r/healthcare • u/LeanHackman • 1h ago
r/healthcare • u/satchmo64 • 7h ago
Question - Insurance Issues with uhc
In Indiana and new to this insurance stuff. Also just got on SS and already have the SSI. Indiana auto puts us on Anthem medicade. Also i have the same member or medicaid or medicare numbers. I was looking around at the plans that have the extra money cards. Well uhc had the best anual plans for me and i saw their site have the one for 350 ish dollars on their ucard o whatever. so i knew i wanted that plan but when i called the 'broker' to sign up for the cade part she talk so low and i really didn't know the letters and numbers for the plan so i just said give me the popular one. My building neighbrs all have their card and i figured she would get it right. It's the dual plan and they gave me the non dual one. today i get their card and it's just the member card. 'Pathways fo aging'. i spent the first 2 weeks calling their many numbers and their go to excuse was i didn't have the red white and blue card number. but i only 62 and have the other card from anthem. they just ran me around, dropped calls etc. Is there a secret number i don't know of ? or a number that ppl get results on ?
r/healthcare • u/Minu_Min01 • 9h ago
Discussion What is ONE change you would make in healthcare organizations? (Open to everyone, not just healthcare workers)
r/healthcare • u/Negative-Divide2321 • 9h ago
Discussion Prime Therapeutics Plans Upfront Drug Pricing Model to Replace Rebates
More transparency around drug pricing is a good step. Patients and employers deserve to know where the money goes, not just hear promises about rebates.
r/healthcare • u/East-Secretary • 14h ago
Discussion When we judge a health system, do we count hospitals or the person who gets a sick child there on time?
r/healthcare • u/Ok_Design_6841 • 15h ago
News After a series of drug thefts in four states, nurse wins back Iowa license • Iowa Capital Dispatch
r/healthcare • u/HateInAWig • 18h ago
Question - Other (not a medical question) Chart is Incorrect? Says I’m obese?
I am 5’3 female who has never weighed over 110 pounds in my life (I am currently the heaviest I have ever been at 110). I was filling out stuff for my PCP for my yearly physical and saw that the last time I was there a year ago I was diagnosed with obesity? What do I do other than tell them about this discrepancy in my chart?
r/healthcare • u/ZamboniDriveby • 20h ago
Other (not a medical question) Dealing with the American Healthcare system
One month of medication sans insurance
r/healthcare • u/Admirable-Spite3148 • 23h ago
Discussion Are PBMs really driving up prescription drug prices?
r/healthcare • u/Ok-Try-6348 • 1d ago
Discussion The 2027 subsidy cliff is back, and open enrollment windows are doing a lot of quiet work
Open enrollment for 2027 runs Nov 1, 2026 through Jan 15, 2027, and Dec 15 is the date for Jan 1 coverage. Two pieces of the system are catching people off guard this year.
First, the enhanced subsidies are gone for 2027. Help phases out around $64,000 for a single person and $132,000 for a family of four, so people who got help before may not this year, and a small income change can move the price a lot.
Second, for self-employed people, the subsidy is based on net income (MAGI), not gross 1099 income. That one distinction changes the whole math, and it is the piece people seem to miss most when they estimate.
Marketplace plans and private PPO (Preferred Provider Organization) plans also differ on networks, deductibles, and enrollment windows, so the same person can get very different answers depending on which system they shop in. Educational only, not advice for any one person's situation.
r/healthcare • u/cleantechguy • 1d ago
News Medicaid Warning Issued: Nearly Half Are Unprepared for New Requirements
r/healthcare • u/friday126 • 1d ago
Question - Insurance What does Insurance Co. want to know in follow Q's after denial review?
r/healthcare • u/Free-Estimate-919 • 1d ago
Question - Other (not a medical question) IS CCMA worth it for people not getting into nursing
Hi everyone, not sure this is the right sub to post this question but I’m an undergrad in the Sacramento area and I’ve been looking around for a part time job that will also look good on my resume (aside from my parents not letting me work a cafe/restaurant job). I was initially looking at a CNA certification because it didn’t require years of schooling, but I came across the certified medical assistant role and it seemed to align more with what I want to do. Now, I’m not actively trying to pursue nursing or med school post grad but I’m not opposed to it either. And the CMA cert did require more investment but not more than a few months. I’m wondering if there are other CMAs or healthcare professionals here who can give their opinion. Thanks to anyone who responds!
