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March 19, 2009

How to save money on prescription drugs

Posted: 02:33 PM ET

A new report from Consumer Reports finds that many Americans are having trouble affording their prescription drugs and have taken dangerous steps as a result.

 

The survey, released this week, found that 28 percent of Americans have taken steps such as not filling prescriptions, skipping dosages and cutting pills in half without the approval of their doctor, and even sharing prescriptions with a friend.

The good news is that there are ways for everyone to save money on prescription drugs.   Here are some of the top tips.

1. Tell your doctor you can't afford the drugs he's prescribing.

According to the Consumer Reports survey, only 4 percent of those polled said they'd had a conversation with their doctors about the cost of a drug. You shouldn't hesitate to talk to your doctor about prices; these days, many people can't afford the skyrocketing price of prescription drugs.

2. Ask your doctor whether there's a generic that would work just as well.

It's amazing how much money you can save with this one little question. For example, if your doctor prescribes Lunesta, a sleeping pill, you could end up paying about $93 for 15 doses. Switch to zolpidem, which is the generic form of Ambien, and you'll pay $33 for the same number of doses, according to Consumer Reports Best Buy Drugs.

To make it really easy, bring in a list of the $4 generics sold at your local pharmacy and hand it to your doctor. If there isn't a generic that will work for your particular problem, ask whether there might be a less-expensive brand name available. Dr. John Santa, director of the Consumer Reports Health Ratings Center, suggests wording it like this: "Can you tell me about other options that would cost me less?"

3. Ask the pharmacist for less-expensive alternatives.

If you didn't get a good answer from your doctor, ask your pharmacist whether there's a less-expensive drug in the same class as the one your doctor prescribed.

4. Use mail order.

You'll save money. Of course, this won't work when you need medicines immediately (for example, antibiotics for an infection), but mail order often works well for medicines you need to take long-term.

For more tips on how to be an Empowered Patient, check out my column at CNNhealth.com

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March 12, 2009

How to shop for health insurance

Posted: 05:10 PM ET

As the economy worsens, more consumers find themselves walking through the minefield of finding health insurance. In the past four months, 2.6 million jobs have evaporated, and analysts say half these people also lost their employer-sponsored health insurance.

So when you're out there shopping for insurance, how do you discern a good policy from a bad one? It can be very difficult, experts say. "I'm a 35-year veteran in insurance, and I still don't understand it," says Rex Bowden Sr., of Global Insurance Consultants. "It's fluid. Sometimes what you think it means, it may not mean."

To get started, you can look at ratings of health care plans by the National Committee for Quality Assurance, which, in conjunction with U.S. News & World Report, also puts out a list of the best commercial health plans.

You can also look at insurance guidance from America's Health Insurance Plans,Families USA and the Patient Advocate Foundation. For help in understanding insurance terms, consult this glossary from the NCQA, or this glossary from the state of New York.

On eHealthInsurance.com you can compare the basics of a variety of plans. While you're doing that, here are five crucial questions experts say you should always ask.

1. How much are my premiums and will they change?

Make sure you get the premiums in writing - and find out how long you'll be paying that particular rate. Sometimes the rate you're quoted won't last long.

"Think of it like a credit card. Sometimes you get a nice, low introductory rate, then after a year, the rate skyrockets," says Steve Luptak, the executive director of Healthcare Advocacy.

2. What are my deductibles and co-pays?

Know what you're paying for. A deductible is how much you have to pay out of your own pocket each year before insurance kicks in. Even after you've met your deductible, you'll likely still have to fork over a co-pay whenever you see the doctor, get a procedure, or go to the hospital. For example, you might have to pay $25 for an office visit, or $50 for a hospital stay. Visit CNNhealth.com, your connection for better living

3. Is the insurance company licensed in my state?

Fraud happens, Luptak says. "Will the company be in business when you need it, or is it 'Shifting Sands Mutual'? "

According to government reports, both employers and individuals are vulnerable to unauthorized or bogus health insurance sales. In a 2003 Government Accountability Office report, there were at least 144 companies identified for selling fake coverage to more than 200,000 policyholders - leaving a at least $252 million in unpaid medical claims.

To make sure the company you're about to send your money to is legit, go to the National Association of Insurance Commissioner's Web site and find state-by-state complaint and financial information about specific insurers. NAIC also has a list of licensed insurance companies.

Experts also recommend checking out whether the insurance company is financially secure. "There's nothing worse than getting insured only to find out they're going out of business," Bowden says. You can research the credit rating of a company for free on the Web sites A.M. Best or Standard and Poor's.

