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.
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.
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.
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.
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'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.
This is something I haven't really thought about. I work in healthcare and I can genuinely tell you I'd have no idea how to handle this, if your meds got sent to my pharmacy there would likely be a huge delay and I guarantee you it would not be anything intentional on our side 😭 of course an insurance company will have dealt with this many more times than a chain pharmacy and should have practices in place for such situations, but I don't think there's anything in my system I could do to say someone is both male and female.
I can genuinely tell you I'd have no idea how to handle this
Yeah that's pretty much the story of my life. Everyone from insurance, to employers, to the military, to legal paperwork, to traveling, and everything else. I was even excommunicated from my church when I was 12 for the "crime" of being intersex.
Not only do I have this issue, my little brother and my uncle on my mom's side does too.
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.
My childhood friend needed an operation, her family made a commercial for the local TV station trying to raise the money, but she died before they could get enough.
I've got cluster headache. Only medication that had any noticeable effect was Prednisone. Not even that expensive of a drug, but more than I could afford out of pocket. Insurance wouldn't cover it because they considered an oxygen mask to be a more appropriate treatment, even though I'd been using them for months with no improvement, and O2 only works for a small percent of people with cluster headache, anyway.
Couldn't afford to get the meds. Not legally, at least. A coworker was taking Prednisone for a different condition, and managed to convince his doctor to double his dosage, and I paid him for the difference, until he stopped taking it altogether. Ended up having attacks again, and missed enough work because of them to get fired. Between the pain and losing my job, that was easily one of the lowest points in my life.
I wouldn't wish our healthcare system on my worst enemies.
The worst thing about that are the prices in the US.
Not only that the insurance system is shit,you are also getting cheated there.
I actually looked up Prednisone in Germany (third most expensive pharma market in the world):
5mg, 100x, 16 bucks. Basically around that price for all halfway normal doses.
In other words, for 60 bucks you could easily cover a year.
Also Canadian, would drag myself across the border on a broken leg and throw myself on the mercy of the Niagara Falls hospital before I ever got near an American hospital. I'd be bleeding from my head wound and assuring the border guard I had no alcohol or tobacco and did not spend over my dominus.
This is scary, as an European. I had my left lung collapse too. Two years later my right one. After that I had to have surgery on my right lung (Pleural Abrasion) and a few months of physiotherapy after that. I also had a yearly appointment with a Pneumology MD for 5 years to follow the development of the lung until it was all fine.
How much did I pay? You guessed it...zero. Now I wonder how much would that set me back in the US with or without insurance.
I’m glad you’ve recovered! They did say it was more likely for my spouse to have a lung collapse again, which is scary.
Luckily my spouse’s employer has someone whose whole job is to fight with insurance. She got insurance to admit that in an emergency we didn’t need pre-approval which brought our bill down some.
Had something similar, failed to get pre-approval for a CT scan to diagnose a pleural effusion. Yes, I was supposed to wait 24-36h for someone unfamiliar with my case and likely not even a doctor to determine if a diagnostic test was nessasary.
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.
When the vaccine came out it was allocated in stages. Healthcare providers and the elderly were prioritized. As they should be. When it was finally available to the general public, the state released a website that helped you find the nearest pharmacy with doses. And it was guaranteed to be free.
I found one local pharmacy in a nearby village and we got our dose. They didn't ask for a copay, but did write down our insurance info. Two weeks later, we got a bill from United Health because we unknowingly used an out of network pharmacy for our 'free' shots.
Minor thing, but it's just an example of our garbage. I've never had a good experience with healthcare in the US. OK - scratch that. The time I needed stitches for a bad cut, the receptionist who was billing me whispered that "If you're any kind of 'medical professional,' you can remove them yourself and avoid another visit." Shit - I own stuff for sewing. That was good, although slightly painful advice.
Canada was wild, though. I visited a walk-in clinic for an abscess on my leg. No bill. I also visited the ER with chest pain. In both cases I felt like a criminal for leaving without giving them my credit card info.
Staged rollout here as well (I think that was pretty universal). Due to traveling a lot, I asked the people at my local Village clinic (yeah, I live in the middle of nowhere), if it was possible for them to make a note that if they happened to have any leftovers doses in the group before me (such as if someone didn't want theirs for whatever reason), if I could have it.