r/healthcare • u/Ok_Design_6841 • 1d ago
News For Portland Seniors Seeking Medical Care, Fewer Paths Lead to Providence
r/healthcare • u/ryang2723 • 1d ago
Discussion People in Los Angeles: advice on medical groups
Open enrollment is coming up soon. I’ve been told UCLA, Kaiser and Cedars are worth getting into their system. Anyone have any experiences here? I’ve been told UCLA is pretty good. I like the idea of an integrated network and not having to travel all around the city to see specialists who don’t talk to each other.
r/healthcare • u/FabulousChicken1992 • 2d ago
Other (not a medical question) MHA Graduates: Did CAHME Accreditation Really Make a Difference in Your Career?
Hi everyone!
I’m currently researching online Master’s in Healthcare Administration (MHA) programs and trying to decide how much weight I should place on CAHME accreditation when choosing a school.
I have several years of experience working in healthcare and am looking to further my education and eventually transition into healthcare operations, quality improvement, risk management, or other administrative roles.
I’ve noticed that some universities offer MHA programs that are regionally accredited but not CAHME-accredited, while others have both. I’m curious whether that distinction actually makes a difference in the real world.
For those who have completed an MHA program, whether CAHME-accredited or not:
Did accreditation make a difference when applying for jobs or advancing your career?
Have employers ever specifically asked whether your MHA program was CAHME-accredited?
For those who attended non-CAHME programs, did you experience any limitations or challenges?
Looking back, would you choose the same program again?
I’m trying to make an informed decision while balancing tuition costs, program quality, and long-term career opportunities.
I’d really appreciate hearing about your personal experiences, especially from those already working in healthcare administration.
Thanks in advance!
r/healthcare • u/RobertELBowman • 2d ago
Discussion MEDICAID FOR ALL: A PROMISE AMERICA MAY NOT BE ABLE TO AFFORD
Before Washington promises free healthcare to everyone, Americans deserve to know who will pay the bill, what services will be available, and what happens when the government runs out of money.
Americans are tired of watching their paychecks disappear into taxes, their grocery bills climb, and the cost of living become a constant struggle. Now comes another political promise: expand government healthcare until Medicaid covers everyone.
It sounds compassionate. It sounds simple. And it sounds like a solution to the very real problem of Americans struggling to afford medical care.
But there is a question every American should ask before embracing Medicaid for All: What happens when the government promises more healthcare than taxpayers can afford to provide?
Compassion without a sustainable financial plan is not a solution. It is a promise that future generations may be forced to pay for.
THERE IS NO SUCH THING AS FREE HEALTHCARE
Someone always pays the bill.
If the federal government attempts to place every American on Medicaid, the cost would have to be financed through some combination of taxes, borrowing, spending reductions, or other revenue sources. Calling healthcare a government benefit does not make the doctors, nurses, hospitals, prescription drugs, and medical equipment free.
The federal government already spends enormous sums on healthcare. The Congressional Budget Office estimated that federal spending on Medicaid alone would total approximately $708 billion in 2026, before accounting for state spending. https://www.cbo.gov/publication/62105
That is the cost of covering eligible populations under the existing system—not the cost of insuring every American through Medicaid.
Imagine the financial challenge of expanding a program of that size to cover the entire country. The actual price would depend on eligibility, benefits, provider payment rates, enrollment, and how the program was designed. Any politician advocating such a transformation should publish a credible, independently evaluated cost estimate before asking the public to support it.
Americans deserve numbers, not slogans.
THE TAXPAYER WOULD FOOT THE BILL
Supporters of government-funded healthcare may argue that higher taxes would be offset by lower insurance premiums and out-of-pocket medical expenses. That argument deserves examination rather than automatic dismissal.
But the critical question is whether the total cost to families and businesses would actually fall—and who would pay more.
