Hey, first: This is a GREAT time to support us — right now, every gift gets matched! Click here to support us.   Longtime listeners to this show know we’ve been talking about something called “charity care” for years. Federal law requires that all nonprofit hospitals have charity care policies – that is, financial assistance policies — to reduce or remove people’s medical bills.  The problem: people don’t know about it, and hospitals don’t always make it easy to access. New research suggests...

Several listeners sent us an article with the headline Make your health insurance cry, about a new AI tool to fight health insurance. We had to learn more.  Meet Holden Karau: a Bay Area software engineer who says she’s “trying to make health insurance suck a little bit less.” So she’s created an AI tool to appeal insurance denials. Her project, Fight Health Insurance, is a labor of love (she’s not earning money from it) and fueled by hatred (of insurance companies).  It draws on her tech...

Something different: We talk with journalist Cara Anthony about topics that don’t always come up in conversations about the cost of health care.  For the last four years, she’s been reporting on the public health effects of racism, violence, and intergenerational trauma in a small Missouri town.. The result: A new documentary and podcast series called Silence in Sikeston.    She sat down with us to talk about the value of breaking silences and the possibility for healing.  Here’s a transcript...

We're sharing an episode of “To See Each Other,” about a question that’s SUPER-relevant to this show:  How do we pay for long-term care, like nursing homes?   To See Each Other aims to complicate the narrative about small-town Americans. In this new season, host George Goehl heads to Lincoln County, Wisconsin — population, 28,000-and-some. And home to a publicly-run nursing home with a 5-star quality rating from the feds.   A conservative county board plans to sell the home to a private...

An $88 “observation room” fee for a check-up didn’t sit right with Kari Greene, a listener from Oregon. When the price went up to $99 the next year, Kari complained to her benefits rep; they thought it was weird, too — but couldn’t do anything about it.  In states like Connecticut and Indiana, legislators are trying to do something about fees like these – often called “facility fees.”  In this episode, we go deep on Kari’s bill, one of dozens that listeners have shared with us over the past...

What happens when a hospital gets hit by a ransomware attack? We’re sharing an episode from a podcast called Click Here that takes us inside the aftermath of a cyber attack on a rural hospital in Oregon.   The story starts the minute the hospital’s IT director finds out they’ve been hacked, and follows him and his colleagues as they scramble to keep the place running while they try to get it back online.  It’s a fascinating adventure, and it gives us a window into the growing problem of...

Caitlyn Mai expected her share of a recent surgery bill to be about $2,000, with insurance covering the rest.  Then she started getting alerts on her phone from the hospital that she owed $139,000 — the full cost of her surgery.  But Caitlyn, a legal assistant in Oklahoma, instinctively knew a cardinal rule of the American healthcare system — “never pay the first bill.”  It’s a lesson we first heard from the journalist Marshall Allen, whose 2021 book Never Pay the First Bill serves as a...

We’re starting a new investigation and need your help. We’re looking into something we’ve talked about a lot on this show: hospital financial assistance – also known as “charity care” — which most hospitals are legally required to offer.  Something like 60 percent of people might qualify to have their hospital bills reduced or even forgiven through charity care — but of course nowhere close to 60 percent of people actually get that assistance.  A lot of people just don’t know about it. (A...

Georgann Boatright's local hospital told her she'd need to pay an $8,000 "operating room" charge for a test she was pretty darn sure wouldn't involve an operating room. So she went elsewhere, even though it meant driving to another state. Avoiding that charge required more than just a willingness to go — literally — way out of her way. Georgann Boatright has knowledge, skills, and grit that most of us don't — although we can maybe learn a thing or two from her. More and more, people are...

For months now, you’ve been sharing stories with us about facility fees, those sneaky fees that keep showing up on your medical bills.  Facility fees are kind of like a cover charge for visiting a health care facility, usually one owned by a hospital. And many of you have been blindsided by them.  Some of you have been going to the same place for years, only to one day get a brand new charge, seemingly out of nowhere. Many of you only found out about a facility fee after the fact, while some...

Folks who expected their health insurance to cover some out-of-network care have been getting stuck with enormous bills instead. Like one couple from Kansas City: Their insurance hung them out to dry for thousands of dollars, all while sending statements touting a “discount” the couple was supposedly getting.  Turned out: A middleman was cutting their coverage — actually a middleman’s middleman — working with their insurance company. The couple’s insurer got the “discount,” and the middlemen...

We take our first look at Medicaid— the big, federally-funded health insurance program for folks with lower incomes— for two reasons:  First, it’s a huge part of our health-care system. Medicaid covers a quarter of all Americans, and four in ten children.  Second, it’s timely: In the last year, more than 20 million people have lost Medicaid — even though there’s evidence to suggest a lot of those people probably still qualify.  More than two-thirds have been dropped for “procedural reasons” —...