I made it clear that I didn't want to jump the queue ahead of anyone before me, as I'm reasonably healthy, but I could really use being at least first in my group.
And I'm glad I did, because they obliged, and a month later I found myself back in the US, and this time I caught covid. I'm sure the vaccines was what caused it to be extremely mild, bordering asymptomatic.
Come to think of it, I've caught covid twice, both times in the US.
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
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.
I could not walk for more than 5 minutes without excruciating pain. I finally asked to be taken to the hospital after a back spasm that had me bash my face after a fall.
Went to the hospital. Was diagnosed with "mild scoliosis" and "anxiety" and sent home with stronger than average Tylenol. Was bedridden for nearly 2 months. Lost my job. Got other appointments for GP. Looked and said I needed a specialist. I could not afford a specialist, as I was now out of money. They shrugged and wished me luck.
I was forced to stay like this for nearly 2 full years.
When I was on the verge of killing myself, someone offered to pay for a chiropractor. I didn't care. I had nothing to lose.
Anyhow, long story short, guy found that my spine had been forcefully lodged into my pelvis and stuck there. Dude had me healed in week.
This is NOT an endorsement for chiropractors— this is a testament to the failure of the healthcare system. I could not see anyone, so my desperation led me there.
I still have back issues. But I can walk again and be touched without pain.
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.
I make over $150,000 a year and I live pay check to pay check because my son has autism level 2, speech delays, and other motor skills deficits. He has some sort of therapy every weekday. He's 13, so we've been doing this for 11 years now. And every year it is a fight to get things paid for.
This year my company switched insurance providers and the speech therapist that he has gone to for 6 years was suddenly out of network. So, I either pull him out and start over somewhere new or do what I did and pay $200 out of pocket every week. Which does not go towards our $13,000 deductible. Next year we're switching again so I'm sure there will be something they won't cover.
I make too much money to get anything from the state, which seeing how I live in Texas, I'm not really sure I'd want their services. Come hell or high water we getting out of this state and if possible this country next year.
In Australia your son would be eligible for the National Disability Insurance Scheme which would supply government funding for all the services he requires. You would possibly also be eligible for your own disability support funding as his primary carer but I'm not sure on the criteria for that.
That would be amazing. Sadly I've looked into immigration for Australia and New Zealand and they both have restrictions based on autism. They aren't guaranteed disqualifier, but it is a risk, that if I found a job that was willing to sponsor me, I might not be able to go.
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.
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.
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!
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.
I had major depression when I was younger. I couldn't get individual insurance because it was a pre-existing condition. I couldn't afford it, anyway, because getting and keeping a job was very difficult because, uh, depression? So, getting a job with a group plan was also out of reach. I had to research it and treat it myself, which, goddamn right I'm proud I managed.
But now I'm middle-aged, single, and probably will never have the savings to retire. Eat a Grand Canyon full of Godzilla dicks, U.S. healthcrime system.
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.
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.
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.
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.
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.
I went for surgery that was to repair a urethral stricture, with the expressly stated reason for doing it as being able to be catheterized in a future spinal fusion procedure. I told every single member of my care team this information, and all knew about the spine instability. A Spondylolisthesis diagnosed by their same hospital system.
I woke up in agony screaming before I could see. They put me in a position that allowed my back instability to shift. I was screaming to drop the bed. The nurse told me to calm down.
When I was finally laid flat, I noted I could not feel my genitals and I could not feel about half of my legs or any of my feet. Totally numb.
I was discharged from the hospital 3 days later with a walker because I couldn’t feel my feet and needed assistance to walk for a proc sure that never should have required it.
They billed me $250 for the walker, and never followed my requests to ascertain why I was paying for a walker that was the resulting need of malpractice. This was sent to collections.
I get phone calls weekly about a walker I should never have needed, and should not have been billed for as “outside of network” because it was not pre-approved for an urology procedure.
Who in the fuck assumed a loss of leg function from an urology surgery? Who gets that pre-approved?
