• LucasWaffyWaf@lemmy.world
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    4 months ago

    A friend of mine was feeling ill, but didn’t go to the hospital because he couldn’t afford it. Once the leukemia started advancing though he only lasted a week.

  • TheAlbatross@lemmy.blahaj.zone
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    4 months ago

    There are far worse out there, but about a year ago I injured my hand somehow. I couldn’t close my fist, which made it hard for me to work and support my partner as I do a majority of the cooking and chores. I couldn’t make a firm enough grip to use cast iron cookware. I was really concerned about this for a number of obvious reasons, so I went to the doctor.

    I looked up an in network doc, call them up, confirm they take my insurance, double check that the kind of care I was looking for was covered. At my appointment they ask to do a physical as well, since I was due for one. During that they asked all the normal questions, the poignant one here being “do you smoke?” I replied “I have one or two cigarettes socially when drinking with some friends, which happens maybe once every other month or less.” This changed the tone of the entire visit.

    My concern about my hand was largely disregarded and the doctor began talking to me about smoking cessation and the dangers of tobacco. Gave me pamphlets, tried to ask if I’d consider quitting, asked if I’ve tried alternatives. I tried to turn things back to my hand and she wasn’t interested. After I strongly insisted that was my sole medical interest, she gave me a referral.

    I pay my copay up front and leave. I go to the specialist a few days later. He looks at my hand for 45 seconds and gives me a wrist brace and tells me to sleep with it on. I pay my copay and leave. Wouldn’t ya know? That did it! My hand was working again.

    I call the specialist to follow up on his care and say it worked well. He told me I need to speak with billing to settle my bill. I’m confused. Wasn’t the copay for that? He says the insurance covered the visit but not the medical device (the wrist brace). So I check with billing and they want four hundred dollars. I’m flabbergasted. I check where they got the product, because surely it couldn’t cost that. I found the identical product, brand and all, on Amazon for $13. I’m livid. I argue with them, they say they can’t do anything.

    I call the insurance and they say my policy was clear about specialists and medical devices. Dejected and feeling stupid, I just pay.

    About a week later I get a call from the first doc saying I needed to settle up as well. I owe them five hundred dollars!!! How?? They say the bloodwork they did wasn’t covered. I plead saying that’s a normal part of a physical, no? They say yes, but I didn’t come in for a physical, according to the billing, I came in for a smoking cessation meeting!!

    I tried for weeks to get the doctor on the phone to rectify this but they wouldn’t speak to me. My insurance company said they didn’t cover bloodwork as part of that and the doctors office wouldn’t change the billing.

    I’m sick of doctors, I’m sick of insurance companies. If I get sick, I make chicken soup, drink tea, and scarf OTC drugs. I sprang my ankle fishing earlier this year. Did I go to a doctor? Absolutely not! I can’t afford a $900 bill every time something goes wrong.

    I pay $360 a month for this. Thankfully I make enough that this wasn’t so damaging on my life, but I stopped buying as much meat and ate mostly beans for a year and didn’t travel for my vacation. I had been hoping to visit my father across the country that year but we had to put it off. It changed my outlook on medical services drastically and I’ll never be so honest to doctors again.

    • JackbyDev@programming.dev
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      4 months ago

      I think what annoys me so much about doctors is that they charge you afterwards. If you knew what you were doing was gonna cost $500 you wouldn’t have chosen to do it. They know what your insurance is. They know what they charge. But they don’t tell you until afterwards.

    • vinnymac@lemmy.world
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      4 months ago

      I had a similar experience in the last year. They basically try to trick you into paying. They know exactly what they are doing too.

      This one time a few years ago I literally went in for a check up (first time all year) to find I had a completely new doctor assigned to me. And I couldn’t even make this shit up if I tried. The new doctor was not in my network, they did not inform me during my visit, and he tried to get me to do shit (upcharge) that fortunately I outright refused the entire time we spoke.

      When the bill came they tried to charge me out of network prices, and I basically fought them for six months saying that it was a surprise bill until they finally gave up. I don’t plan on ever going back to that office again in my life.

    • acchariya@lemmy.world
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      4 months ago

      If we all just stop paying the insurance, and instead just put $50/month towards the exorbitant medical bills, boom, universal healthcare

  • Stovetop@lemmy.world
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    4 months ago

    I used to live in China, where socialized medicine was in theory available for everyone, but in practice most everyone who had a decent job had private insurance from their employer not unlike in the US, which was my situation. It was…fine, but I was a healthy young adult and didn’t have much going on medically. I’ve heard some horror stories from others about the degree of care they received, and had one experience where my doctor simply attributed my migraines to my “unhealthy American lifestyle”, but I never had to worry about coverage.

