Monday, November 23, 2009

New women's health guidelines leave many questioning their coverage

Last week's double announcement from two separate leading health panels scaling back the frequency of cancer screenings for women left many questioning their own preventive care and insurance coverage.

New guidelines for mammograms issued last Monday from the U.S. Preventive Services Task Force pushes the recommended date for a woman's first mammogram from 40 to 50 years old.

Four days later, the American College of Obstetricians and Gynecologists announced that women should delay their first Pap test until age 21, and every two years after that.

Health insurers, including Medicare, say they're unlikely to change coverage for cancer screenings, pointing to other guidelines from such groups as the Amercian Cancer Society -- which urges more frequent screening.

If the clinical guidelines do eventually change, health plans may change their benefits for routine mammography and pap smears to reflect the new guidelines, but this would be phased in over time. But Washington women have extra protection. State law requires insurers to cover mammograms if recommended by the patient's provider.

Insurance news: the hazards of looking happy on Facebook and where to spend those flex-plan dollars

Lots of coverage of the health-care reform debate in Congress this morning, and the headlines sum it up:
-Health Haggling Heats Up (Wall Street Journal)
-Schumer: Dems ready to go it alone on health care (Seattle Times)
-Gaps for consumers in Democrat health care bills (Seattle Times)
-Health bill threatened by friction between moderates, liberals (Tacoma News-Tribune)

To the north, there's the story about the Canadian woman who was off the job for a year with depression but then made the mistake of posting happy-looking photos on her Facebook page. Result: benefits denied.

Finally, some financial advice, also from the Seattle Times: Spend down your flexible spending account. (Tip: things like hand sanitizer, first aid supplies, contact lens supplies qualify.)

Insurance-fraud charges against Tacoma couple

A Tacoma couple and a co-worker are facing felony insurance fraud charges after allegedly falsifying receipts for an insurance claim.

Anthony Mezias, 37, and his wife Melissa Mezias, 34, have been charged in Pierce County Superior Court with one count each of first-degree theft and two counts of making a false claim or proof in an insurance case. Also charged was Benjamin Little, 33, of Seattle, who faces one count of false claim or proof.

In late 2006, the Mezias’ reported that their home had been burglarized and their car stolen. Over a period of four months, they submitted inventories to their insurer, State Farm, totaling more than $49,000 in personal property they said had been stolen.

The claim included a 57-inch television, allegedly purchased from a stranger for $5,800 in cash. The Mezias’ provided the insurer with a notarized proof of purchase from the seller, Benjamin Little. The notary information turned out to be forged, and Little reportedly was a co-worker of Anthony Mezias.

Also in the insurance claim was a $3,000 Persian rug that the Mezias’ allegedly bought from their next-door neighbor. Investigators from state insurance commissioner’s Special Investigations Unit questioned the neighbor. He said he’d never sold the Mezias’ a Persian rug. He also said that the Mezias’ were looking for someone to pretend to be the seller so that they could collect money from their insurance company.

Arraignment for all three is scheduled this week in Pierce County Superior Court.