. He's being sued by a debt buyer under what's known as a rule 3.740 collections case.According to the 2020 California Rules of Court, "Collections case" means an action for recovery of money owed in a sum stated to be certain that is not more than ,000, exclusive of interest and attorney fees, arising from a transaction in which property, services, or money was acquired on credit."Team 10 discovered a 157% increase in the number of rule 3.740 collections lawsuits filed in San Diego County court from 2015 to 2019. 1927
While it's true that premiums for the popular silver Obamacare plan could shoot higher for 2018, most enrollees will actually end up paying less for coverage next year.In fact, more consumers will be able to snag policies that will cost them nothing each month.How can that be?It's because premium subsidies are soaring too, making many plans on the exchanges more affordable.The Trump administration, however, is stressing how much premiums will rise, saying this is yet another sign that Obamacare is irreparably broken. They are downplaying the fact that the subsidies will cover most, if not all, of the cost.Obamacare advocates worry that consumers will be scared off by the news that premiums are skyrocketing for next year. They plan to highlight the fact that many people will be able to find lower-premium policies thanks to the subsidies.Even the Trump administration found that Obamacare plans will be more affordable next year. Some 80% of enrollees will be able to find a policy for a month or less -- up from 71% this year and the highest share so far."This year, more people than any previous year have access to a plan for or less," said Josh Peck, a former Obama administration official and co-founder of Get America Covered, which is promoting enrollment for 2018. "That's what we want everyone to know."Here's why this is happening:Many insurers jacked up the rates of their silver plans in part to make up for President Trump ending federal support for Obamacare's cost-sharing subsidies. These subsidies reduce deductibles and co-pays for lower-income enrollees.Premiums for the benchmark silver Obamacare plan will soar 37%, on average, for 2018, according to federal data released Monday.The premium subsidies are pegged to a benchmark silver plan in each market. So if that plan's rate rises, the value of the subsidy does too. More than eight in 10 Obamacare enrollees receive premium subsidies.Insurers, however, did not hike the price of bronze or gold plans nearly as much. The rate of the lowest-cost bronze plan is rising 17%, on average, while the cheapest gold plan is going up 19%, according to the Kaiser Family Foundation.That means the more generous premium subsidies will cover more of the monthly cost of these plans, so consumers will pay less.A 40-year-old earning ,000 will pay 75% less, on average, for the cheapest bronze plan and 21% less for the lowest-cost gold plan, according to a new analysis by the Kaiser Family Foundation. A 40-year-old earning ,000 will see a 28% drop in the price of the cheapest bronze plan, and an 8% decrease in the least expensive gold plan's premium.Bronze plans have lower premiums, but their deductibles are higher -- nearly ,900, on average, for an individual in 2018, according to a new report from Health Pocket, an online health insurance shopping tool. Meanwhile, gold plans have higher premiums, but their deductibles are only ,320 on average for a single enrollee next year.The cheapest gold plan will have lower premiums than the least-expensive silver plan in 459 counties next year once subsidies are factored in, Kaiser found. Silver plans will have an average deductible of just over ,000 next year.Many more consumers will be able to enroll in bronze plans and pay nothing each month. For instance, a 48-year-old consumer earning roughly ,000 can find a zero-premium policy in nearly 1,050 counties next year, up from 132 counties in 2017, according to an analysis by Oliver Wyman consulting group.Not everyone, however, will be so fortunate. Enrollees who don't qualify for premium subsidies -- those who earn more than ,000 as an individual or ,500 for a family of four in 2018 -- may be hit with the full premium hike. They may be better off buying bronze or gold plans or looking for individual coverage outside of the Obamacare exchanges. 3877
WHCA Statement on White House Press Secretary testing positive for Covid-19 pic.twitter.com/viC6ywK7fv— WHCA (@whca) October 5, 2020 140