Dad was prescribed a medication that fixed his health issue. Changed jobs and insurance. New insurance says that medication isn't for that issue and that he needed to take a different medication that his doctor had previously tried and didn't work very well along with nasty side effects instead. They argued about it. Now he's stuck with the worse medication.
Had to go to the er for a staph infection, no insurance. In short I'm in about 8k worth of debt to the hospital. I was in the er for about an hour. 8k for an hour get fucked integris, so I never paid it out of principle
'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?!
Group bargaining works, it's just that people heard "we're going to use our position to lower consumer costs", but what they said was "we're going to use our position to lower costs". They have no motivation to pass those savings on, considering you probably get a plan partially subsidized by your employer so it's cheaper than what you can get alone, and you're legally obligated to buy insurance.
Look at what the government can essentially dictate as the procedure costs because they're big enough that their "accept our terms or don't see our patients" is a compelling threat, particularly when backed by the tax ramifications of saying no. They've got leverage and no particular profit motive, so they can tell a hospital "a surgery suite costs you $250 an hour, the surgeon $150, staff another $500, and material $100, with recovery costing another $250. We'll pay 80% and you can bill the patient the remaining $250. If they have gap insurance they'll pay and they can't dispute because we payed". And the hospitals invariably just accept it, rather than lose tax status and ~60% of their patients.
only profit when human beings suffer. how many other industries get to do that?!
Defense contractors, daytime talk shows, and reality TV. 😛
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.
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.
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.
How does this work with the reproduction of new blood cells when you donate so often? I donate blood as often as I can and missing 500ml of the red juice is really noticeable.
I did drink a lot of water but otherwise felt really good with fresh oil. I donated 32 times the first year I was diagnosed. Weekly was the most frequent I could do it, sometimes if my vitals or hemoglobin were off I would have to skip. My ferritin was 2700ng/mL when I found out. The normal range is 30-400. When I had a liver biopsy it showed my bile was carrying iron, something my hepatologist had never seen.
Once I got my ferritin down I was able to donate less often but whenever my count gets higher I have to donate more frequently. Unfortunately I no longer can see the doctor who is familiar with my case and can't afford the time off of work to find a new doctor covered by my insurance.
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.
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.
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.
Cigna dropped my medicine coverage. I had to to drop two name brands simultaneously to generic else i would be out 4k every 30 days.
The switch was not pretty.
Like, mental breakdown, life changing, never-will-be-the-same not pretty.
That was..8 years ago. I imagine if it was something maintaining my physical health I certainly would have died. I mean, shit, I nearly did.
Don't get me started on the arm i broke as a kid, that didn't heal correctly because a narcissist parent(RN) wanted to skip the er wait and had hospital buddies patch me up on the dl instead. A bionic arm sounds more feasible than actually getting it to where I could play strings again without pain.
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.
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.
I went in for a $10,000 surgery. Told them to bill my insurance and I came out with a bill for almost $30,000! Insurance barely paid $7,000 left me with the rest
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.
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.
£80 for 60 days of full coverage would be fantastic rates for an American. Many are paying $350/month for insurance, and still have +$5000 deductibles.
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.
Mine are all boring shit like my insurance deciding how many relapses of cancer my mom was allowed to fight or them challenging my surgery a month before despite having gotten pre approval or needing pre approval at least once a year for a med I'd been on for a decade.
But a friend had an actually entertaining one, she had trans bottom surgery and they paid for everything except for the "removal of the penis" which they demanded to know why it was necessary
Edit: sorry thought it said health insurance story
In theory my insurance covers my weekly out-of-network therapist. In practice, I pay the therapist, submit my bill to insurance for reimbursement, and it disappears into the ether. They claim they'll pay me back within 60 days (sometimes 60 business days, sometimes calendar days).
I've gotten a couple reimbursements in the last year, but I'm currently waiting on at least 5 months of payments. That's maybe $2000 and I'm lucky I can float that through savings.
And this is all supposed to go towards my annual maximum out-of-pocket expenses but the online system doesn't show that, but the papers I'm mailed do.
Oh, and in theory I could go to an in-network therapist but in practice they either don't exist or aren't a good fit.
Edit: and this is with what's theoretically really good insurance, thanks to my union. I spent 5 months not knowing if they'd arbitrarily deny my therapy.