Tag Archives: out-of-pocket costs

Rise in naloxone costs for uninsured, a significant access barrier to life-saving drug

Photo courtesy of the FDA website.

The cost of naloxone has risen sharply for people lacking insurance, even as laws have made it easier to prescribe and obtain the treatment for opioid overdoses, a new report found.

A study of claims data showed the mean out-of-pocket cost of naloxone for the uninsured rising to $249.97 in 2018 from $35.39 in 2014, according to a study published in JAMA Health Forum in August.

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Inflation Reduction Act will benefit millions of older adults

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Millions of older adults will soon benefit from lower prescription drug prices and a cap on out-of-pocket costs thanks to landmark legislation signed into law by President Biden today. Continue reading

Being ‘underinsured’ another measure of health coverage

A recent Commonwealth Fund report shows that the rate of Americans who are underinsured reached 41 percent last year, up from 12 percent in 2003. The fund defines an underinsured person as having been insured all year but with out-of-pocket costs (excluding premiums) of 10 percent or more of income; out-of-pocket costs, excluding premiums, equal to 5 percent or more of income if low-income; or deductibles equal to 5 percent or more of income.

The Commonwealth Fund

This year the rate of those who are uninsured has risen steadily, as the Gallup Sharecare Well Being Index shows. In the third quarter, the share of Americans without health insurance was 12.3 percent, according to Gallup’s most recent quarterly report.

After President Donald Trump announced that he would end cost-sharing subsidies under the Affordable Care Act (ACA), Danielle Wiener-Bronner covered the story for CNN and Jeffrey Young wrote about it for The Huffington Post. Continue reading

New studies raise the question: Are out-of-pocket costs getting out of control?

Source: Adrion ER, Ryan AM, Seltzer AC, Chen LM, Ayanian JZ, Nallamothu BK. Out-of-Pocket Spending for Hospitalizations Among Nonelderly Adults. JAMA Intern Med.Published online June 27, 2016. doi:10.1001/jamainternmed.2016.3663.Researchers from the University of Michigan’s Center for Healthcare Outcomes and Policy studied the cost of hospitalizations for insured consumers and found that costs rose sharply from 2009 to 2013.

Source: Adrion ER, Ryan AM, Seltzer AC, Chen LM, Ayanian JZ, Nallamothu BK. Out-of-Pocket Spending for Hospitalizations Among Nonelderly Adults. JAMA Intern Med.Published online June 27, 2016. doi:10.1001/jamainternmed.2016.3663.Researchers from the University of Michigan’s Center for Healthcare Outcomes and Policy studied the cost of hospitalizations for insured consumers and found that costs rose sharply from 2009 to 2013.

Two new studies indicate that out-of-pocket costs of health care are rising sharply.

The share of costs that consumers are paying rose by 13 percent from 2014 to 2015 according to a new report from TransUnion Healthcare. What’s more, the report shows that as these costs rose, patients had fewer resources to pay those increased expenses because their amount of revolving credit had declined.

Out-of-pocket costs are a combination of what patients pay in deductibles, coinsurance and copayments for covered services. Coinsurance is a percentage of the total bill and a copayment is usually a fixed amount due at the time of service. Consumers pay for these costs until they reach the out-of-pocket maximum when insurance starts paying. Continue reading

Parents skipping needed care for children, pediatricians say

Photo: Alex Prolmos via Flickr

Photo: Alex Prolmos via Flickr

High-deductible health plans (HDHPs) discourage families from seeking primary care for their children, according to the American Association of Pediatricians. The problem is so severe that the federal government should consider limiting HDHPs to adults only, the AAP said in a policy statement published in Pediatrics.

“HDHPs discourage use of nonpreventive primary care and thus are at odds with most recommendations for improving the organization of health care, which focus on strengthening primary care,” the association said in its statement. Under the Affordable Care Act, preventive services are covered in full without charge.

This is the second time in as many months that a report has shown consumers skipping needed care because of the cost. Last month, we reported that out-of-pocket health care costs force one out of every eight privately insured Americans to skip necessary medical treatment, according to the survey from the AP-NORC Center, “Privately Insured in America: Opinions on Health Care Costs and Coverage.” The Robert Wood Johnson Foundation funded the survey. In a report earlier this month, “Too High a Price: Out-of-Pocket Health Care Costs in the United States,” the Commonwealth Fund expressed similar concerns. Continue reading