• LucasWaffyWaf@lemmy.world
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    2 months ago

    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.

  • That_Devil_Girl@lemmy.ml
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    2 months ago

    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.

    • papalonian@lemmy.world
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      2 months ago

      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.

      • That_Devil_Girl@lemmy.ml
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        2 months ago

        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.

  • Stovetop@lemmy.world
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    2 months ago

    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.

  • Sterile_Technique@lemmy.world
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    2 months ago

    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.

  • GooseFinger@sh.itjust.works
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    2 months ago

    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.

  • Rob@lemmy.world
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    2 months ago

    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.

  • hactar42@lemmy.ml
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    2 months ago

    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.

    • CetaceanNeeded@lemmy.world
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      2 months ago

      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.

      • hactar42@lemmy.ml
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        2 months ago

        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.

        • CetaceanNeeded@lemmy.world
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          2 months ago

          I’m saddened to hear that, I’ve heard a few horror stories about emigrating here, it’s unfortunately restrictive. I hope you can find somewhere that will work for you and your son.

  • neidu3@sh.itjust.worksM
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    2 months ago

    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.

  • LaunchesKayaks@lemmy.world
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    2 months ago

    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.

    • PriorityMotif@lemmy.world
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      2 months ago

      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.

  • ChillPenguin@lemmy.world
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    2 months ago

    My wife has a rare disease. Requires expensive drugs monthly. We hit our max out of pocket early every year.

    Bye money. forever. until I die.

    Sometimes you don’t need anything crazy to describe how shitty our healthcare system is.

  • JTskulk@lemmy.world
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    2 months ago

    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!

  • AA5B@lemmy.world
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    2 months ago

    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

  • IzzyScissor@lemmy.world
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    2 months ago

    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.

  • SuzyQ@sh.itjust.works
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    2 months ago

    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.

  • sunbrrnslapper@lemmy.world
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    2 months ago

    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.