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We are in the midst of a national crisis affecting the lives of more than one 100 million Americans, including residents of New Jersey. This crisis is exacerbating racial disparities in health and wealth. It prevents some Americans from saving for retirement and others from investing in their children’s education. It is forcing patients who may only have months to live to spend their last days on earth battling companies over medical bills and coverage. This is America’s medical debt crisis, and it’s crushing millions of hard-working families.
That’s why in October—Health Literacy Month—Quality Care consumers share information New Jerseyans can use to help keep their health care costs low and avoid medical debt. The main tips are to avoid tough health insurance plans and policies, ask good questions about charitable care options, and know your consumer rights if you have trouble paying a sudden medical bill.
Choosing the right health insurance has a huge impact on Americans’ finances. When choosing insurance for you and your family, it’s important to pay attention to short-term limited-term insurance plans, or STLDI plans. These so-called “unwanted plans” are insurance in name only, and are exempt from many of the consumer protection measures found in the Affordable Care Act. Although they may have lower monthly premiums, STLDI plans often exclude pre-existing conditions, have dollar value limits on covered services, and are not required to cover preventive medical services at all. In fact, for every dollar you pay in premiums, STLDI plans often spend less than 10 cents on your health care — and out-of-pocket expenses can build up quickly under these plans.
But it’s not just unwanted plans that lead to higher out-of-pocket costs and medical debt. The emergence of health insurance plans with high deductibles (the amount you are liable before your insurance begins to cover treatment), high co-costs (the amount that insurance requires you to pay for treatment) and high co-insurance (the percentage of insurance coverage costs) the service you pay until after your deductible is met) means that NJ insureds who seek care are often left with large bills that they cannot pay.
Some of these plans also have co-accumulators that transfer prescription drug costs from insurance companies to patients by preventing any financial assistance you receive — such as a voucher or voucher — from relying on your deductible. Paying for your grocery purchases is like with a gift card, but when you swipe the gift card and the store takes all the money from it, they won’t let you get your purchases until you pay repeatedly – For the second time – cash from your own pocket. It’s a double dip insurance company, and it has left many Americans mired in debt or unable to afford life-saving medications.
Despite fourteen states banning co-pay accruals, New Jersey lawmakers have taken no action to protect patients, highlighting the need for a national ban on this harmful practice that leaves many patients in our state and across the country with medical bills they can’t afford to pay. .
In addition to researching challenging insurance plans, you should also ask good questions about your options if you receive treatment at a nonprofit hospital. The truth is that while nonprofit hospitals aim to provide affordable care to the public in exchange for significant tax breaks, nonprofit hospital executives often focus on making the big money instead. For example, IRS rules require nonprofit hospitals to provide financial assistance to eligible patients, but Less than half of these hospitals Patients have already reported that they may be eligible for charitable care. worst, 45% non-profit Hospitals regularly bill patients who qualify for charitable care.
To protect yourself, ask about your options if you are receiving treatment at a nonprofit hospital. If you feel that you have been denied charitable care unfairly and unlawfully, file a complaint with New Jersey Department of Health.
Finally, you need to know your rights if you receive a surprise bill from your Medicare provider. A law called the No Surprises Act went into effect earlier this year to help stop unfair surprise billing practices that have plunged millions of Americans into debt. Unfortunately, about 1 in 5 Americans have reported receiving a surprise medical bill since the law went into effect. If you received a surprise medical bill this year that you believe violates the No Surprises Act, visit the Centers for Medicare and Medicaid Services website to learn more and file a complaint. Legal aid organizations in your community may also be able to provide assistance.
It’s no secret that we need major reforms in our healthcare system, reforms that prevent hospitals and insurance companies from viewing patients and their families as sources of profit and nothing more. Until then, CQC will work hard to make sure New Jersey residents are informed by sharing the information they need to make sound health decisions.
Honorable Mrs. Donna M. Christensen is a member of the Consumer Council for Quality Care. She retired in 2015 from the US House of Representatives, serving nine terms. Born in Teaneck, New Jersey, Christensen is the first female physician to serve as a member of the US Congress.