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Resolving Insurance Issues

2022 October, Benefit Spotlight September 25, 2022

It’s never fun to get bills in the mail. It can be additionally frustrating when they’re medical bills for a procedure you thought was covered.

Health benefits can be confusing to sort through, and alarmingly, insurance billing errors are not uncommon. Depending on the source, it’s estimated that between 7% and 80% of medical bills contain errors.

If you receive a bill that you think is incorrect, start by asking the provider to explain the exact charges submitted to your insurance carrier. For example, if you went to your primary care provider (PCP) for what you thought was a routine preventive visit but see additional charges, call your PCP’s office and ask what those charges were for. You can also check the bill against the Explanation of Benefits (EOB) that your insurer is required to send you after your medical provider has filed a claim. An EOB will detail exactly what your medical insurance covers and what it has paid toward this claim.

If you see discrepancies between your bill and your EOB, talk to your doctor’s office, explain the discrepancies, and ask them to review and fix the charges. If your insurance provider has not covered something they are supposed to, you should also contact them to review your case. You may need to file an appeal – make sure to do this as soon as possible to avoid your bill going to collections. See HERE for a more detailed, step-by-step outline.

You may not have to do this on your own. Check to see whether your employer provides access to third-party vendors like Health Advocate or Alight. These companies will help you review your benefits and dispute charges you think were made in error.

What to Do if Your Medical Bill Has Mistakes (webmd.com)
This simple form can keep you from overpaying for medical care (cnbc.com)

Aging Out: Finding Insurance At 26

With the passage of the ACA, health plans and insurers that offer dependent child coverage are legally required to let children under the age of 26 stay on their parents’ health care plan, regardless of whether the adult children have gotten married, had a child of their own, or are no longer tax dependents.

After their 26th birthday, however, in most cases adult children are no longer eligible for their parents’ plans. If you have a child who is nearing 26, now is the time to help them take steps toward getting their own healthcare benefits.

If you live in Florida, Nebraska, New Jersey, New York, Pennsylvania, or Wisconsin, you may have a little more time. These states allow your adult child to apply for a health insurance rider, which would allow them to remain on your insurance a while longer. The rider requirements and extensions vary by state – see HERE for more information.

If you don’t live in one of those states, or your child is not eligible for a rider, and you have employer-sponsored health insurance, your child has until the end of the month that they turn 26 to sign up for a plan of their own. There are several options for your child:

Employer-sponsored coverage: if your child works full-time (or even part-time, in some instances), they are likely eligible for their company’s health insurance plan.

School coverage: many universities offer student health insurance coverage, so if your child is attending a university, they should check out this option.

Private health insurance: your child can check out any healthcare provider to see what private plans they offer, though these can be more expensive than employer- or state-sponsored plans.

State/federal health insurance: your child may seek coverage through their state health insurance marketplace or the federal marketplace. After turning 26, they will have a special enrollment period of 60 days to sign up for a plan through their state health insurance marketplace.

This transition can seem like a stressful venture, but it doesn’t have to be. Researching the best option ahead of time will make this process much easier for you and your adult child.

Health Insurance Coverage For Children and Young Adults Under 26 | HealthCare.gov
Turning 26: Health Insurance Guide for Those Aging Off Their Parents’ Plan – HealthCareInsider.com

Pushing Past Implicit Bias

None of us like to think of ourselves as prone to bias — subconscious or conscious judging others based on any number of stereotypes we have internalized.

Nevertheless, it is important for a fair, healthy, and functioning society (and workplace) for us to think about the way that we think about others. While race and sex tend to be the best-known types of biases, bias can be based on personal appearance, age, religion, and many other factors.

It’s important to note that bias does not equate to moral failure. We all have unconscious biases. This stems in part from the human need to sort things into different mental boxes. This organization is not in itself intrinsically good or bad, but it can lead to us unfairly associating certain traits with certain people based off stereotypes or ideas by which we make judgments. Our unconscious biases may even run counter to the beliefs that we actually hold, but sometimes we act on them anyway (hence, “unconscious” bias).