    When I moved back home to Massachusetts a few years later, I didn’t have a job lined up right away, but I did gain immediate coverage through MassHealth (the system the Affordable Care Act was based upon) and it was very cheap. I didn’t have to pay for coverage, but did have a couple copays here and there which weren’t anything crazy.

    I started up one job, was laid off after just a couple months when the pandemic happened, and MassHealth was still there to give me some peace of mind. It’s not a perfect system, but it beats running the risk of suffering a health episode that leaves you financially destitute for years and years. I don’t know how well I would have managed elsewhere.

    I eventually landed a more stable-long term career and get employer-provided insurance through Tufts. And it’s okay, but I recently had to fight a months-long prolonged battle to get a prior authorization approved for a med I had been taking for years that they just decided out of the blue I didn’t need to take anymore. And it took a lot of back and forth from my doctor to really stress that I needed to stay on this med before they eventually caved and gave me a 1-year approval, but now I’m worried I’ll have to go through this whole song and dance again when that time elapses in a few more months.

    I think it’s just a bit ridiculous that the insurance company can simply decide they know my health situation better than myself or my doctor who I’ve been seeing for years now, and out of the blue make life-changing decisions without even having spoken to me or my doctor first.

  • GooseFinger@sh.itjust.works
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    4 months ago

    I transferred to a new college and learned the first week of class that they required a few vaccinations I was missing. No problem, the on campus health center can provide them. I confirm with them that they accept my insurance, so I go get the shots.

    A few months later, I get a bill in the mail for over $3000. Apparently the health center wasn’t in-network, so I have no idea what they meant by “we accept your insurance.” I layer learned that if I had driven 10 minutes west across the state border, there was an in-network office where those two vaccinations would’ve been completely covered.

    I still haven’t paid a penny towards that bill, fuck them. I get daily phone calls from an unknown number, it’s probably collections, but I don’t know for sure since I never answer it. This was years ago and my credit score never took a hit. I’d rather die than reward these parasites with my money.

    I’m pretty sure I have a tumor growing on my hip too. I’d get it checked, but between student loans, insane cost of living, and rising costs of literally everything else, I can’t afford to right now. I’m a childless engineer with “great” health insurance and a roommate, so I’m relatively well off. I have no idea why shit hasn’t boiled over yet. Makes me want to depose some CEOs too.

  • Sterile_Technique@lemmy.world
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    4 months ago

    I work in healthcare, and the response from the workers in my hospital to the UHC CEO assassination has been… pretty much the same as the response here on Lemmy!

    Couple morale-high-horse folks pearl clutching about no one deserves to die or some shit; but 99% of us are on team Luigi.

    We fucking hate parts of this industry, with a strong emphasis on insurance bullshit.

    My two cents from the inside.

  • Rob@lemmy.world
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    4 months ago

    Blue Cross denied my claim for coverage of therapy ($125/week) because the address is clearly not a business address. Yes, that’s right, my therapist operates from her home, which is a horse farm. So does this mean BC doesn’t cover any home offices? Or is it just ones that have “ranch” in the address?

    We’ll see! I’ve filed a grievance challenging the denial. I’m looking at around $6000 for the year if they persist.

  • LaunchesKayaks@lemmy.world
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    4 months ago

    Worked in insurance for a few months and saw someone with an $8000 deductible.

    Was denied life-changing, medically necessary weight loss surgery because my company has less than 50 people employed.

    I had to live with a failed gallbladder for a month and a half while the insurance decided if they were gonna pay for surgery. I lost 20lbs in that time because I couldn’t keep anything in my body. I almost died.

    One health care facility near me doesn’t accept patients who work at or have previously worked at their competition.

    Had my ankle reconstructed last year and the surgery alone billed for $16,000. A piece of foam for my walking boot billed for $150.

    My headache medicine would cost me around $1000/month if I didn’t have insurance. With insurance it’s $40/month. My pharmacist helped me sign up for a discount card through the manufacturer so now it’s only $5/month somehow

    Got some medical bills sent to collections before the bills ever reached me. By email or paper mail. Haven’t paid any of them and I don’t plan on ever paying them because fuck the people who just sent that shit to collections. Also medical debt is dumb and you just don’t have to pay that shit. They eventually stop bugging you about it and I haven’t seen it reflect on my credit score ever.

    A 20 min ambulance ride, with amazing insurance was billed for $575.

    My sister almost broke her spinal cord and the insurance gave us the runaround after the corrective vertebrae surgery.

    The VA didn’t want to cover the cost of my grandfather’s leg amputations that were a direct result of contact with agent orange in Vietnam.

    The VA doesn’t want to cover a coworker’s therapy and medication for PTSD caused by being stationed in the middle east for 4 years.

    The VA won’t release my mom’s army medical records because she was part of experimental vaccines when she was in the army. She thinks it was anthrax vaccines, but can’t be sure because nobody will tell her.

