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Medical/Medicaid, Medicare & Health Insurances

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Northern America’s healthcare system has been a health SCARE for some especially to the middle class with the high cost health insurance and steeply-priced pharmaceutic . Middle class are affected utmost when the upper class can afford and the low- income are covered mostly by Federal’s Medical / Medicaid programs. However recent government surveys show that about 90% of population are covered under existing low cost- healthcare programs (ACA or Affordable Care Act). More people indeed have insurance coverage now, but some are still struggling to pay their deductible and copays. The Affordable Care Act (ACA) was signed as Obamacare on March 23, 2010 , intended to make healthcare affordable, providing preventive healthcare like immunizations, preventive imaging like colonoscopy, x rays , women and child wellness at NO cost. However, while we are seeing these ACA freebies a blessing, lightening up the healthcare costs, “The ACA did not specify the ACA rules and operations around it, are left up to individual insurers — like what procedure codes are covered under the umbrella of each of those services in same or spirit, who qualifies, how often they can get them is up to each individual insurer,”. This is according to Paul Shafer, assistant professor of health, law policy, and management at Boston University School of Public Health. What this meant was- for instance, if a colonoscopy was done as preventive measure, ACA covers and patient need not pay. But when a certain disease or diseases were discovered during colonoscopy, preventive procedure of colonoscopy is not charged but the additional procedure done to remove, treat a disease like polyps removal, will be billed with its corresponding code. Codes are reference for bill rates or pricing, to whatever health insurances the patient carry primarily, or secondarily – if the primary insurance won’t take the bill. The end point is the ‘surprise billing’ can be sent to the patient eventually, when neither insurances would cover pay the bill.

A study published in 2021 in the journal Preventive Medicine found that “in addition to premium costs meant to cover preventive care, Americans with employer-sponsored insurance were still charged between $75 million and $219 million in total for services that ought to be free to them.
The No Surprises Act, which became law in 2021, was intended to prevent patients from receiving surprise medical bills. Insured patient gets a copy of a detailed descriptions of what was billed on their recent clinic visit or hospital procedures. Unfortunately, there are loopholes or gaps that can end up charging some services that ought to be free. These gaps or grey areas , as exemplified in the supposedly free preventive colonoscopy case mentioned above, will need changes to avoid patients from getting the brunt of paying more than what is due or what they are capable to pay for. Policymakers, insurers and healthcare providers need to scrutinize and conduct more studies to strategize these grey areas, to eventually deliver a reliable, and truly affordable healthcare.
For now, the best approach is to learn which health insurances around are trustworthy, and fits well on each individually. If you are a health buff, you should not be paying much on health insurance than a person with multiple health issues or is sick a couple of times annually. Healthcare insurances, just like car insurances , also increase your monthly premiums from multiple claims and treatments. You can find help on a lot of health insurers online and if you find some sites or deals with skepticism, we can help if you are lost. We can also guide match you to the more appropriate health insurances in our network of trusted providers and insurers, with you foremost in our minds.
Whether it is a surprise billing or questionable decline of your benefits from your Medicare, Medical or Medicaid or other health insurances, RLabNet insurance reps are around to help too. Our experiences find that more often the beneficiaries’ cases are declined from improper presentations and/or from blurry, questionable issues on claims which are recipes for decline.