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> SCREWED: Uninsured in America, Discussion and Practical Advice
anarch
post Jun 10 2011, 10:44 AM
Post #1


Hardcore BUSTie
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Posts: 873


Not your fault, nbdx. I think they make the system deliberately complicated to confuse people.

Go easy on yourself if you can, huh?
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nbdx0645
post Jun 8 2011, 08:27 PM
Post #2


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Posts: 134


Hi all,
I had some issues with coverage for my counseling. To recap, 6 months ago, my insurance denied my counseling sessions, saying that the counselor I chose wasn't in-network. The insurance company, however, accidentally paid the first one, and said that they'd cover it because it was an error.

I just received a notice in the mail that I have 90 days to pay it or else I go to collections. I have a print-out that shows they knew it was an error 6 months ago, but I don't think it's going to be enough to get it cleared. I just wanted to vent...because I feel so stupid that I didn't understand my insurance. My counselor was in HMO, but not the specific HMO my company has. What a costly mistake I've made. =/
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nbdx0645
post Feb 1 2011, 08:31 AM
Post #3


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Posts: 134


Thanks billybonka and anarch. I was looking at http://www.canadapharmacyonline.com/ and I'll be considering it. I was also thinking that if a couple transactions go well, maybe I can inform my mother. She's been taking blood pressure meds and anti-depressants while paying full-price. (she doesn't have insurance; she works 2 part-time jobs)

I've heard scary stories how tablets have been talc and tylenol, or rat poison, or they have too much/too little main ingredient. I don't want to choose wrong.
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billybonka
post Jan 31 2011, 07:25 AM
Post #4


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Posts: 522
From: Texas


nbdx, I've used Canadapharmacy.com a number of times in the last 3-4 years with success. The only drawback I have found is the inevitable delay in doing things via the mail.
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anarch
post Jan 31 2011, 03:09 AM
Post #5


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Yay for the good news!

I have no experience with ordering from online Cdn pharmacies, but I checked ask.metafilter and possibly some suggestions in these threads might help. (or might not)

specifically, it looked to me like drugbuyers.com and InhousePharmacy got decent reviews.
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nbdx0645
post Jan 30 2011, 09:32 PM
Post #6


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Posts: 134


Good news: I finally hashed it out with my counseling group,and paid them their base rate for sessions. I cut a check in full and said I'm going to take a little break and come back when I'm ready. Then I found out that they fired my counselor (who was totally awesome) and she's working elsewhere. See ya later, previous counseling group.

Not-so-good-news: I got a Rx for epi-duo but my insurance denied it. Figures! I was wondering if anybody has had any luck with buying their prescription meds from online Canadian pharmacies. $20/tube would sure beat $170. I could road trip to Canada for that much money.
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anarch
post Dec 13 2010, 01:40 PM
Post #7


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(((nbdx0645)))

I'm sitting here shaking my head. That woman didn't have to be a bitch about it.

Good luck sorting the mess out and protecting yourself.
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nbdx0645
post Dec 9 2010, 08:27 PM
Post #8


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They said they just received the claim, and that it usually takes this much time. :/ I thought that they'd see "claim denied" much sooner, but they didn't. And more unpaid claims are going to be coming in over the next few days.

The worst part was when the woman at my therapists billing said statements like "You didn't do your research" and "You are responsible to pay, and we're suspending all sessions until we receive payment." Healthcare is a cruel mistress, and my company's HMO is a Frankenstein plan that has pages of exclusions and amendments . I was trying to work through all the information throughout my workday, and eventually started crying at my desk. I was so embarrassed. It's so hard to coordinate between the therapist's office, and then the insurance company, and then my general doctor. Health Alliance also messed up my billing by paying for 2 sessions like I was on a traditional HMO plan, but said they were not going to resubmit claims. However, when I called today, only 1 session was paid by them.

I'm hoping that what I'm saying makes sense. I'm still trying to figure out if all groups are being honest with me.
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anarch
post Dec 9 2010, 08:15 PM
Post #9


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(((nbdx0645)))

And your therapist's office didn't tell you this earlier because...?

This country's "health care" system makes me want to stab the people who have cushy take-care-of-everything plans and don't give a shit about making things better for people who don't.

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nbdx0645
post Dec 9 2010, 08:02 PM
Post #10


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I needed a place to rant, partially because I was too careless with my insurance coverage and did not read the fine print, and I thought my office was going to pre-authorize my insurance.

I was looking for a therapist. I found one and asked if they take Health Alliance HMO insurance. She later notified me, via e-mail, that she was in-group for the Health Alliance HMO, and that her office would take care of all billing. I gave them my information and about 2 weeks later, started seeing the counselor (and paying $25 in co-payments.)

2.5 months (and 5 sessions) later, I received a call that all of my claims were denied because my counselor is not in-group for my HMO and HA did not receive a referral and authorization. I was informed that Health Alliance has tailored HMOs for each company, and my company opted out of being in that plan. Also, the therapist's office did take care of all billing -- they submitted the information to Health Alliance and it was denied. There's a referral clause on the benefits statement that my office received, but it points back to me not taking the steps to get that referral. Does that make sense?