    • PriorityMotif@lemmy.world
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      4 months ago

      If anyone still needs help with the VA you can reach out to your local American legion or other veterans organization and they can help break through some of the red tape.

  • neidu3@sh.itjust.worksM
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    4 months ago

    European visiting the US, so it’s going to be pretty mild.

    This was early January, 2021, so I needed a negative covid test before I could start the one month of work I had planned (my reason for being there).

    Me: “Noted. I see there’s a clinic across the street from my hotel, I can have it done tomorrow morning.”
    Shoreside rep: "Sorry, can’t do that here. It has to be this specific clinic with which we have an agreement.
    Me: “How about my travel insurance, won’t they cover it anywhere?”
    Rep: “We don’t know that until billing, and then you’d have to expense the copay, which management doesn’t like”

    That’s when I learned wtf “copay” is. I had loads to do the day after, but I spent most of the day in a car, back and forth, so that I could visit this one specific clinic for a test that took five minutes.

    And if Houston city planners weren’t bribed by Big Concrete and Big Car Dealership, I’m sure the ride would have been significantly shorter as well. As a sidenote, I find it pervertedly fascinating that Houston is a city that somehow manages to be located surprisingly far from Houston itself.

  • ChillPenguin@lemmy.world
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    4 months ago

    My wife has a rare disease. Requires expensive drugs monthly. We hit our max out of pocket early every year.

    Bye money. forever. until I die.

    Sometimes you don’t need anything crazy to describe how shitty our healthcare system is.

  • JTskulk@lemmy.world
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    4 months ago

    I filled out a form wrong and didn’t have healthcare this entire year. I tried to fix it and my company told me sorry, the period for enrollment is over, wait until the end of the year to enroll for next year. Found out when I went to buy a prescription and they started asking me a bunch of questions and then charged me 150% of the normal cost. Good thing I stayed (relatively) healthy this year!

    • JackbyDev@programming.dev
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      4 months ago

      I think a change in employment is a qualifying life event, so you may be able to apply for a part time job, change insurance, and immediately quit. I’d look into this more before trying it though lol. It might be considered fraud.

  • AA5B@lemmy.world
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    4 months ago

    My wife had surgery. However they didn’t prescribe painkillers until after the surgery.

    I got her comfortable at home and ran down to pick them up … and was rejected as “drug seeker”. Wtf. It took a full day before I could convince them to fill it, and they kept wanting her to come in person when she just had surgery

  • IzzyScissor@lemmy.world
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    4 months ago

    On a road trip, got food poisoning so bad that I couldn’t eat for 5 days, barely kept fluids down and was so weak that walking into an appointment, the doctor told me to go to urgent care.

    They gave me an IV, did an ultrasound, and gave me some anti-nausea and anti-diarrhea meds, which barely helped. It still took 3 or 4 days before I started feeling better.

    Insurance comes back with a 5K bill. They claimed that even though I had my regular prescriptions go through both before and after the trip, the trip claim itself was denied because it was “during a time when I did not have coverage”.

    Took several months and phone calls of pointing out the before/after is approved without questions so there’s no way to claim I wasn’t covered during this one week. Every human I spoke to agreed with me, but it still took months.

  • SuzyQ@sh.itjust.works
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    4 months ago

    First one:

    About ten years ago my husband got a job and our health insurance changed providers (very common here). My second child needed a refill on his control inhaler for asthma. He’d been on the same one since he was initially diagnosed at 2 years old. Insurance denied covering that brand (which was older and therefore cheaper) until he tried expensive brand. Expensive brand was $80 out of pocket, and I am still livid that they fucked around with his health like that. The only way they’d consider covering the original one was if we tried expensive brand and it didn’t work. For a six year old. With asthma. Thankfully, it did work but it still pisses me off.

    Second one:

    Shit happened and my kids and I ended up on state Medicaid for almost a year. My state privatized it and they declined to cover every. single. visit. and now, years later, I’m still fighting for them to retroactively cover visits so I’m not on the hook for thousands of dollars.

  • xmunk@sh.itjust.works
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    4 months ago

    In three consecutive months, for the same amount of the same medication from the same pharmacy, I paid 270$, 30$, and 0$.

    Healthcare pricing is complete fucking bullshit.

  • Dagamant@lemmy.world
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    3 months ago

    Between my wife and I we make 200K a year. We have a roommate to help pay bills because between her chrones disease and our kids health issues we can’t afford to live. She has been without her chrones medication for 6 months because the humera was causing problems and the new prescription has been in limbo between pharmacies not wanting to deal with it or her insurance and her insurance continually sending her to pharmacies that don’t accept her insurance. Medication that is easily affordable and available in other countries is dangled just out of reach while she suffers.