First Aid Kit

Hey there. When it comes to getting your prescriptions for cheaper, there’s a whole universe of options out there. And not enough of us know about them. None of these options will work for everyone. This is a set of patches for a broken system. But if there’s even one that works for you, we want to help you find it. So today, we’re kicking off a series about how to get our prescriptions at a price we can afford.

Hey there— Every year, I learn some new getting-health-insurance pitfall, and this year’s is a doozy. The title of this recent New York Times essay sums it up: It shouldn’t be this easy to lose your health insurance (gift link, no paywall). The writer, Danielle Ofri, describes getting “an unfamiliar health insurance card” in the mail, just before New Year’s. She calls HR, figuring they’d screwed up. “It’s not a mistake,” they tell her.

First Aid Kit is a newsletter meant to help you fight a brutal enemy — the American health care system. Because if we’re going to change this system, we have to survive it in the meantime. And I think I can help with that. My name is Dan Weissmann* —I make a podcast about why health care costs so freaking much and what we can maybe do about it. (It’s called An Arm and A Leg.

Hey there– I want to introduce you to Barbara Faubion. For 25 years, she worked for an insurance broker. Whenever one of his clients had a problem with their insurance, Barbara got it fixed. As we’ve talked about so many times in this newsletter, there are a lot of problems with insurance. Insurance companies deny all kinds of claims for all kinds of reasons, some of them nonsense, some of them shockingly horrible in the bad faith they seem to exude. Sometimes they don’t even read the claims.

Hey there— More and more often, providers are asking for payment in advance. Before a test or procedure, they might want you to pay whatever they expect your share to be after insurance. And maybe it’s not just a $30 copay, or something similar, but your whole deductible. Which could be thousands of dollars. Um, yikes. Paying upfront goes against one of our major pieces of advice: Don’t pay a medical bill without fact-checking it.

Hey there – Does this sound familiar? You want to start going to therapy, and you want a therapist your insurance will pay for. After all, that’s what insurance is for. But none of the therapists on your plan’s list are panning out. Either they don’t take your insurance, or they’re not taking new patients. Or maybe the listed phone number doesn’t work. This sort of thing happens a lot.

Hey there — Recently, our pal Jared Walker was on the excellent NPR podcast Life Kit, to talk about negotiating medical bills. He crushed it, of course. And beyond the basics we’ve covered in the newsletter recently — don’t rush to pay, see if you’re eligible for charity care, get an itemized bill and fact-check it — the best piece of advice Jared shared was to not freak out in the process of disputing a bill. “You have time,” he said.

Hey there— I am not going to tell you to skip having insurance. Although it often sucks, it’s still a backstop against some of the worst-case scenarios. But sometimes, you may want to skip using your insurance and try paying cash. You could pay less for care that way. A lot less. That’s because of the one-two punch that often makes health insurance so lousy. Most of us have high deductibles — the amount we have to pay before insurance kicks in for most things — often in the thousands of dollars.

Hey there — A quick, extra newsletter today, because if this is relevant to you, then you want to know today. And maybe take some action. If you signed up for a 2023 Obamacare plan — or know somebody who has: Double-check to make sure “in-network” docs are really in-network. Like, call them. Today. Because with at least one big insurer, the one that enrolls the most people, your doctor — or almost any doctor you might need to see — may not be in network.

Hey there— I said recently that prescription drugs are probably the worst part of the U.S. Health Care Ripoff Machine, but… Emergency rooms are actually the worst. That’s one of the first things Dhaval Bhatt learned as an immigrant to the U.S. from India. "People always told me to avoid the ER in America unless you are really dying," he told me and my pals at Kaiser Health News.