LaShanda Jones

Rethink Pain Care Incentives
Health insurance incentives helped steer chronic pain patients toward opioids, an overlooked factor in the ongoing opioid crisis.
One plan example: generic meds cost $10/mo, while physical therapy costs $50 per session after deductibles.
Weekly physical therapy totals $200/mo, ~20x the drug cost, making opioids the cheaper, easier option.
Non-drug options like acupuncture can require time, transportation, and childcare, and may not be covered at all.
Non-drug treatments carry lower risks, can offer lasting benefits, and acupuncture eased sciatica pain for 1 yr.
Despite a decade of deprescribing, opioids remain a predominant chronic pain treatment, reinforcing the need to change coverage incentives.
I’m seeing how insurance coverage can unintentionally push people with chronic pain toward opioids by making non-drug care harder to access. Better incentives could support safer, longer-lasting treatments like therapy and acupuncture.

Insurers Should Incentivize Non-Drug Pain Treatments

Avoid Medicare late penalties
Medicare’s Initial Enrollment Period lasts 7 mo, starting 3 mo before 65 and ending 3 mo after.
Missing Parts B and D deadlines can trigger lifelong penalties: premiums cost 10% more per 12 mo delayed.
Example: enrolling at 68 means 30% penalty
Monthly premium: $241.89 → $314.46
Yearly extra: $870.84
12-yr extra: $10,450
Some exemptions can avoid penalties, including certain employer coverage, serious illness, VA coverage, Medicaid, or creditable drug coverage.
If you miss the initial window, apply during the General Enrollment Period: Jan. 1 through March 31.
I’m seeing a common retirement planning pitfall: missing Medicare enrollment can create lasting extra costs. The key is knowing the enrollment windows, understanding exceptions, and acting quickly if you miss the first deadline.