[CML] Medical costs prove a burden even for some with insurance

[Rob]

Think your health insurance has you covered? Think again. Even insured workers can find themselves on the hook for thousands of dollars, often at a time when illness has decreased their income.   Glossary of medical insurance terms People with health insurance not only pay all or part of their premiums, but also face other costs. The following are some terms common to many insurance policies: Co-payment The portion of the bill that patients must pay. Generally, co-payments are set dollar amounts for doctor office visits or prescription drugs. Often set in increments of $10 or $20, they are common in HMO policies. Co-insurance is a form of co-payment and is a percentage, such as 20%, of the cost of the visit or drug. They are more common in Preferred Provider Organization (PPO) policies. Out-of-pocket maximum An annual limit that's part of many, but not all, insurance policies. It caps the amount patients must pay in deductibles and co-payments. Policies might have several different parallel caps, such as for medical care, drugs and out-of-network treatment. The maximums can run to several thousand dollars a year. Out-of network Insurers generally have contracts with doctors and hospitals in which they have negotiated discounts. Out-of-network doctors and hospitals have no such agreement with the insurers. Patients generally pay a larger percentage of the costs for such out-of-network providers. Balance billing The practice in which doctors or hospitals bill patients directly for care above what the insurer pays. It is not allowed in Medicare. Balance billing is most common when services are provided by out-of-network providers. The amounts billed may not count toward the patients' out-of-pocket maximum. Deductible An amount that must be paid by patients for medical care before insurance kicks in. Some policies have separate deductibles for drugs, hospital care and medical services. Some have annual limits on deductibles. Some policies have per-admission deductibles for hospital care. Few workers realize the limits of their insurance until the bills start coming for: policies that don't cover rehabilitation care or limit it to a few visits; expensive drugs that come with a 20% charge, rather than a $20 co-pay; separate deductibles for drugs and medical care; doctors at "in-network" hospitals that aren't members of the insurer's network, leaving patients vulnerable to thousands of dollars in bills; annual "out-of-pocket maximums" that aren't always true ceilings on expenses. Such costs can quickly add up. A drug co-payment of 20%, for example, could cost thousands a year for patients taking some cancer drugs. Avastin, a colon cancer drug, recently went on the market at a price of more than $4,000 a month. Erbitux, another colon cancer treatment, can cost $12,000 or more for a month's treatment. Gleevec, for leukemia, is more than $2,000 a month.   http://cmlsupport.blogspot.com/2005/04/medical-costs-prove-burden-even-for.html New! Sign up for local CML support group meetings in your local community at http://cml.meetup.com Apply for Commercial Real Estate loans online and submit your deal to dozens of hungry lenders in just minutes. Loan programs for all types of business and commercial real estate. Apply anytime at http://realestatezoo.com CML (Chronic Myelogenous Leukemia Support List) --------------------------------- Part Of CMLHope.Com An International Community Of CML Patients For more information: http://cmlhope.com Post Message: cml@yahoogroups.com Subscribe:  [EMAIL PROTECTED] Unsubscribe:  [EMAIL PROTECTED] Change To No Mail/Web: [EMAIL PROTECTED] Change To Digest: [EMAIL PROTECTED] Change To Email: [EMAIL PROTECTED] List Help: [EMAIL PROTECTED]  CML Group Web Site http://groups.yahoo.com/group/CML Yahoo! Groups Links To visit your group on the web, go to: http://groups.yahoo.com/group/CML/   To unsubscribe from this group, send an email to: [EMAIL PROTECTED]   Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.