The good news is that there are ways for us to overcome our implicit individual biases. To start, we must cultivate self-awareness – we must recognize that we have implicit biases and uncover what they are specifically (this test is a helpful place to start). Experts in the field note that we are more likely to act on our implicit biases when things are moving quickly, so taking a moment to slow down and think about why you feel a certain way about someone is crucial to unraveling bias. Click HERE to learn more about personal and systemic bias.

Ups And Downs: Understanding Bipolar Disorder

Have you ever seen someone struggle to make a decision, change their mind in rapid succession, and laugh it off, saying “I’m so bipolar”?

While that label can get thrown around casually, bipolar disorder is a very real and sometimes dangerous condition. A basic overview can help us understand the condition’s symptoms and effects on everyday life.

The key features of this disorder are cycling periods of mania (or hypomania, which is less intense than mania) and depression. Manic periods are characterized by euphoria, recklessness, energy, and restlessness. People experiencing mania or hypomania are more likely to make risky decisions, not sleep enough, and have trouble focusing.

Depressive periods are characterized by disinterest in life, sadness, loss of energy, lack of appetite, and even sometimes suicidal ideation (see HERE and HERE for more on depression). The symptoms are broadly the opposite of manic symptoms but can impact one’s daily life just as severely.

There are several disorders in this cluster that are all characterized to varying extents by these periods of mania, hypomania, and depression. The good news is that bipolar disorders are treatable, most often through a combination of medication and therapy. If any of these symptoms sound familiar to you and are impacting your life, talk to your doctor. There is no shame in seeking help.

If you are experiencing suicidal thoughts, call the Suicide Prevention Lifeline at 988 or text HOME to 741741 to chat with a crisis counselor.

Pearly Whites

It’s easy to see photos of celebrities and models with brilliant white teeth and want that for ourselves. There are many methods that purport to lift the color of our teeth by removing stains, but some of them are safer – and more effective – than others.

Brush your teeth with a paste made of baking soda and water (or use a toothpaste that contains sodium bicarbonate). After a few weeks, the baking soda will gently remove stains from your teeth. Limiting intake of staining beverages such as coffee, tea, and red wine will help your teeth stay whiter.

There are many charcoal-based products to lighten teeth. However, a recent study shows that charcoal does not remove tooth stains. Charcoal can actually harm your teeth over time by wearing down the top layer of your enamel.

There are over-the-counter toothpastes and whitening trays that contain hydrogen peroxide, which gradually whitens your teeth. Look for products that contain the American Dental Association’s seal of approval and follow the instructions for the best results. There are some possible side effects, such as sensitive teeth and gum irritation.

Professional teeth whitening is also an option, and likely the safest bet. Talk to your dentist about what option is best for you.

Teen Eating Disorder Warning Signs

Eating disorders are on the rise.

According to the American Journal of Clinical Nutrition, eating disorder prevalence increased from 3.4% to 7.8% globally between 2000 and 2018. And according to Johns Hopkins, 95% of people with eating disorders in the U.S. are between ages 12 and 25.

An eating disorder is a focus on food and bodyweight that causes a person to go to extremes when it comes to eating — everything from restriction to binging. They’re more common among teenage girls but can affect teenage boys, too. The earlier eating disorders are diagnosed and treated, the more likely the probability of complete recovery. However, many adolescents go undiagnosed and do not receive treatment until their eating disorder is at an advanced stage.

Teens with eating disorder often try to hide their behaviors from friends and family, so it’s important to look out for these signs that indicate symptoms of an eating disorder:

  • Changes in what, when, and how much they eat
  • Being restrictive or regimented about their eating
  • Unusual weight fluctuations
  • Expressing unhappiness with their body or their weight
  • Exercising much more than usual
  • Spending a lot of time in the bathroom

Prevention is key, and it begins with open communication. Talking to your children about the following will help them understand what it is to have a healthy relationship with food and body image.

