Ask Lemmy

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.

I have health insurance through my employer. I haven't found a general practitioner doctor that will take my insurance that is within a two hours' drive. So I haven't been to a doctor for a regular checkup in years. I've just been going to Urgent Clinics when something bad happens. This is not sustainable.

My obgyn retired two years ago. I haven't been able to find a replacement.

I will likely need a hysterectomy within the next 5-10 years, assuming I follow the pattern of all older sisters, mom, and aunts and cousins on maternal side. That is my greatest medical concern right now; I'm not sure it will even be legal to get it by the time I need it. Getting it done now is not medically necessary so it won't be covered by insurance.

I was in a car crash just over a year ago and am still waiting in line for physical therapy. There are places I could go sooner, but they aren't covered by my insurance.

Once upon a time there was a man who was very, very, very, very, very glad he never had to deal with the American healthcare system. He lived happily ever after.

'group bargaining' is a giant lie in the united states. the idea that groups of insured people can bargain for cheaper healthcare. a complete fabrication.

my monthly insurance costs were cut by 75% when i dumped my corporate health insurance program and signed on to my wifes plan, where she makes far less than i do but the benefits are amazing. because its a government job.

and i work in the healthcare industry!

its all a giant fucking scam designed to rape the american people of money.

private insurance companies only profit when human beings suffer. how many other industries get to do that?!

Backstory: I have hemochromatosis. My body doesn't eliminate iron like most people's. As a result I am at risk of getting iron deposition in my organs; most commonly the liver and kidneys are affected.
The simple treatment for hemochromatosis is therapeutic phlebotomy; bloodletting. When my ferretin (iron) count in my blood gets high I have to donate blood to get it lower. This wouldn't be an issue except I need to do so weekly/bi-weekly and not the requisite waiting period blood donor centers require.
Because of this I have to get 'therapeutic phlebotomies' ordered by my hepatologist.

I could not afford to pay my entire balance with the healthcare provider my doctor's office is part of. Their system would not allow me to make a partial payment and would not allow me to check in for my appointment unless I paid the amount in full ($450+). Because of this I could not attend my doctor's visit and because we did not have a visit they cannot prescribe the routine maintenance my condition requires.

TLDR: I have a genetic condition with one of the easiest treatment plans which is giving my blood away, something that saves lives, but I cannot receive treatment because I cannot pay my full balance with the healthcare provider.

Nothing totally outrageous as I've been pretty lucky to not need to request for a denial for anything major, but I had an issue with pain in a toe and went to a podiatrist who said they'd need an MRI to tell what was going on. UHC denied it and said that I should just do an ultrasound, which the podiatrist said would just be a waste of money as they wouldn't be able to see anything there, but I wasted my money anyway and naturally he wasn't able to see anything...

The pain eventually went away for a bit, but now it's just an occasional reoccurring thing that I just deal with as opposed to wasting more money on copays for nothing.

A pediatric neurologist told me definitively that my oldest son did not have autism. After a year of no improvement and assuming he was a particularly hard to diagnose, I got on the wait-list at the local university medical hospital. They were able to diagnose him quickly (apparently he's pretty text book, but the pediatric neurologist didn't ask the right questions). But he had been without supporting therapies and help in school for years as a result of the misdiagnosis.

My other kid (also autistic) had an ear ache. The urgent care doc was unfamiliar with how to deal with an autistic kid and assumed he didn't have an ear infection. The next day his ear drum burst and we ended up at the big children's hospital.

In both cases we had huge delays in appropriate care and had to pay twice.

I don't have any because I know I can't afford to go to the Dr. so I don't.

I went to the ER once because my heart was acting weird. Turns out it was a benign issue, but they kept me over night to be safe. $10k copay. Insurance covered almost nothing. I paid $10 a month for 5 years and eventually they called me and said they would take $2000 if I paid it all right then.

When I went on a trip to the US I bought a relatively expensive travel insurance as I knew if something would've happened I would be screwed forever.

It did cost me about 80 eur but they claimed 100% cost coverage without copay or any of that nonsense. The coverage was for a whole year but only 60 days after the start of the vacation. It also included legal insurance for medical things with a max payout of 100,000 eur and medical transport back to Germany if possible and necessary.

Did not need to use it fortunately but they advertised that they even covered stuff like decompression chambers after a dive accident. I wonder how much I would've needed to fight them if it came to it but I had a cheaper coverage with similar coverage from them when I went to Turkey. There I got the whole sum after I went to the hospital for a really bad insect sting without any fuzz. But it was only a hundred euros or so.

Fortunately this is the closest near contact with the us healthcare system.

Shitty physical therapist twice raised what I owed per visit because of their clerk's incompetence. Not just for future visits but retroactively for visits I already had. (Edit: I should say this was possibly fraud and if I had a lawyer it may have been worth pursuing).

I knew I was screwed when the clerk pronounced tier as tire. Oh well, lesson also learned for me: Always conduct a three-way, recorded conference call with provider and your insurer before provided service.

Another fun fact; Per KFF, 50% of Americans forego medical attention for free of medical debt. Naturally, this snowballs leading to them inevitably going anyway for a more costly, complex procedure. Our system is top-heavy with specialists for this reason, lacking adequate preventative care and rapid accessibility.

Bunch of dental work all done with no payment at time of service. Fantastic PCP. Amazing rheumatologist. A 10k infusion every two months costs me $5.

I would probably work for no pay with my medical issues.

Where's the one guy who had "good" insurance but still almost died because his employer was being bought out when he got sick

Crossposting to [email protected]

Been having pretty bad chest pain on and off all week. If I go to the hospital and it's something serious it could bankrupt me. However, if I don't go, and I expire, at least my life insurance will cover the house so my family will have somewhere to live.

It's been nearly two months since Publix filled my prescription. At the one month mark I sent my refill to CVS instead and they filled it the next day. I have no fucking clue what's wrong.

it was seemingly resolved but I did get a $1600 bill years after getting some bloodwork done due to one of the myriad tests “not being pre authorized” After a millions backs and fourths between the billing department at the hospital and my insurance it was determined that what had happened was the 3rd party company that “authorizes” blood work (after a doctor orders it and insurance reviews it and the patient gets the blood stolen) had changed names and somehow the idiots in the billing department at the hospital that deals with this company on a daily basis somehow didn’t know this. Why was I the one who had to figure this out and not the people paid to do that? Only Brian Thompson knows.

Related, my insurance changed its name this July, let everyone know repeatedly for months, but that didnt stop some clerical agent at my drs. office to message me and say they don’t take my insurance and are beginning the offboarding process until I told them its literally the same company. Their response was basically the Ah, Eto… BLEGH meme.

I feel like these companies will change their names constantly just as another attempt to not pay out what they are supposed to.

20 years of hell.

Just paying good money all these years and now I am concerned that I might be fucked over.

They appear to be targeting more complex and high cost patients with these tactics while mandane shit just get push through without too much drama.

But there still issues like residual billing which are technically illegal but some how still happen.

Point being, if you have not been fucked over like these horror stories, do you trust these people when you will need them?

I don't.

Went to a clinic to get birth control, had to convince them I wasn't interested in using it to control whether or not I gave birth, when I finally got a prescription it turned out it would cost over $100 for the medication.