Episode 69: What to know about your Health insurance, Medicare and the role of PBM’s
Health Insurance continues to be a very complex, difficult to understand and in many instances less than transparent entity.
This episode explores health insurance from multiple perspectives (individuals, employers, health care providers and care delivery organizations.
The role of Pharmacy Benefit Managers (PBM’s) is also explored
Guest:
Dr Jeffrey Frankel, MD, Is a Past President of the Washington State Urology Society, a Past President of the Western Section of the American Urological Association, a Past President of the American Association of Clinical Urologists, and he currently chairs the Government Affairs Committee for the Washington State Urology Society He has practiced Urology in the King County area since1985.
During This Episode We Discuss:
What is your responsibility regarding your insurance coverage prior to visiting a medical providers office, undergoing a procedure or study and or surgery.
How does your coverage differ from someone else who might be under the same plan
What happens when you are in Network or out of Network.. What does that mean?
What happens when you care provider becomes employed by a healthcare entity, clinic or insurance company
How does Medicare, Medicaid work? How is it different from private insurance?
What are Medicare advantage plans?
What are Pharmacy Benefit Managers?
Recommended Resources:
Episode 17 Understanding and Navigating the health Insurance System, The Original Guide to Men’s Health