For more tips, check out my column at CNNhealth.com

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February 13, 2009

How to get health insurance if you lose your job

Posted: 12:45 PM ET

In January, according to the Labor Department, over a half-million Americans lost their jobs.  For many, that means they are also losing their health insurance.  Negotiating with doctors and hospitals is just one thing you have to learn how to do when your insurance disappears, says Steve Luptak, executive director of an assistance group called Healthcare Advocacy. "I've had so many people who've just been laid off coming to me for help because they've lost their insurance. They're so stressed, they're so depressed, they feel like it's the end of the world," he says. "But there are things you can do. It's not a futile situation," he says. VideoWatch for more tips for the uninsured »

If you want to try to get new, affordable insurance, or find programs that offer you financial help for doctor visits, prescription drugs and more, follow these steps:

Step 1: Get good advice

When you get laid off and lose your health insurance, you may need someone in your corner. Several places specialize in helping people find new, affordable insurance and free care:

Healthcare Advocacy

Patient Advocate Foundation

Patient Services Incorporated

Step 2: Search for affordable insurance

With advice from experts at the groups above, begin your search for affordable insurance. Start with COBRA, which means you continue with your employer's insurance, except now you're paying the entire premium on your own. You can learn about COBRA at the Department of Labor's Web site.

If you can't afford to go on COBRA, you're in good company; a recent study by the Commonwealth Fund found that only 9 percent of people who are offered COBRA actually use it. Sometimes it's less expensive to buy your own insurance policy rather than going on COBRA. You can compare prices at ehealthinsurance.com.

Step 3: Get your child on SCHIP

Even if you have too much money to qualify for Medicaid, your children may qualify for SCHIP, the State Children's Health Insurance Program. Here's a state-by-state directory of SCHIP programs.

There are other government programs, too. Your entire family may qualify for insurance from a state high-risk pool if you live in a state that has one.

If you think you might quality for Medicaid, see this state-by-state Medicaid directory.

For more tips, check out my column at CNNHEALTH.com

 

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February 2, 2009

Getting help for a child with autism

Posted: 03:21 PM ET

This week for CNN American Morning, I’m sharing the story of the Bilson family, whose 13-year-old daughter, Marissa, has autism. The Bilsons have had a tough time with Marissa; she often pitches fits, and the entire family suffers. Not knowing what to do next, the Bilsons called in a therapist who spent the week with them, teaching them skills for making life better for Marissa and for the rest of the family. You can read more about Marissa here, and see a video about the therapy here.

Here’s the problem: the therapy costs about $20,000 for the week. The Bilsons received it for free, because our cameras were videotaping it, but that price tag is out of reach for most families with autistic children. So what are some affordable approaches for these families? There are many affordable programs out there, but it’s not always clear how parents can access them. Here, from mothers of children with autism, are ways parents can advocate for their children with autism, from babyhood through the school years.

1. Trouble getting a diagnosis? Bring in a video, letters.

The first step towards getting assistance for your child is to get a diagnosis of autism. Some parents have had difficulty with this, since a child doesn’t always display the worrisome behavior during a doctor’s appointment. If this is the case,  Alison Singer, executive vice president of Autism Speaks, an awareness and advocacy organization, suggests videotaping your child's behavior and showing it to the doctor. "You could play it on your laptop, or even just bring in the video camera," she says.

Getting a letter of support from your child's day-care provider or preschool teacher might also help.  "Teachers are seen as other professionals, and a letter saying, 'In 20 years of teaching, this behavior is really unusual,' can go far," says Singer, who has a 10-year-old daughter with autism. If your child isn't in day care or school, even a letter from a neighbor who knows your child could help, she says.

Educating yourself about autism will also help you have a discussion with your pediatrician. Autism Speaks, First Signs, and the American Academy of Pediatrics all give excellent overviews. Autism Speaks' Video Glossary has more than 100 video clips comparing the behavior of children with autism spectrum disorders with the behavior of a typical child.

2. Sign up for early intervention

Any child younger than age 3 with a developmental delay qualifies to receive services through Early Intervention, a government-mandated program that provides services to eligible children. Services are free of charge, and vary from state to state; they may include speech and language instruction, and/or occupational and physical therapy.

To learn how to apply for Early Intervention, click on this state-by-state directory from the National Dissemination Center for Children with Disabilities and scroll down.

