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The Pharmacist Answers Podcast

Have a question for the pharmacist? Get your answers here! Clear explanations about complicated medical topics that anyone can understand. Disclaimer: The information contained in this blog and related podcast are not to be taken as medical advice, they are for informational and educational purposes only. If you resemble anything that is mentioned in this blog or related podcast, contact your doctor. The information contained in this blog and related podcasts is the opinion of the author and does not relfect the views of her employer, Walgreens. If you want to know what Walgreens thinks, ask Walgreens!
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Now displaying: May, 2016
May 26, 2016

Collaboration is a hot topic in many arenas these days, but healthcare seems to still struggle with it.

My friend, Ronei Harden, has a periscope show called Coffee Talk and she has talked a lot about collaboration.  You can watch her live, or see some of her older conversations on her YouTube channel.

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

May 16, 2016

If you're a fan or follower of Jon Acuff, you will have heard of 30 Days of Hustle.  Started as a set of emails and a facebook group, but has become as way of life for many.  It may be too late to join in Jon's #30DOH community, but it's never too late to start hustling!  (And I'm not representing Jon or 30DOH, just a fan...because with them, this wouldn't be here!)

Not a lot of information today, but here's the take-home message...

Treat those you encounter in the healthcare arena with respect, and confidently and respectfully demand they do they same.

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

May 9, 2016

2 Tips to make using your insurance cards go smoothly

  1.  Know your cards
    Different companies print and send their cards differently, so you need to be familiar with yours.
    1. Medical card: if it doesn't say "Major Medical" or "Health Plan", look for clues like copay structure (UC $10/Spec $25/ER $75) to indicate what copay you will pay at which type of healthcare business.
    2. Dental card: should say "Dental", nothing else special about it.
    3. Prescription card:  Some prescription insurance companies have names with "Rx" in it, which is the abbreviation for prescription or pharmacy.  Other times, there will be numbers or codes that are labeled "Rx Bin" or "Rx Group".  Sometimes this info will be in a little box on the side of the Medical card.
  2. Don't let logos lie to you
    Sometimes insurance companies are managed by an umbrella company that may also own a large retail chain pharmacy.  They will put their logo on the card in big, bright print.  This does not always mean that is the only place you can go for prescriptions.  Don't let it fool you!

Kaiser Permanente can be a great healthcare solution for some people, but not every company is for every person.  They have their own extra set of rules. So, if this is your insurance company, make sure you know their rules, so you don't get stuck without care or with paying a lot of money for care.

Following these two steps can ensure that you do not have interrupted to delayed care, and that you hang on to your power to choose where you get care!

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

May 2, 2016

Terminology
- Premium - it is like paying dues to be in the club, and being in the club means that the insurance company will have to pay for your care if you get sick or hurt.  
- Deductible - a portion of costs that you are 100% responsible for before the insurance company chips in.  Low premium = high deductible.
- Copay - Co = together, pay = payments; you and your insurance are paying the total bill together.  Copays are usually standardized, and are a price predetermined by the insurance.  Medication copays are broken down into Tiers.
- Coinsurance - rather than a set price, it's a set percentage.  Based on the total cost of the service, the price you pay may change.
- Out Of Pocket - OOP; some insurances keep track of all the money you pay and they have a limit (called Lifetime Maximum or Lifetime Limit).  If your costs reach that limit, the insurance will take care of everything after that.
- Formulary - a list of medications that insurance decides they will pay for.  Insurance can change this whenever they feel like it.
- Prior Authorization - insurance requires the payment of a particular medication or service to be authorized prior to them paying for it and/or you receiving it.  Usually require documentation and justification from your doctor.
- Networks - Providers in the Network usually have a negotiated discount or other beneficial contract with the insurance, which will translate to lower costs for you.
- HSA - Health Savings Account; YOUR money that you put back to use to pay for healthcare costs in the future.  Does roll over.
- HRA - Health Reimbursement Account; an incentive from your employer or insurance for you do things to prevent illness, and then THEY will give you money to pay for your healthcare costs.  Does roll over.
- FSA - Flex Spending Account; YOUR money that you put into an account to pay for healthcare costs or health related items (some OTC things are approved).  They usually require receipt submission to prove you purchased approved items.  But if that money is not used by the deadline, it does NOT roll over, you do not get it back.

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

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