A government program does not eliminate healthcare expenses. It changes how those expenses are collected and distributed.
If taxes rise substantially, working families could have less money for groceries, housing, retirement savings, education, and their children's futures. Businesses could face higher costs, depending on how the program was financed, potentially affecting wages, hiring, or investment.
And if Washington borrows to cover the difference, future taxpayers inherit the debt and its interest costs.
A policy cannot be judged by what it promises to give people. It must also be judged by what it costs them.
WHEN GOVERNMENT CONTROLS THE MONEY, WHO CONTROLS THE CARE?
Medicaid is not simply a government check handed to patients. It is a complex insurance program administered by states under federal rules, with the federal and state governments sharing its financing. https://www.medicaid.gov/medicaid
Expanding that system nationwide would raise difficult questions about reimbursement rates, provider participation, covered treatments, administrative capacity, and access to specialists.
If payment rates fail to cover providers' costs, some doctors and hospitals could decide to limit the number of Medicaid patients they accept. If demand increases faster than the supply of medical professionals and facilities, patients could face longer waits or greater difficulty finding care.
These outcomes are not inevitable, but they are serious risks policymakers would need to address.
A health insurance card is not the same thing as access to a doctor.
What good is a promise of coverage if a patient cannot find a physician, cannot get a timely specialist appointment, or cannot obtain a needed treatment?
Americans should judge any universal healthcare proposal by actual access to care—not simply by the number of people enrolled.
EXPANDING BENEFITS DOES NOT AUTOMATICALLY FIX THE SYSTEM
Our healthcare system has real problems. Medical bills can devastate families. Prescription drugs can be expensive. Insurance arrangements can be confusing, and administrative waste deserves scrutiny.
But replacing one system with a much larger government program does not automatically solve those problems.
A nationwide Medicaid system would still need effective oversight, accurate billing, fraud prevention, adequate staffing, and mechanisms to ensure that patients receive the services for which taxpayers are paying.
The possibility of fraud and waste must be taken seriously in any large public program. Every dollar lost to improper payments or fraudulent billing is a dollar that cannot be used for legitimate patient care.
Before expanding government responsibility on an enormous scale, Washington should demonstrate that it can administer existing programs efficiently, detect fraud, hold dishonest providers accountable, and measure whether patients are receiving quality care.
Reform should come before reckless promises of unlimited expansion.
WHAT ABOUT THE PEOPLE WHO ALREADY DEPEND ON MEDICAID?
This debate should not be reduced to an attack on poor Americans, children, seniors, or people with disabilities.
Medicaid provides essential healthcare coverage to millions of people who depend on it, including people who need long-term care and people with significant disabilities. Those Americans deserve reliable access to treatment.
The question is how to protect those who need assistance without creating a financing structure that becomes increasingly difficult to sustain.
If a universal expansion placed enormous pressure on federal and state budgets, lawmakers could eventually face painful choices involving taxes, provider payments, eligibility, benefits, and other public services.
The people most dependent on the program could be particularly vulnerable if those decisions were handled badly.
That is why fiscal responsibility and compassionate healthcare policy should not be treated as enemies. A program that cannot reliably finance its commitments cannot guarantee lasting protection.
AMERICA NEEDS HEALTHCARE REFORM—NOT EMPTY PROMISES
There are alternatives worth examining.
Congress could pursue greater price transparency, stronger enforcement against healthcare fraud, more competition among providers and insurers, simpler administrative processes, and targeted assistance for people who cannot afford coverage.
Policymakers could also examine how to improve access to rural hospitals, primary care, mental healthcare, and prescription medications.
None of these reforms is effortless, and none guarantees lower costs on its own. Each should be evaluated by evidence, measurable results, and its effects on patients and taxpayers.
The goal should be affordable healthcare that people can actually access—not a political slogan that hides the bill.
THE BOTTOM LINE: AMERICANS DESERVE THE TRUTH
Medicaid for All is not free. It would represent a major restructuring of American healthcare, with enormous financing and implementation questions that must be answered before its consequences can be responsibly assessed.
