Deny. Defend. Depose.

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.

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 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.

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.

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.

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.

20 years of hell.

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

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.

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.

My husband was diagnosed with ulcerative colitis in his early 40s. There was a medication that kept his symptoms more or less in control.

Then he lost his job. The meds ran out and it turns out they cost thousands of dollars without his work insurance plan. This was just before Obamacare, and there was no way we could afford unsubsidized insurance for him on my salary.

His colitis got exponentially worse, and was treated only spotadically when I could scrape together a few hundred dollars for the doctor visit, where he might be able to get enough free samples of the med or a round of steroids to reduce the gut inflammation.

One night as we were lying in bed winding down to sleep, I heard him drop his magazine on the floor and start what I now know was agonal breathing. I called 911 and did my best with CPR, but his heart had stopped and in all likelihood he was dead before the paramedics arrived. He was 53 years old.

I found out from his death certificate that he had severe ischemic heart disease. It was undiagnosed because he hadn’t had regular medical care for years because of the vicious circle of unmedicated symptoms/inability to work/no insurance.

That’s my horror story. There’s also my 4+year quest to be diagnosed with MS, being told by multiple doctors that if I lost weight I wouldn’t be so fatigued I could barely move, or have vertigo, or fall down for no reason, or whatever symptom I had at the time. But hey, at least that story eventually ended with diagnosis and treatment… as long as I have my job and insurance, anyway.

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.

I’m intersex and have both male and female anatomy. US healthcare “insurance” isn’t coded for people like me. It assumes a sex binary when the facts of reality show otherwise.

Back at my old job, I had full premium health insurance. However, they kept denying each and every claim, denying literally everything. They unofficially recognized my intersex condition and used it against me.

Whenever I filed a claim as female, they’d deny it and claim I was male and thus the claim was incorrectly filled out. When I filed as male, they’d pull the exact same stunt now claiming I’m female and thus the claim was incorrectly filled out. Whatever the claim, large or small, it was always the wrong sex on the paperwork.

It was a "heads I win, tails you lose" situation. I have a better job with the government and with a different insurance company, but they too are starting to pull the same stunt. I hate this country for allowing such corruption to thrive.

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.