Debbie Perlman Blog

Drugs to prevent organ rejection are not always covered for patients who had transplants before they enrolled in Medicare. The question might seem indelicate. But transplant centers find it is necessary these days to know the answer even before they place a patient on the list for an organ transplant. “How will you pay for the anti-rejection drugs?” These are patients with insurance — they need it to pay for the transplant itself — so it might seem obvious that their insurer would pay. But if, as often happens, the patient gets an organ transplant with private insurance and later enrolls in Medicare, she may be in for a shock. Necessary anti-rejection drugs may not be covered under Medicare. And without those medications, the body may reject the organ, with deadly consequences. It is “an emerging and alarming problem,” according to the American Society of Transplantation — another maddening twist in our convoluted, contradictory and confusing health care system. For ...

Like every social, political and economic policy in our country; health insurance is complicated. We started with an already complex system. Then Affordable Care Act (ACA) was passed, setting up insurance “exchanges” that offer consumers and small businesses a choice of health plans. While hugely beneficial to many, definitely muddied already murky waters. Then just when I started to understand ACA, Trump starts to dismantle it. But politics are only part of the blame in the healthcare jumble. God forbid you are navigating through the Consolidated Omnibus Budget Reconciliation Act (COBRA), Medicare or Medicaid. With all of this chaos, is it any wonder that most Americans don't understand their own health insurance policy?  A 2016 survey identified four key health insurance terms necessary for a basic knowledge of healthcare: deductible, co-insurance, co-pay, and out-of-pocket maximum ...

One of the many flaws with our current health care system is that, too often, health insurance coverage fails people precisely when they need it the most. It’s as if your car insurance has been paying the cost for your oil changes for years, but won’t pay the costs to fix your car following a major accident. A disturbing example of this failure currently impacts patients living with end-stage renal disease (ESRD), or kidney failure. More than 660,000 people in the U.S. are living with ESRD. It is a devastating condition that would be fatal without regular dialysis. Patients who cannot receive their dialysis at home, need to spend an average of four hours at a dialysis center, three times a week. While life sustaining, the treatments are debilitating, time consuming, and can make living a normal life, including holding down a job, all but impossible. According to the American Kidney Fund, over 70 percent of dialysis patients, most of whom suffer from multiple dis...

Investing to become wealthy is different than investing to preserve wealth. A lot of financial articles are written for those who want to preserve wealth.  If your investment objective is to become wealthy, here's what you need to know. For the last 10 years, the risk-free interest rate has been less than the inflation rate. If your objective is to become wealthy, you need a better return than the risk-free interest rate which means you have accept some risks. However, you have a choice of which risks to take. Broadly speaking, it is useful to divide risks into two buckets; market risks, and company risks. Market risks are those that affect all stocks. Two good examples are monetary and fiscal policy. When monetary and fiscal policy is conducive to a strong economy, the market can deliver excellent returns. However, the opposite is also true. When monetary and fiscal policy is headed in the wrong direction, the economy shrinks, and the market falls....

It's peak season for travel insurance claims, a time of year when vacationers are sending their reimbursement requests for their ill-fated year-end holiday getaways. If you're one of the unlucky travelers who are about to file a claim, be careful to not make one of several common travel insurance mistakes,` any of which can potentially lead to a rejection of your claim. Travel insurance claim denial rates are not publicly reported, but they are said to be somewhere between 2% and 5%. Don't worry, you can easily avoid the most common travel insurance claims mistakes. All you need is a cheat sheet of the most common claim mistakes and a few insider strategies for getting around them. If you've purchased a policy through a third party, there's good news: The company will help you and ensure that you've filed all the paperwork correctly. For example, G1G.com, a travel insurance comparison site, can process a claim either through a customer care...

Opponents of the role of consumers and markets in health care have one go-to argument above all others: that you can’t shop for health care when you’re unconscious. The rising problem of gargantuan, surprise medical bills in surgical wards and emergency rooms shows that they have a point. The good news is that constructive, bipartisan reforms may be on the horizon. A close encounter with surprise billing A few years back, my wife and I had an up-close look at how surprise billing works. We were about to have our first child. I had warned my wife, Sarah, about the problem of surprise billing. She meticulously researched everything to make sure that the hospital she chose—part of the St. David’s HealthCare system in Austin—was part of our insurer’s provider network. She then did the same for her obstetrician and her anesthesiologist. When Sarah went into labor, and we got to the hospital, the receptionist asked me to sign a form, agreeing to allow the on-call pe...

