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Under the Affordable Care Act, many insurance plans are required to cover a range of essential services, such as hospitalizations and prescription drugs. But durable medical equipment isn’t among them, except for breast pumps, which most plans must cover.
These days, insurers often contract with selected medical supply companies to provide equipment, just as they negotiate rates for other services. But patients often don’t realize that, said Alice Bell, a physical therapist and senior payment specialist at the American Physical Therapy Association, a professional group. Patients who don’t use an insurer’s preferred provider may be charged a higher rate or have to pay the entire amount out-of-pocket, she said.
“It’s important to make sure the supplier is in-network, even if the doctor prescribes it, because it varies,” Bell said.
When Bruce Lee, 48, strained a ligament in his left leg, his doctor prescribed a walking boot and gave him a list of medical suppliers. The doctor warned Lee to make sure he chose one in his insurance network.
Tens of thousands of health care workers are scheduled to go on strike Monday across the University of California system, including UCSF Medical Center, which rescheduled surgeries and delayed cancer treatments for several hundred patients.
While UC’s six medical centers will be affected the most, every part of the 10-campus system will feel the impact, with workers at student health centers and in some other parts of the campuses also walking out.
The planned three-day walkout is an effort by the American Federation of State, County and Municipal Employees Local 3299 to persuade the university system to increase salaries and address racial and gender pay inequalities.
“It is a major disruption,” said Sheila Antrum, senior vice president and chief operating officer for UCSF Health, on Parnassus Avenue. “We have patients who have been counting on getting their procedures done, people who are counting on infusions who are being delayed.”