Aldeer.com Forums Alabama Deer Talk Aldeer General Forum Health care officially sucks.

***RANT ALERT*** At the end of the year I signed up for health care for me and my wife. I prepaid for December like i was told to. I have Multiple Schlerosis and take Ocrevus every 6 months to help treat it. Well, this year they told me I had to have a Silver plan from BCBS to cover my drugs and such. They offered only one plan(the same as we've had for the last 3 years). Well, it came time to have my infusion, got the meds ordered and then BCBS tells me I can't see my Dr., as she's not on the plan they way she had been the past 3 years. So , i'm stuck paying for coverage I can't use. I was supposed to go in Thursday for a procedure to check out the veins in my left leg that aren't functioning properly. My leg turns purple below the knee and stays cold and hurts like hell 24/7. The nurse from Grandview just quoted me $24,0000 for a $400 test. So I'm stuck without an MS Dr., or a way to have these 2 tests done! So now I'm stuck trying to find a hospital that will take my insurance( most don't take it right now) that basically covered me and my wife for our needs. Now, I have no coverage at all. They changed the policy after the first if the year (Grandview didn't renew the contract) and I am stuck with it. It should be illegal to bait and switch like this. It shouldn't be this hard to get what you signed up for. Since when does a health insurance company practice medicine, where they mandate who i can see AFTER i signed a contract? I know I'm just pissed off right now, but it shouldn't be this way.

That doesn't sound like a rant to me, it's more of a legitimate complaint. It sucks that insurance has gotten to the point of being unusable. It especially sucks for someone such as yourself with serious medical needs. Hope you're able to find a solution. I'll be praying for you.

Haha welcome to my life… I deal with insurance companies daily and fight and claw with them. The clamp our balls as to how to practice medicine. Yep… it’s not the docs fault as you wouldn’t want to work for free due to the insurance company not wanting to pay it etc. That sucks man…praying you get it all worked out!

Ask for a non insurance cash price. I know it sounds crazy but it’s often lower and sometimes much lower than your copay.

Bullshit! Welcome to my world 😂 It sucks but ultimately it is your responsibility to make sure your provider is in the network. It’s not a bait and switch. Reality of the situation is that providers can leave carrier networks at any time. If Tiler takes Ambetter and decides not to during the year he can leave the network. Your agent should have reviewed providers in the network with you to ensure your provider was part of it. But in the end the agent cannot guarantee the network will be the same. Network providers change all the time. I review my prospect’s providers and let them know if they are in the network but always with the caveat that network providers can change at any time. There are no guarantees. This is why I tell my Medicare clients who are concerned about keeping their provider to stay in original Medicare and get a supplement. This way you can go to any provider who accepts original Medicare. Part C plans, group health and ACA you’re SOL as far as networks and providers staying the same. Sorry this happened to you but it’s not unusual.

One of the first things I asked about is the network and are my Doctors and what all other services are in it... then it's about my coverage... I don't sign onto a thing until I'm satisfied about a plan and what is covered.

I have a brother who had to go to the ER while were eating chinese in Foley , al ... passed out in the restaurant , paramedics get there and whisk him off to the ER just spitting distance away on I59, not two miles drive I'd bet... they check him out he gets stable .. looks like his metformin was bothering him , he gets a bill from the Ambulance company .... like $2000 dollars and his plan says he only pays $150 .... turns out that price is only if the ambulance service is in the network... this company wasn't in the network.. he's got the BCBS select silver plan. I'd have thrown him in the truck drove him myself if I knew the ambulance company was going to ask for a leg and an arm... I told him don't get sick in Baldwin county ever again.

My visit to the UAB trauma center last year was billed at $28K, for about 4 hours. Insurace paid a little over $250 and I paid a co-pay of $250.

Insurance being a hassle is why so many therapists and psychiatrists don't accept insurance. You pay them the hourly rate they want, and then you file with your insurance to get reimbursed.

The whole process is a racket and a scam.

Short of the Luigi option how can we fix it? $12.00 a year x 330 million is $4 billion either accept the money or get your business license revoked. Drug companies must have a North American base of operations(heres the authortian/socialism part.) Use the Military to transport drugs to usa. You go bankrupt your no longer allowed in healthcare. Some potentate. in whereverastan doesn't want to release drugs to harm America? Turn the AC130s loose and rain fire. Haven't got it all figured out just doing Dave exercises.

I remember when BCBS was gold standard insurance. That was before Obamacare ruined it for the vast majority of America. Once you are required to buy it, they limit choices and the entire thing goes to hell. I'd love nothing more than to see Obamacare completely trashed. We don't need a new law or program. Let it roll back to what it was before Obamacare. Then open up competition across the states and you'll see improvement.

Guru, maybe try calling the insurance company and ask them where to go have the test done. I would light their phone lines till I got an answer. certainly frustrating.

This "in network/out of network" is the biggest scam in insurance.

I know I've told the story here of when my son was born. Wife's water breaks at 10:30 on a Friday night...we're 100% having a baby. We load up, and drive 50 miles to Mobile Infirmary...an "in network" hospital. Her OB/GYN is out of town, so one of the other doctors in the group who is on call shows up...also "in network". Everything is awesome, as I've paid my $200 copay. Anesthesiologist and nurse anesthetist come in and do their thing. Son decides he isn't ready, so 17.5 hours later, decision is made to do a c-section. Goes great. Son enters the world, and we go home 2 days later.

One month later...we get a single bill in the mail from the anesthesiology group. Somewhere in the neighborhood of about $3200. Turns out, even though we did everything like we were supposed to do, the anesthesiologist that was on call that night was "out of network". Something we had ZERO control over. Insurance had paid 50% of the "out of network" charge, and they wanted me to pay the other half. I asked them how much they would have been paid if they were in my insurance's network, and it was about $1600. I told them to pound sand, and I'd send them $25/month until it either got paid off, or they got tired of getting that $25/month. About a year into this payment arrangement, with them calling wanting more money about every two weeks, they finally sent me a letter saying that if I were willing to send them $400, they'd consider it paid in full. I called and told them that I would send them $200, and consider it paid. They agreed...I made them send me an invoice for the total amount of $200 with a letter saying that would pay off the bs debt. When it arrived, I wrote a check, put "paid in full" in the "for" line, and never heard another word from them again. Still mad about it.

United Healthcare, for anyone wondering.

Also…I’ll add. A good primary care doc/nurse can help fight this stuff with you.. my nurse as well as my office insurance ladies fight them daily and are fantastic at it. I’d reach out to your pcp for help as well

When I signed up all my Dr's and meds showed covered(December). January 8th is when I find out that Grandview didn't agree with the new contract. So I'm left out in the cold. MF'rs. Then it's too late to change they say.

One more thing to add. This is why the CEO that was killed was targeted. And that's why so many view the shooter as an hero.

healthcare in the US sucks like hell.

Yes Sir you are correct Im dealing with some of these issues now.

You'll be happy to know united is supposedly under investigation. https://x.com/unusual_whales/status/1922790126721052812

From what I have seen over the last several years, you are correct.

Stay healthy as long as you can. Change your modifiable risk factors like smoking, sedentary lifestyle and obesity is all i can say.

In hindsight, I probably shouldn't have even mentioned United Healthcare. To me, this is more of a doctor billing issue. There should not be different amounts of bills for the same procedure, depending on how you are paying, or who your insurance carrier is...other than maybe a small discount for paying cash up front. Standardize it, and be done. Insurance has "x" amount of time to pay the doctor.