Early Intervention is invaluable because it links parents to services in the community, but Lisa Goring, mother of a child with autism and director of family services at Autism Speaks, warns that parents may also have to search on their own, since it can be hard to find services without a long waiting list. "There just aren't enough service providers for the kids who need them," Goring says. To find services on your own, wrightslaw.com, which offers information about special education law and advocacy, has a Yellow Pages for Kids that lists providers.

Long waits are so prevalent that Nancy Wiseman, founder and president of the advocacy group First Signs, whose 12-year-old daughter has autism, has a few suggestions for how to get in quicker. First, parents should stress the age of their child (many clinics will give priority to children under 3), and should ask the pediatrician to make a call to the specialist. More suggestions are in her book "Could it be Autism? A Parent's Guide to the First Signs and Next Steps."

3. Know your child's rights in school

When your child enters public school, he or she has rights under federal and state laws. The U.S. Department of Education has information about federal laws and state laws. The National Association of Parents with Children in Special Education has information about children's legal rights as well.

Wiseman says that even with these protections, you'll still have to work to get what's best for your child. For example, Wiseman moved to get into a different school district, and then a few years later, when that district no longer worked well for her daughter, she twice fought to place her child out of the district. "It's very frustrating to battle a school, and you really have to do your homework," she says.

You and the district will have to come up with an Individual Education Plan (IEP). To prepare, Wiseman recommends "The Complete IEP Guide: How to Advocate for Your Special Ed Child" by attorney Lawrence Siegel.

Also, school districts often have a Special Education Parent Teacher Association. Member parents often give good advice on how to work with the school district.

 

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January 22, 2009

Three ways to get EMS workers to take you seriously

Posted: 02:34 PM ET

A study published recently in the journal, Circulation: Cardiovascular Quality and Outcomes found that women who called 911 complaining of cardiac symptoms were 52 percent more likely than men to experience delays from emergency services.

The time it took for ambulances to arrive on the scene was similar for men and women, according to researchers at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston, Massachusetts, who published the study.

The delays began after ambulances arrived and while they were on the way to the hospital, the researchers found.

Part of the problem is that too many health care workers - doctors, nurses, paramedics - still think of heart attacks as something that happens to men, and not to women, according to Donna Mason, former president of the Emergency Nurses Association.

While she says health care workers are smarter now, too many still think of heart problems as a man's disease. "We need to change that mindset," she says.

Another problem: Women often don't have the "classic" signs of a heart attack. "Women don't have the 'typical' heart attack like men do," Mason says. "Women don't present as dramatically, and therefore aren't taken as seriously."

About a third of women experience no chest pain at all when having a heart attack, but often have symptoms such as nausea, vomiting, and extreme fatigue, according to the Women's Heart Foundation.

If you're a woman who fears she's having a heart attack, here's what you can do to decrease the chance of delays in your emergency care.

1. "Don't be a martyr"

Dr. Nieca Goldberg, cardiologist and author of "The Women's Healthy Heart Program" says too often women hesitate to call 911 even if they think they're having a heart attack. "Don't be a martyr," she says. "This is a big mistake because time is of the essence."

Or as Dr. Jesse Pines puts it, "Time is muscle." The longer it takes to get treatment for a heart attack, the more extensive the damage to the heart muscle, says Pines, an emergency room doctor at the University of Pennsylvania Health System.

2. Don't play down your symptoms

Mason says in her 35 years of working in emergency rooms, she often saw women pooh-pooh their pain. "Women tend to blow things off, and men don't," Mason says. "This is a time when you can't downplay your symptoms."

Pines warns that telling emergency workers "it's nothing" or "it's just indigestion" could lead to delays. Don't diagnose yourself, he advises - just explain your symptoms in detail.

3. Tell emergency workers if you have a family history of heart attacks

Knowing this could make a real difference in the care you receive from emergency workers, Mason says.

For more tips, check out my column at CNNhealth.com

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January 12, 2009

How to live to 100

Posted: 04:26 PM ET

Happy 100th Birthday, Nana!

A few years back, I did a CNN documentary called the “Fountain of Youth.” In an effort to try to figure out why some people live to be 100 while most of us don’t, the show’s producer, Emily Probst, put a call into the Centenarian Project at Boston University looking for centurions to share their secrets for longevity. “They’ve got a great family for us,” Emily told me when she got off the phone with Dr. Tom Perls, who leads the project at Boston University. “Charlotte Chipman is 101 and Sara Weintraub, her niece, is 94. What do you think?”

“What do I think?” I said to Emily. “That’s my great-great aunt and my grandmother!”