If you’re 65 or older, working and have an employer group health plan based on your current work, you may have questions about how your job-based insurance coordinates with Medicare. On our Medicare Rights Center National Consumer Helpline, such questions are among the most frequent ones we get. Here’s what you need to know: For people who work and have job-based insurance, knowing when to enroll in Medicare falls on them. There is no formal notification from the Social Security Administration or Medicare. Some people are misinformed by employers or don’t have reliable information about Medicare enrollment, leading them to delay enrollment in Medicare Part B and then incur penalties and high medical costs. The Rules on Coordinating Medicare and Employer Coverage Having job-based insurance does allow you to delay Medicare enrollment without penalty and delay paying the Medicare Part B premium (the standard Medicare Part B premium is expected to be $134 a month in 2...

Health insurance plans cover a variety of medical procedures, prescriptions and provider visits. A recent change in how some plans interpret health-related insurance benefits may see more plans offering food-based benefits, including meals and healthy groceries. Hippocrates, of the eponymous Oath, famously wrote “Let food be thy medicine.” A little over a decade ago, the editor of the British Medical Journal lamented, “Although many patients are convinced of the importance of food in both causing and relieving their problems, many doctors' knowledge of nutrition is rudimentary.” Fortunately, food as prevention-based medicine is gaining traction across the country, with some seeing the paradigm already shifting. The federal government recently gave the go-ahead for Medicare Advantage plans to broaden the scope of supplemental, “health-related benefits” for individuals. The Centers for Medicare & Medicaid Services (CMS) has signaled that they will consider ...

Marriage is a partnership. There are many demands and expectations that enter into the partnership and therefore equality, respect and trust must be shown by both sides. As you grow the marriage, hopefully, smart investing and sound business decisions have allowed you to grow your financial portfolios as well. Often, one partner takes the lead on the financial decisions and without even realizing, leaves the other partner at a huge disadvantage. I’ve been in the financial services industry for nearly 30 years and over and over again, I have clients come in after the death of a spouse terribly upset and confused about where to turn next. They don’t know what accounts they have, where to look or even who to contact. According to the Allianz Women, Money and Power Study (2016), 90 percent of women will eventually be solely in charge of household finances. Today, make the time to sit with your partner and discuss your financial status and financial goals along with the...

In Tanzania, if you work in the formal sector, your job probably has health insurance. Unfortunately, only about 7% of the population falls into that category. Pretty much everyone else is either a farmer or has a job in the informal sector, perhaps getting paid off the books and definitely not being covered by health insurance. That’s according to Lilian Makoi, a social entrepreneur and data analyst who decided to find a way for all those people to afford insurance. About four years years ago, she founded EdgePoint Digital, a company aimed at providing such a product through a mobile-based system she named Jamii Africa. She’s also one of the more than 140 impact entrepreneur scholarship winners at SOCAP, the impact investing conference happening this week in San Francisco. How does it work? Customers pay a premium—the cheapest is $3 for three months—via the Jamii platform and the company takes 22% as an administrative fee. That premium covers $30 of medical se...

Modern healthcare is effective but expensive. The cost of superior medical treatment is rising day by day. Due to rampant rise in life-threatening diseases, the longevity of an average human is reduced to 60-70 years in developing nations like India. One of the most dangerous and life-threatening diseases which is infecting Indians at an alarming rate is cancer. As per the Cancer Organisation of India, the total deaths due to cancer alone stood at 7,84,821 (4,13,519 males and 3,71,302 females) in 2018. The risk of dying from cancer before the age of 75 years is 7.34% in males and 6.28% in females. On the other hand, there are cardiovascular diseases. As per the September 2018 issue of health journal- The Lancet, Cardiac ailments killed more Indians in 2016 (28%) than any other non-communicable disease. Cardiac ailments or cardiovascular diseases comprise various ailments related to stroke, blood vessels and the heart. The coronary heart disease, also known as isc...