We’re launching a brand new project and need your help! We’re zooming in on charges that are becoming more and more common on your medical bills: facility fees.  Facility fees are charges tacked onto your bill for visiting a doctor’s office or clinic related to a hospital or larger health care system… or even talking with a doctor who’s in one of those places on a telehealth visit.  If you’ve ever seen a charge for a facility fee on your medical bill, we want to hear from you.  ... and if you...

When a subsidiary of the giant UnitedHealth Group got hit by a cyberattack recently, a big chunk of the country’s doctors, pharmacists, hospitals and therapists just stopped getting paid.  It’s been a huge disruption, with some providers wondering if they can keep their doors open. But thanks to their huge size and reach, the situation may have had a silver lining — for United. Which seems like a big problem, and got us wondering: What can we maybe do about it? The answer turns out to be:...

Reporter Bob Herman from STAT News unpacks his blockbuster investigation about the country’s biggest health care company.    Covering the American health care system means we tell some scary stories. But this episode is almost like a horror movie.  It’s got some of Hollywood’s favorite tropes: Machines taking over. Monsters from separate franchises meeting face to face in a new movie, like Godzilla and King Kong, or Jason and Freddy. And a couple perceptive folks warning everyone, ”Hey, look,...

Health insurance sucks. Which leaves lots of us counting down the days until we turn 65 and can get on Medicare – the federal government’s health insurance program for seniors.  But Medicare is a lot more complicated – and costs more money – than a lot of us realize. (Also, it involves insurance companies.) And:t There will be huge, complicated decisions to make when you turn 65, that can have huge consequences.  The biggest, and most consequential: Choosing between original Medicare and...

A listener wrote to us at the beginning of the year with a query, “I was just reading the news about the price of insulin going down to $35! Is that for everyone?” It turns out, there is a lot of good news about the so-called “poster child” for the high cost of prescription drugs. But to say it costs $35 now is an oversimplification – and diabetes activists don’t think this fight is over. Senior producer and self-proclaimed “insulin correspondent” Emily Pisacreta took a hard look at the...

Dealing with the American health care system as a patient means lots of tough moments – unexpected bills, meds not covered, insurance and hospitals making you go back and forth without a clear answer, endless hold times and phone trees… the list goes on.  So listeners ask us all the time: How do I stay strong and fight for my rights without totally losing my s---?  We’re bringing back one of our most useful episodes ever: How to keep your cool in a tough moment, according to a self defense...

Real quick: Now's the best time to support this show! Thanks to a few super-star Arm and a Leg listener/donors, your donation is matched two for one right now. Here's the link to donate. Ok, now: We’ve got a mini-episode for you today, a four-minute coda to the epic story we brought you in December. It features a last tip for anyone who might want to ask a hospital about charity care — which, as we learned from these recent stories, is most of us. And it comes with my big thanks for being...

Hey! The BEST time to support this show with a donation just got even better. Right now, any gift you make, up to $1,000, will be matched TWO for ONE, thanks to a few super-generous Arm and a Leg fans who’ve pooled their dough. . It’s a great deal, and it will set us up to kick maximum butt in 2024. Here’s the link, go for it! And… are you ready for our most-ambitious story yet? We’ve been working on this investigation all year, with our partners at Scripps News and the Baltimore...

Hey, it’s the BEST time to support this show with a donation. Thanks to NewsMatch, any gift you make, up to $1,000, will be doubled. It’s a great deal, and it will set us up to kick maximum butt in 2024. Here’s the link, go for it! We’ve been working on this investigation all year, with our partners at Scripps News and the Baltimore Banner.  For years, we’ve been hearing about hospitals suing patients over unpaid medical bills – sometimes even in bulk, by the hundreds or thousands at a...

Last fall, actor-writers Ellen Haun and Dru Johnston were hustling to get their health insurance sorted out for 2023. To qualify for insurance through the actor’s union, SAG-AFTRA, Ellen would have to book a little more work — doable, but not a sure bet.  So they came up with a plan: crowdfund a bunch of money to make a short film, starring Ellen … called “Ellen Needs Insurance,” of course. It worked! And the movie, a 13-minute comedy, is terrific.  Ellen and Dru sat down with us to go over...

In 2019, Dr. Luke Messac was a medical resident who found himself spending his day off in a courthouse archive. He’d heard about hospitals suing their own patients over unpaid medical bills. He wanted to know if the hospitals he worked in were doing the same. They were.  Trained as a historian, Messac then set out to trace the history of this phenomenon, and the story of medical debt in the U.S. His new book, Your Money or Your Life is the result of that research.  Luke Messac sat down with...

First: an update on our recent two-parter with the writer John Green, about the global, decades-long fight to make an important tuberculosis drug more widely available.  Just two days after we posted part 2, the activists waging that battle scored a major victory. John Green was kvelling on YouTube, of course. We’ll get you up to speed.  And for the meat of this episode, we’ve got a guest a lot of you have been asking for: Physician/comedian Will Flanary, AKA Dr. Glaucomflecken.  His punchy...