Post your gripes about health insurance here!

[derby378]

I've got a couple:

First off, my insurance provider (BC/BS) no longer allows patients to choose their own doctors - which of course is one of the promises of Obama's reform initiative. Instead, I'm allowed to choose a "group" of physicians whose clinic is covered by BC/BS, and I'm assigned a doctor out of that group. Fortunately, my doc is pretty cool, but if you don't like the doc you're stuck with, your only recouse may be to transfer to another group.

Also, they refused to cover my latest blood test because they say the fact that I'm overweight means they don't cover tests based on "obesity." Now it's true that I need to lose some more pounds, but come on.

This is not an HMO plan, incidentally - this is a PPO, where the care is supposed to be a cut above. Well, guess what?

:mad:

Your turn!

[HopeHoops]

1. 27 pieces of mail for a simple checkup

1. "We have received a request for a claim and a are processing it" (no reference)
2. "We are still processing your claim." (no reference)
3. "Claim denied - insufficient information." (call an 800 number, punch in some numbers, Barbie says it will be refiled)
4. "Request for reconsideration received."
5. "Action required. Submit proof that you don't have other insurance."


And so on...

[derby378]

2. "Submit proof" of no other insurance?

That is so not right. Hang in there.

[HopeHoops]

4. OH YEAH!

You have to sign a statement that you don't have ANY secondary coverage. If you DO have secondary coverage, they obviously want to claim that IT is the primary coverage and shift the ball into that court.

[derby378]

6. Who's your provider, if I may ask?

:hi:

[HopeHoops]

12. CIGNA now, but they aren't bad.

I had some REALLY bad ones in the past.

[Raineyb]

3. I had a hard time getting immunization that I'm covered for.

It was unfortunately a measles shot that I had to retake because the school didn't like the dates on my record. I called about 10 pediatricians who are part of the network. Almost all of whom insisted on me paying full price for a visit because I wasn't their patient. (One wanted 200 dollars. He promptly hung up on me when I laughed at him saying he had to get paid too that he didn't work for free. I wasn't asking for anything free I pay my premiums and the immunization is part of the bloody package.) I refused because I pay my premiums I should not have to pay for a covered shot. I finally had one call me back who kindly gave me the shot and didn't charge me for it. My insurance company paid for it as they were supposed to.

On the other hand, I've also had a prescription I'd been taking for years suddenly refused because the insurance company suddenly decided they didn't want to pay for it. When I went to pick up my medications I was one short and I KNEW I called in all of them at once. I had to get my doctor to change up the prescriptions in order to get around this. Why I should have to do this is beyond me. If the doctor says I need a prescription why the hell should the insurance company say I need to take different meds. They're not necessarily interchangeable.

[chi910]

5. 24 years old and she died because she did not have health insurance

Three weeks ago my 24 year old daughter in-law died along with her unborn baby after being in ICU for two months. Jen did not have to die. She leaves a two year old daughter and her husband....
I am asking you to read Jen's story so that others who are faceless and voiceless will not die in vein as she did. After reading her story, tell me why in the richest country in the world this young woman lost her life!!

Always in our hearts and prayers. Please read Jen's Story
http://bit.ly/doUQR

[truedelphi]

8. I am speechless. So sad

This household offers its condolences.

[Okie4Obama]

10. An outrage

That is the most horrific thing I have read in a long time. I can not imagine your family's pain. This is why health care reform is so badly needed!

[trigz]

7. Outside opinion (from Norway)

Can I just say that, as a Norwegian, and in lieu of this
speech:
http://www.whitehouse.gov/issues/health_care/?e=14&ref=image
- I find it to be completely and utterly incomprehensible that
anyone (apart from big insurance) should protest this health
care reform.

Take it from me, most Europeans are gasping in disbelief at
the level of "rhetoric" spouted in the debate around
the bill. And we are also very impressed with Barack Obama and
the 50-odd per cent of you who voted for him. He is the best
thing to happen to the US in...well, I hasten to say ever, but
time will tell.

[truedelphi]

9. I take it the trolls have already Un rec'ced.

I am at rec one, right now.

[KansDem]

11. Here's mine...

In 2003, I suffered a heart attack. After a week in ICU and four weeks medical leave, I returned to work half-time and underwent cardiac rehab for a couple of months (bicycle, treadmill, weights). I was feeling the best in years!

However, I made an appointment for a six-month checkup with my doctor. The appointment was made for 8:30am. Now, I had taken out a few hundred dollars, all $100 bills, from my bank account the day before to take care of grocery shopping and paying a few bills onsite. Well, I had one last $100 bill left and took it for my copay.

I walked in for my appointment and when asked for my copay which was $15-20 at the time, I presented the $100 bill. I was told they (the front desk) couldn't accept it because they couldn't break it--I'd have to go out and make change. Okay, I thought and started out the door. I got just outside and thought, "What the hell?! The bank doesn't open until 9am so I'd have to go to a grocery store. So I turned around and went back in and sat down in the doctor's office waiting room. The person at the front desk was surprised that I was back so soon and she asked, "Did you get change?" I replied, "No, it would be an inconvenience." She said, "We can't break your bill," and I replied, "Sorry, but that's not my problem."

Well, I wat there for awhile--fuming--and finally the door to the inner sanctum was opening and I was called. "Hmmm," I thought, "assertiveness education paid off," and went inside. A couple of the office employers were there and they told me I would not see my doctor if I couldn't give them my copay. I told them I had my copay, but they wouldn't accept it. They said they couldn't break the bill, and I said, too bad, that's not my problem.

We went back a forth a few times and they let me know in no uncertain terms that they were not going to permit me to see my doctor. I left.

I got home and called my doctor--left a message; called his nurse--left a message, and called the "front desk" and demanded to talk to the office manager. He was in a meeting but would call me when he was free. My doctor called back and apologized, saying that he was only an "independent contractor," and, aside from some input in hiring the front-office staff, he had no control over the policies. Those were set by the corporation.

The office manager called me back and explained they kept only about $80 in the till and therefore couldn't break my bill. I said that wasn't my problem and asked why they couldn't have simply billed me. He said they tried that in the past, but the patients didn't pay. I said I had my copay but they wouldn't accept it. He said it was because they couldn't break my bill. I repeated that that wasn't my problem. We went back and forth a few times: he was insisting I didn't have my copay but I kept reminding him I did have it, they wouldn't accept it. I told him they should have billed me, he said they tried that in the past but the patients wouldn't pay, I told him I was ready to pay but they wouldn't accept my bill...etc.etc.etc.

What's so funny about all this is I could have gone across the street to a large grocery store and used my $100 bill to by $15-20 worth of merchandise and know the store would have no problem in giving me change.

Finally, I advised him to do what Baskin/Robbins does...Post a sign saying "We will not accept bills larger than $20" I suggested he's policy was "rinky-dink," and reminded him that I found his argument laughable as he represented the industry that brought us the $5 aspirin tablet.