• Share

PRINT

As we all know, the U.S. healthcare system is very complex. No matter what stage of life you are in, it is crucial to understand your options to obtain the best care in the most cost-effective way.

Philip Moeller, author of the popular Get What’s Yours series, has a new book that will prove invaluable. Get What’s Yours for Health Care: How to Get the Best Care at the Right Price (Simon & Schuster) will help you find the best, most cost-effective health insurance, physicians and hospitals.

You will get a better understanding of the healthcare you need and what it really costs. You will also learn how to reduce the cost of prescription drugs and how to handle your medical debt.

The book covers many aspects of private health insurance coverage and useful details about deductibles, co-pays and co-insurance. Moeller discusses high-deductible plans and the many tax advantages of health savings accounts, including after you retire.

The book outlines the 10 essential benefits all plans must cover under the Affordable Care Act, as well as the six health conditions they must cover. Moeller covers the differences among the four types of ACA plans and identifies the tax benefits of ACA.

There’s a section on the Veterans Health Administration, which covers about 9 million veteran enrollees, providing services at 170 medical centers and 1,100 outpatient clinics.

Studies regularly find VA care is comparable or even superior to private care, and often less expensive. VA eligibility categories depend on service records. Eight priority groups are identified specifying eligible benefits.

Medicare and Medicaid

The book covers all components of Medicare, including whether you need it. No one is required to get Medicare. If you continue working after 65, your options are discussed.

Medicare Advantage (MA) plans, offered by private companies — which must include all the features of Original Medicare (including Parts A and B) — are discussed. Advantage plans, which are known as part C, include some benefits not offered by Original Medicare. They now account for more than 35% of Medicare coverage.

Although traditional Medicare does not provide health coverage outside the U.S., some Medicare Advantage and Medigap supplemental plans do provide emergency coverage up to $50,000.

Medicaid has surpassed Medicare as the government’s largest healthcare program. This has happened because of the ACA expansion incorporated by the majority of states. Eligibility and coverage rules vary by state.

Medicare does not cover nonmedical care that disabled and older people need, such as custodial care, referred to commonly as long-term care. Medicaid does cover this type of care, but the eligibility requirements regarding income and assets are complex.

While the book provides helpful information, you should consider the guidance of an elder care attorney, or an attorney with expertise regarding Medicaid regulations, if you wish to qualify for coverage.

Find the best-rated doctors, hospitals, treatments and more

Prescription drug coverage can be a complicated topic. The book will give you a good understanding of the rigid rules associated with the timing of enrollment.

The book discusses which tests and procedures are necessary, so you can avoid unnecessary expenses.

You will learn how to build a personal health team to support you and execute documents on your behalf. You will learn how to use a long-term professional care team made up of specialists, clinics and physicians.

The book has great advice on finding reliable rating services to identify the best quality providers, accurate pricing information so you can shop for cost-effective doctors, procedures and prescriptions, and which tests and procedures are actually necessary.

Get What’s Yours for Health Care contains valuable appendices such as: centers of excellence, by category of treatment; top-rated preventive care measures; and the most reliable rating sites for doctors, hospitals and nursing homes.

You will find this book essential for making intelligent healthcare decisions for all your family members.

Elliot Raphaelson welcomes your questions and comments at raphelliot@gmail.com.

© 2020 Elliot Raphaelson. Distributed by Tribune Content Agency, LLC.