  • Encourage healthy-eating habits – Discuss how diet can affect your health, appearance, and energy level. Encourage your teen to eat when they are hungry. Eat together as a family.
  • Discuss media message – Television programs, movies and social media can send the message that only a certain body type is acceptable. Encourage your teen to question what they have seen or heard.
  • Promote a healthy body image – Talk to your teen about their self-image and offer reassurance that healthy body shapes vary. Don’t make or allow hurtful nicknames, comments or jokes based on a person’s physical characteristics, weight or body shape.
  • Foster self-esteem – Respect your teen’s accomplishments and support their goals. Listen when your teen speaks. Look for positive qualities in your teen, such as curiosity, generosity, and a sense of humor. Remind your teen that your love and acceptance are unconditional — not based on their weight or appearance.
  • Share the dangers of dieting and emotional eating – Explain that dieting can compromise your teen’s nutrition, growth, and health, as well as lead to an eating disorder. Remind your teen that eating or controlling their diet isn’t a healthy way to cope with emotions. Instead, encourage your teen to talk to loved ones, friends or a counselor about problems they might be facing.

If you suspect your teen is experiencing disordered eating, talk with them and reach out to their pediatrician immediately. Visit National Eating Disorders (NEDA) for more information.

Sources:

https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-eating-disorders/art-20044635
https://healthyteenproject.com/about-eating-disorders/
https://www.health.harvard.edu/blog/eating-disorders-spike-among-children-and-teens-what-parents-should-know-202204212731

Child Vaccines

Mumps, diphtheria, polio – these all sound like old-timey diseases you could only risk contracting in the Oregon Trail video game.

However, it wasn’t all that long ago that there were no vaccines for many of these severe and potentially life-threatening diseases. Vaccines for measles, mumps, and rubella – combined now into the MMR shot – were developed between 1963 and 1969 – only a few years before the original Oregon Trail game itself was developed in 1971.

These diseases are highly uncommon today because vaccines are highly effective when given to very young children, who have underdeveloped immune systems. Some parents worry about vaccinating their infants, having heard that vaccines can cause autism or otherwise hurt their children. However, vaccines are extremely safe. The Federal Drug Administration requires years of development and stringent testing, and monitors use and side effects of vaccines after releasing them.

The idea that vaccines cause autism has been thoroughly debunked. The original study that suggested a link was retracted years ago due to blatantly unethical research methods. There is no evidence that vaccines cause autism in any way. There are often some mild side effects to vaccination, such as a sore arm and occasional mild fever. Very rarely a child will be allergic to a vaccine component and experience more severe side effects (a 2015 study indicates this is literally a one-in-a-million chance). In rare cases, some health conditions, such as weak immune systems or cancer, make certain vaccines not an option for certain children (see a full list broken out by vaccine HERE).

Vaccinating your child also helps protect other children who may be immunocompromised or unable for other health reasons to receive certain vaccines. If you are experiencing any concerns about vaccinating your child, take time to talk to their pediatrician. The doctor will be able to answer any questions you have and help you ensure your child is protected from easily preventable diseases.

Vaccine Safety FAQs for Parents and Caregivers | Vaccine Safety | CDC

Childhood vaccines: Tough questions, straight answers – Mayo Clinic

What Every Parent Should Know About Immunizations (stanfordchildrens.org)

Collagen Supplements

If you’ve ever done a quick Google search on how to thicken your hair, improve your skin, or even help with arthritis pain, it’s likely that collagen supplements popped up.

Collagen, the most prevalent protein in the human body, forms a type of tissue that helps comprise bone, skin, muscles, tendons, and cartilage. It helps keep your joints healthy and your skin elastic.

The human body makes collagen naturally, but this production can decline with age. Collagen is also reduced by smoking, excess sun exposure and alcohol, and stress. Therefore, proponents of collagen supplements suggest the product will help your joints and skin.

While there are some limited studies that suggest collagen supplements may help with skin hydration and elasticity and joint pain, the body of research is simply not developed enough to promote collagen supplements. Problematically, many of these studies are sponsored by or tied to organizations that would financially benefit from positive study results. Overall, the FDA does not test supplements for safety, and one independent review found heavy metals present in a particular brand of supplement.

While the available research is inconclusive, it has not turned up evidence to deter anyone from taking collagen supplements. There are, however, steps you can take to boost your own collagen production. Eating foods like eggs, dairy products, legumes, fruits, some nuts, and vegetables will provide your body the building blocks to make collagen. Reducing stress, excess exposure, and caffeine and alcohol intake will help slow the loss of collagen you already have.