A hard lesson has been learned =/ I can't help but feel a little mislead, but it's stated in my benefit handbook. I just thought that my therapist's office was going to take care of it.
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anarch
post Mar 9 2009, 03:40 PM
Post #11


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Short-term health insurance policies:

"Diagnosing and treating an illness may not fall neatly into six-month increments. While Pat had been continuously covered since 2002 by the same company, Assurant Health, each successive policy treated him as a brand-new customer. In looking back over Pat's medical records, the company noticed test results from December, eight months earlier. Though Pat's doctors didn't determine the precise cause of the problem until the following July, his kidney disease was nonetheless judged a "pre-existing condition" — meaning his insurance wouldn't cover it, since he was now under a different six-month policy from the one he had when he got those first tests."

One link from that discussion is a New Yorker piece, "How Should Obama Reform Health Care?"
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anarch
post Jul 9 2007, 05:09 PM
Post #12


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Michael Moore's Sicko -discussion.

US vs Canada vs Europe comparative anecdotes.

"In 2003, Americans spent an estimated US$5,635 per capita on health care, while Canadians spent US$3,003... Canada’s single-payer system, which relies on not-for-profit delivery, achieves health outcomes that are at least equal to those in the United States at two-thirds the cost."

"There was a woman who had very good health coverage. It covered mental health benefits. She was raped and went to see a psychiatrist as a result of the trauma she was suffering afterwards. But her health insurance refused to pay the psychiatrist because they said the rape was a pre-existing condition. It had happened before she went to the psychiatrist, so they wouldn't cover it."
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nohope
post Sep 2 2006, 06:29 PM
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Democrats and Republicans Downplay Health Care Crisis
http://www.gp.org/press/pr_2006_08_24.shtml
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hoosierman78
post Sep 1 2006, 07:36 AM
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Like has been said, driver's license box only means something if you have no family to override it. As far as I know, the only way to mostly (anymore, ANYTHING can be challenged in court, which is unfortunate if someone's personal wishes are very clear) ensure your wishes are carried out is to have a living will. In that, you can outline how long, if at all, you wish to be on life support, how far you want the medical professionals to go to save you, if you want to be an organ donor, etc.

While it can be challenged, just like any other legally 'binding' document, the better the language (i.e. have it done by a lawyer, not just written out and notorized - though that is better than nothing) the better the chances of your wishes being upheld.
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anoushh
post Aug 30 2006, 09:04 PM
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No, unfortunately your family can override your wishes to donate just because they say so. However, I was just reading on the BBC that this is due to change in the UK, which at the moment has the same policy, so that the donor's wishes are legally binding. Yay!

Lowredmoon, you made my day. Really--that put me in a good mood!
(And I'm afraid I"m with you on the hitting. And I don't approve of hitting generally.)
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venetia
post Aug 30 2006, 07:13 PM
Post #16


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From: Aotearoa (aka New Zealand)


Are drivers licence donor boxes legally binding in the US? In NZ people assume they are, but in reality the family's consent is what it actually hinges on. There is a move here towards changing the law because we have such a low donor rate.
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lilacwine13
post Aug 30 2006, 12:58 PM
Post #17


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Posts: 835
From: greater Minnesota


I agree, lowredmoon. Not sure about hitting anyone, though. (Well, maybe a well-placed smack upside the head...)

I was covered through my company, which is one of the reasons why I stayed so long with them. I didn't renew it because I think that will give me even more of a reason to find another job. Also, they switched providers and managed to find one that was even worse than the one they had before. sad.gif I guess I'll just stay healthy until I find another job and am eligible for coverage through them.


--------------------
All I know is that I don't know nothing.--Op Ivy
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lowredmoon
post Aug 30 2006, 12:04 PM
Post #18


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From: Morgantown, WV


i just renewed my driver's license today, and am now a proud organ donor.

i'm still uninsured, and at this point i'm actually looking for work based solely on getting healthcare. my older brother can't leave the job he hates, because his kids need health insurance. i'm convinced the US system is eventually going to hit critical mass and reform will HAVE to happen, and then people will be all, "oh, why didn't we do this in the first place?" and then i will have to hit someone.


--------------------
"Another belief of mine: that everyone else my age is an adult, whereas I am merely in disguise."
--Margaret Atwood
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anoushh
post Aug 30 2006, 11:02 AM
Post #19


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It seems that the fact it's totally not true should go without saying, but unfortuately a lot of people think it is.

The fact is there are very rare circumstances in which an organ can be used. You have to be reasonably young, and essentially die suddenly of an accident rather than an illness. (Maybe a few exceptions to this, but very few.) And honestly, who is going to be thinking "well, we might be able to save this patient who just had a car wreck, but hey, that looks like it might be a good liver, so let's not try too hard, ok guys?"

I know medical people can be scum--I've worked in the field for years--but that DOES NOT HAPPEN. (And many medical people are wonderful, of course.)

And anyone who is involved in a transplant knows that the donated organ or part has come from someone else's loss. Generally there's a hell of a lot of respect and even reverence around that.

I would very much hope that at least something of mine can be useful after I'm gone, rather than everything just decaying uselessly. And I can't say, but if I was in my family's position and knowing how important organ donation is to me, I'd think I'd take some comfort in knowing something good came out of something painful.

I mean, how often can you literally save someone's (or more than one person's) life???

I'm not a religious person by any means, but I do have strongly held values, and the word that keeps coming to mind about this is it just seems sinful to let other people suffer when they could be using organs you no longer need.

the American system also means that in spite of spending more money per capita on health care than, say, the UK, we actually have worse health.
Which is totally not surprising.

The US system is in even worse shape than when I left the US four years ago. It's an absolute disgrace and getting worse.
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ferraro
post Aug 30 2006, 10:05 AM
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From: cowboy country


maybe that is what dani means venetia but its totally not true.
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