Today, Nana turns 100. On behalf of my entire family and with great love, we wish her the happiest birthday ever and all the joy in the world. She’s seen a lot in her life and has kept up with it all (how many centenarians do you know with a cell phone, or email?), and her legions of children, grandchildren, and great-grandchildren love her very much.

So what’s the secret to reaching your 100th birthday? For starters, don’t smoke and keep your weight under control, says Perls. Of course, good genes help, too. Beyond that, he says staying alive involves having a healthy spirit as well as a healthy body.

1. Stay involved
“You very rarely find a lonely centenarian,” says Perls, noting that the people in his study are very involved with their family and their community. “If there’s a wedding, or a bar mitzvah, or a birthday, all you have to do is invite me. Sometimes I go even if I’m not invited,” said my aunt, who lived on her own until she died at age 101 a few months after our documentary aired in 2003.

2. Let go of the bad
“My secret is resilience,” my grandmother told me when I asked her how she’d lived so long. “Resilience is being able to come back after great disappointments and great hurts and great blows and truly be alive.”

3. Do what you love, love what you do
Rueben Landau, who was also in our documentary, practiced law until the age of 103 – he’s believed to have been the oldest practicing attorney in the United States. “I’m happy with what I’m doing,” said Landau, who died in 2007. “If a person’s happy in what they’re doing, that’s going to eventually affect their health.”

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November 17, 2008

What vitamins to take and which to avoid

Posted: 03:19 PM ET

Americans love to take their vitamins. More than 150 million Americans take dietary supplements according to the Council for Responsible Nutrition, a supplement industry trade group. But it’s hard to know what vitamins to take – any grocery store aisle has a dizzying array. That's why this week the Empowered Patient asked two wellness experts what supplements they take every day – and what supplements they say you shouldn’t take.

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Dr. Andrew Weil; Age: 66; director, Arizona Center for Integrative Medicine; drweil.com

What he takes:

1. A daily multivitamin/multimineral

2. Vitamin D. Vitamin D deficiency has been linked to breast cancer, colon cancer, prostate cancer, heart disease, and multiple sclerosis, as well as other conditions. Studies show many of us are vitamin D deficient. Weil says look on the label to make sure you're getting vitamin D3, not vitamin D2.

3. Magnesium. Lack of magnesium may lead to irritablity, muscle weakness, and irregular heartbeat.

4. Juvenon (or "Omega"), a compound believed to enhance cellular health and function. This supplement contains two nutrients, acetyl-L-carnitine and alpha lipoic acid. The company that makes Juvenon says benefits include "more energy," a "sharper mind", and "more restful sleep."

5. Co-Q-10, a supplement that boosts coenzyme Q10, which is produced by the human body and is necessary for the basic functioning of cells. Animal studies have found that coenzyme Q10 helps the immune system work better and makes the body better able to resist certain infections and types of cancer.

Weil, author of 10 books including, "Eight Weeks to Optimum Health," says it is important to take studies, like the one in JAMA, with a grain of salt. "I believe vitamins E and C are important as part of our antioxidant defenses, even if we have not yet documented specific preventive effects," says Weil.

What not to take

Weil says men shouldn't take iron unless they've been diagnosed by a physician as having iron deficiency anemia. He also advises against men taking calcium supplements; he's concerned they could increase the risk of prostate cancer.

Dr. Christiane Northrup; Age: "50 something;" author, "The Secret Pleasures of Menopause;" Drnorthrup.com

What she takes:

1. Antioxidant supplement

2. Fish oil. Some studies have found fish oil, which contains omega 3 fatty acids, can help lower triglyceride levels, lower blood pressure, and help depression, among other uses.

3. Calcium, which can help prevent osteoporosis - a problem in particular for older women

4. Magnesium

5. Coenzyme Q10

6. Vitamin D

Northrup, an authority on women's health and wellness and author of the new book "The Secret Pleasures of Menopause," says it is important to remember that vitamins are not drugs. They don't work the same way in the body.

"Vitamins are best taken in the correct proportions to each other," says Northrup. For example, she says if you are taking folic acid, which is a B vitamin, you'll do better when you also take the other Bs that make up the B complex. Says Northrup, "That's how nutrients occur naturally and how the body best utilizes them."

What not to take

Northrup says postmenopausal women almost never need iron, and taking too much might pose a risk for heart health.

For more tips on taking vitamins, check out my column at CNN.com/empoweredpatient

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August 28, 2008

How to get out of medical debt

Posted: 03:53 PM ET

One issue sure to be mentioned in Barack Obama’s acceptance speech is health care and the millions of Americans who are fighting to get out of medical debt.

