The current state of health insurance...

[Dreamstalker]

I had an OB/GYN appointment this morning. Or so I thought.

I get down there early as usual, go to check in, the receptionist verifies my information and then calls a supervisor (huh?).

Apparently, the particular variant of the state health plan that I'm on is not accepted by the hospital...I was never made aware of this. Nor was I notified that I was accruing a balance...gee thanks guys, if you had told me before this happened I could have been able to pay or at least work out a plan.

I've been using this hospital and specialist for the past four years. Not once was I told "we don't take this plan, we'll take you this time but you need to pay up front and by the way you have a balance of $XXX"...which I would have been happy to do while getting my plan changed, if only I had been advised of the situation.

As far as the appointment which was scheduled in October...no dice. No PCP, no appointment, never mind that the doctor knows me well. As the hospital doesn't take the plan I'm on, I can't exactly get a referral.

I guess the thing that pisses me off the most is not being told there was an issue with my insurance until there was a balance sent to collections Granted, it could be partly my fault for not checking, but I had no reason to (my card was accepted without question).

[Flyndaran]

That sounds more like a case of horrible customer service than anything specifically to do with health insurance.

I also had a recent spate of ignorant health care provider syndrome.
I wasn't told that my doctor that had been prescribing my paxil for 11 years suddenly decided to switch specialization and practices.
I was told by my pharmacy after I had tried to refill my prescription.
It took me a week of horrible withdrawl symptoms to even get an emergency supply.

[Greenday]

Sounds like you definitely got screwed over. Health insurance is a joke these days. It costs craploads of money, half the time you can't go to a doctor you like, and it won't cover the prescriptions you need because they deem them unnecessary.

[Dreamstalker]

I'm actually on a state-subsidized plan being that I'm working with another state agency for job placement. So I don't have to pay, but that doesn't necessarily mean I'm totally unable to (had I been aware of a past balance before it got to the ridiculous level it's at now, I could have paid).

But...if my plan wasn't accepted, why was I allowed to make appointments (for which I don't even need a referral according to the plan's own policies) or use the pharmacy? I suspect there was a breakdown in communication that had nothing to do with me directly...

ETA: Called my provider, and I'm unable to change the plan I'm on (some BS about being designated "long-term unemployable"--WTF?). My hospital did accept the plan I am under, but stopped doing so about a year ago. That still doesn't explain why I was not only never notified by either the hospital or my provider, but why, if I was accruing a bill*, the hospital never made me aware of that fact.

* It is apparently in collections, yet I have never received calls or notices to that effect (if I had, believe me I would do all I could to rectify things).

There are some nice supervisors down there, I got one of the bad ones.

[blas87]

Health Insurance is a joke.

I lose a good chunk of my check every pay period to pay ridiculous copays just to see a damn doctor or get a shot in my rear end from a nurse, and of course the doctor charges fees even though I don't even see her.....

I got sent to collections because I couldn't give them $100+ a month for my bills. My insurance is such a joke, and simple Pap Smears are so expensive (and I won't even go into how much colposcopies are), that over a couple of years, I acrued over $1,000 in medical bills, and this clinic demands 10% payment a month or you're in collections.

It should not cost $200 to find out that I have a stomach flu. It should not cost nearly a whole month's rent to swab my cervix with a giant Qtip.

[Dreamstalker]

My mom is now questioning if the debt can be considered collectable, as neither I nor her ever received any paper bills or notices of any sort.

I rarely let a bill go unpaid for long...the key is of course I need to know about it (duh).

I should have gotten the supervisor's name and really pressed the issue, but I was just too floored by the whole thing to say much (I can't really make my rent this month and you're dropping a $900 bill on me with no explanation?).

People should NOT need to choose between rent and medical care.

[blas87]

I'd say fight it. It sounds fishy and just plain wrong.

I wish I would have fought the clinic. Come to find out, as long as you are paying something a month (and I mean, I was giving them what I could, about $50 to $75 a month) they CANNOT send you to collections or demand more.

[Flyndaran]

...
People should NOT need to choose between rent and medical care.

But that's not the american way! This is about the only industrialized nation that demands we all pay for medical care regardless of our ability to pay.

[DesignFox]

I'd fight it. That's bullshit.

My OBGYN pulled something similar, once. Told me a certain test was covered under my insurance and then tried to bill me for it when it wasn't.

They straightened it out. I kept the paperwork to prove it just in case, too.

[Dreamstalker]

All I can do is fight IF they press the issue. I have no record of any actual bill (should I not have gotten at least one bill on paper?), ONE phone call timestamped that morning (when I was already on my way to the appointment) and the insurance company is not involved at all (the only entity trying to go after me for money is the hospital). My provider was actually surprised that the hospital did not tell me they were no longer accepting the plan.

Yes, it boils down to he-said-she-said, but IME any bill or request for payment has to be written for it to be binding. It was the hospital's responsibility to tell me of the coverage change, which they did not do. All the supervisor would say is "we've been trying to contact you"...dates please? I never received anything.

[MaggieTheCat]

I too hate how health insurance works in the U.S. Currently I am not working so I am not getting any kind of employer coverage. However I am eligible for COBRA through my previous employer, but it's something like $400/month. I am probably going to pay it for this month and next, and by then or shortly after I will hopefully be under my fiance's health insurance plan. $400 is a ton of money but...health insurance really saved me earlier this year, when I had to have my gall bladder removed. Between the ER visit and the surgery itself, the whole ordeal would have cost me over $30,000 if I hadn't had insurance. With insurance it was around $2000. So yes, for the time being I will pay for insurance, much as I hate it. I probably won't even need it for the few months that I'll be on COBRA. But the minute I drop coverage, I'll get in a car wreck, or my vertebrae problem will suddenly get a lot worse, or my spleen will explode, or something, and I'll wish I'd have kept it.

There were many times at work when I considered dropping my health insurance because I didn't use it for the longest time. Really glad I didn't.

[DrFaroohk]

I hate health insurance. I don't even understand how it works but I know it sucks. I had a similar situation of going to the doctor just to get a check up and a physical, assured by the staff that it was all covered, then I get a bill for like 800 bucks.

It seems like health insurance only ever covers rare acts of god. Ah, you've been stabbed through the heart by a black piece of steel from an 18 wheeler that flew at you from a 45 degree angle at precisely noontime! Oh boy, THAT'S covered.

[Flyndaran]

Health insurance only really works when it isn't a choice. That may seem harsh, but it's the only way to enforce collective risks. Then all those healthy for a while pay for those unhealthy or simply unlucky enough to need "more than their share" of coverage.
This isn't really bad for the healthy people, because anyone can and will get unhealthy eventually be because of age or again accident.

[AFPheonix]

http://www.time.com/time/magazine/ar...899873,00.html

I read this the other day and thought it was pretty interesting.

I especially liked the ideas from Germany and Britain. The German one sounds really interesting because our main killers in this country could be so preventable if people took better care of themselves and maintained their chronic disease states better.
The British one caught my eye as well. Many brand name drugs are legitimately expensive, but others could probably be significantly cheaper if we changed the way drug companies can market. I'm ok with drug reps coming around to us and doctors, I disagree with marketing direct to consumers. I don't think it really improves health outcomes at all.

[linguist]

I hate health insurance. I don't even understand how it works but I know it sucks. I had a similar situation of going to the doctor just to get a check up and a physical, assured by the staff that it was all covered, then I get a bill for like 800 bucks.
.

i recently spent about 3 weeks in the hospital. my total bill (for emergency care, multiple surgeries, multiple specialists, drugs, the stay itself, etc.) was over $100,000. my total out of pocket expense? $3,400.

yay health insurance!