Oral supplementation of specific collagen peptides has beneficial effects on human skin physiology: a double-blind, placebo-controlled study – PubMed (nih.gov)
Collagen | The Nutrition Source | Harvard T.H. Chan School of Public Health
Health Benefits of Collagen: Pros and Cons, Nutrition, and More (webmd.com)

Student Loans

There is no doubt that the subject of student loan debt has become incredibly contentious over the last few years.

The U.S. Department of Education has once more extended a pause on student loan payments in light of the ongoing Covid-19 pandemic. Before we dive into ways to address student loan debt, let’s take a look at the big picture.

The average cost of full-time college at a four-year institution (tuition, fees, room, and board) in 1980 was $3,167 for one year, or $9,307 (adjusted to 2019-20 dollars). The average cost in 2019-20 was $25,281. See HERE for a further year-by-year breakdown, which also includes tables differentiating private and public institution costs.

Student loan debt in the US totals $1.747 trillion. In a regular year, the total debt grows 6 times faster than the nation’s economy (like everything else, the pandemic has affected this rate in 2020-22). The U.S. Department of Education holds 92% of outstanding student loan debt, totaling over $1.611 trillion.

43.4 million people have federal student loan debt. The average federal student loan debt balance is $37,113, or potentially as high as $40,904, including private loan debt. The average public university student borrows $30,030 to attain a bachelor’s degree. The average interest rate for federal student loans is 4.12%, and 5.8% when factoring in private loans.

It is projected that for 2021 graduates, it will take the average four-year undergraduate degree borrower 7-9 years to pay off their loans, and the average graduate degree borrower 13-18 years. The average doctoral degree borrower will take 13-38 years.

Unlike other kinds of loans, it is extremely difficult to have these loans discharged due to bankruptcy. The U.S. Student Aid website says one may have some or all of one’s loans forgiven only if paying them off will leave a borrower unable to maintain a minimal standard of living, among other qualifications.

It is possible to chip away at student debt over time. Consider enrolling in autopay to ensure your monthly payments are made. Check to see whether your company has any programs to help pay employees’ student loans. You can also refinance your loan to secure a lower interest rate (though note that this path may entail a shorter repayment period and bigger monthly payments). Click HERE for additional strategies to help pay off student debt more quickly.

MeasureOne Research and News-Private Student Lending | Research Report
Student Loan Debt Statistics [2022]: Average + Total Debt (educationdata.org)
MeasureOne Private Student Loan Report Q3 2021 (hubspotusercontent00.net)
Average Student Loan Interest Rate [2022]: New & Existing Loans (educationdata.org)

FMLA: Ensuring You Can Take Time Away

If you’ve been in the workforce for a while, it’s likely you have a set number of sick and vacation days. The average American worker has 7-8 paid sick days, but some years that just isn’t enough time. Between prolonged sickness, birth or adoption of a child, or family illness, you may need a longer block of time away from work.

In 1993, Congress recognized the need for extended time away from work and passed the Family and Medical Leave Act (FMLA). This act allows eligible employees to take up to 12 unpaid weeks off from work with the guarantee that they will be reinstated at the end of their leave or be given an equivalent position. It also guarantees that employees keep any benefits they had before the leave period began (for example, you would not lose your medical coverage if you had accrued it before taking leave). The FMLA applies to all public agencies, public and private elementary and secondary schools, and companies with 50 or more employees.

There are multiple reasons one may qualify to take FMLA-covered leave (this list is not exhaustive, but a full list of requirements can be found HERE):

  • The birth, adoption, or foster care placement of a child within one year
  • Taking care of an ill spouse, child, or parent
  • Being too ill to properly do one’s own job
  • Emergencies related to the employee’s spouse, child, or parent being a covered military member on active duty

Additionally, in order to be eligible, one must:

  • Have worked for their employer at least 12 months
  • Have worked at least 1,250 hours over the past 12 months
  • Work at a location where the company employs 50 or more employees within 75 miles

If you need to apply for FMLA, the best place to start is your company’s Human Resources department. They can let you know whether you are eligible and help you through the application process if you are.

Fact Sheet #28: The Family and Medical Leave Act | U.S. Department of Labor (dol.gov)

Private industry workers with sick leave benefits received 8 days per year at 20 years of service : The Economics Daily: U.S. Bureau of Labor Statistics (bls.gov)
The Family and Medical Leave Act (FMLA): The Basics | Bipartisan Policy Center