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A report out last month from the Commonwealth Fund found that 28 percent of the population said they were paying off medical debt in 2007, up from 21 percent in 2005.
"Two-thirds of the people who go into medical debt have insurance," said Mark Rukavina, executive director of the Access Project. "When medical debt hits, it hits very quickly. It's a jolt, and it's generally not very predictable."
"These are all honest, hardworking people," added Jessie Maurer, a medical billing advocate in West Des Moines, Iowa "This could happen to just about anybody."
By avoiding the mistakes below, you can get your medical debt under control.
Mistake No. 1: You ignore your bills
"The most dangerous thing people do when they get into debt is ignore the statements and notices," said Mary Jean Geroulo, a former hospital administrator and now a partner at Stewart and Stimmel, a health care law firm in Dallas, Texas.
"They think doctors and hospitals won't send them to collection agencies, but they absolutely will," she added.
To find an advocate, visit the Medical Billing Advocates of America, The Fairness Foundation and the National Foundation for Credit Counseling also offer help to those in debt.
Mistake No. 2: You don't look for errors in your bills
"I had a client once who was charged for a surgery she never had," said Nora Johnson, vice president of Medical Billing Advocates of America in Caldwell, West Virginia. "Another one was charged more than $5,000 for disposable gloves."
To catch errors, you have to get an itemized bill. Often, say experts, you have to ask for one.
Mistake No. 3: You don't negotiate the price down
"People think they have to pay the amount on the bill. But doctors and hospitals are very willing to negotiate," Rukavina said. "Remember, the squeaky wheel gets the grease."
Maurer, for example, says one of her clients owed $14,000 for a five-hour stay in a hospital emergency room. "She could afford to pay $4,000, so I told her, 'Show them a certified check for $4,000.' She did and told them, 'This is all I have in the world,' and they took it."
For more tips, check out my column at CNN.com/health

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August 18, 2008

Top tips to prepare for a hurricane

Posted: 01:55 PM ET

"Be prepared." It is the Boy Scout motto, but it is also true when it comes to hurricanes and other weather emergencies. Here's a list of things you should keep close at hand in case you are ever in a weather emergency.

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1) Emergency supply kit: According to ready.gov, keep these things in your kit: a first aid kit, prescription medicines, bottled water, a battery-operated radio, a flashlight and batteries.

2) Important documents: Make sure you have a copy of the following documents: driver's license, Social Security card, list of doctors, insurance policies, wills, deeds, birth and marriage certificates and tax records.

3) Family evacuation plan: You may not be with your family when disaster strikes. According to the American Red Cross, you should decide ahead of time where to go if you have to evacuate. You should also discuss ahead of time how you are going to get in touch with one another in case you get separated. Experts suggest making an out-of-town friend or relative a contact in case the phone lines are down in your community.

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August 7, 2008

How to have a baby when it's not so simple

Posted: 01:15 PM ET

Pamela Madsen knows a thing or two about getting pregnant. She did it twice, and it took several teams of doctors, six rounds of artificial insemination, six rounds of daily injected drugs, and four rounds of in-vitro fertilization.

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She's madly in love with the results - son Tyler is 19 and Spencer is 15 - but she didn't always love the process. That's why she started the American Fertility Association - to help other couples in the same position.
"Getting pregnant isn't always an easy thing to do," said Madsen. "Doctors are not gods, and you have to remember that no one's going to care about you as much as you are."
Here are a few things Madsen said she did right while going through infertility treatments.
1. Get Dad out of the hot tub
"Sitting in a 103-degree tub for prolonged periods of time may impair sperm quality," said Dr. Alan Copperman, with Reproductive Medicine Associates in New York.
2. Stay healthy
Drinking heavily, using illegal drugs, smoking, and being overweight can decrease fertility for both men and women.
3. Go to a clinic that's open seven days a week
When it comes to procedures such as harvesting eggs and implanting embryos, one day can make a difference," Madsen said. "If they're not open seven days a week, they're manipulating your cycle to fit their schedule."
For help finding a fertility clinic, check success rate statistics at the Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technology.
Want more tips on how to increase your chances of getting pregnant?  Check out my column at CNN.com/health

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About this blog

Clark Howard helps you become a wise consumer. We know you're busy, and that's why Clark's tips are quick and effective. He'll arm you with the information you need to make smart choices. During these tough economic times, Clark wants to help you save more, spend less and avoid getting ripped off!