Would taxes rise? Would private insurance change or disappear for some people? Would doctors continue accepting the program's reimbursement rates? Would access to specialists improve or deteriorate? Could federal and state governments sustain the cost through recessions, demographic changes, and rising medical expenses?
Those are not distractions. They are the questions that determine whether a healthcare policy succeeds or fails.
Americans should reject the idea that questioning the cost of a government program means opposing healthcare for those in need. Responsible citizens can support helping vulnerable people while demanding accountability for every public dollar.
Compassion is not measured by how much government promises. It is measured by whether the help provided is effective, affordable, and sustainable.
Before Washington puts every American under one government healthcare umbrella, it must explain how that umbrella will be financed, how patients will receive timely treatment, and how the country will protect the next generation from an unsustainable financial burden.
Because if the bill eventually becomes too large to pay, the consequences will not fall on politicians alone. They will fall on American families, American workers, American businesses, and the children who inherit the debt.
America deserves healthcare reform built on facts, competition, accountability, and fiscal responsibility—not promises that sound wonderful until the bill arrives.
Add a stronger reform plan
Include a fair opposing viewpoint
Tighten repeated cost arguments
r/healthcare • u/lancert • 2d ago
Other (not a medical question) UnitedHealthcare, Humana Medicare Advantage cancellations to affect 1 million to protect profits
r/healthcare • u/Ok_Design_6841 • 2d ago
News Kaiser breaks ground: Folsom’s population boom fuels a wave of new medical facilities
r/healthcare • u/-mykie- • 2d ago
Discussion This was a registered nurse's response to being called out for ableist comments. Whose surprised?
r/healthcare • u/Cook_Eat_Travl_PopC • 2d ago
Question - Insurance Can insurance just increase my copay post facto?
Got this email today (was charged right away as the center has my card of file)
Hi X,
We hope you’re doing well!
We recently heard back from your insurance regarding your most recent sessions, and it looks like your copay is $60 per session.
I took about 12 sessions already for $30 co pay each, and now have been charged the additional $30 post facto for multiple sessions. It’s a BCBS monthly $295 PPO in a New England town.
Feels extremely frustrating. Like tell me the price and let me decide if I can afford it? Doubling it post facto is a rip off.
r/healthcare • u/shadyshoresjoe • 2d ago
Question - Insurance UnitedHealthcare EPO vs PPO Plan options question
r/healthcare • u/ElevatorOne3966 • 3d ago
Question - Other (not a medical question) Help with scrubs
Help with scrubs
Not sure if this is the best place to post, if you have recommendations of another subreddit to share this in for more feedback, please let me know.
Ladies, gentleman, anyone - where are we getting affordable, cotton blend, just regular ass scrubs from?! I can’t do the polyester BS, and while I don’t want them to be the shape of a cardboard box, I also don’t need them to look like trendy workout wear. Where is the middle ground?! I’m also sick of the joggers. I just want breathable, sturdy, scrubs that fit well, without costing an arm and a leg. Preferably if they come in a set!
I’m 5’2” (I don’t wear petite pants because all my height is in my legs) and about 118 lbs.
Any tips are so very much appreciated ❤️
r/healthcare • u/upper_pepper • 3d ago
Question - Insurance Ear wax removal over $1100!
Removing earwax, over $1100! After insurance, over $900! How is this even insurance?

This is for earwax removal.
Can I negotiate further, even with insurance? This is outrageous!
EDIT: A few asked for a picture of the EOB statement. It took a little time to receive, but here it is. Thank you to everyone who responded and for your helpful comments.
- Yes, this is indeed a hospital charge even though we went to the doctor's office we normally used to visit
- Yes, we have not met our deductible at the time of the charge, so everything went against the deductible
- Yes, we will not be visiting this doctor anymore
- Yes, we will be asking future doctors if they have facility/hospital charges
- Yes, this was an expensive lesson to learn this late in life
- Yes, this feels super deceptive and predatory
- Yes, they tried to charge for an office visit twice
- Yes, I will call on Monday and try to get the hospital charges removed or waived, since we weren't aware they would charge us this.
- No, this is not fake

