Where do you put insurance company bureaucrats on this continuum of trust? You know, those guys who are paid to minimize the insurance company’s “medical loss ratios” by denying or minimizing claims? Because if your doctor says one thing and the insurance bureaucrat says another, the insurance bureaucrat wins. It’s one of the most insidious things about the US health insurance system, and would be abhorrent to doctor and patient alike in any country with a civilized health care system. The fun fact to top it off is that you’re paying for this privilege, because insurance bureaucrats don’t work for nothing. It takes time, money, and office space to tell your doctor to piss off because they’re not paying for your treatment.
I too am somewhat baffled by the greater American faith in someone whose employer wants to minimize payouts to increase profit, over a government employee less obviously restrained. It’s at best borderline dogmatic.
I am 100% sure this is the biggest cause of health insurance problems in America. I’ve told this story a million times on here, so I’ll give you the quick version: I tried my damnedest to price out a wrist (knee?) MRI. I called doctors, but they told me to call the insurance company. I called the insurance company, they said to call the doctor. They said I couldn’t get a price 'til I filed a claim, and I couldn’t file a claim until I had the procedure.
I spent at least 15 hours over 3 days on the phone trying to get prices. Eventually someone told me $500 was the magic number.
It ended up being over $660.
Fuck. This. System.
Well, I’m infuriated. Anthem Blue Shield is pulling out of my area, and the only available plan is through Blue Cross. I live in a very expensive town in California, and there is a single large medical foundation that almost everyone goes to. So, I can no longer go to my primary care doctor and the specialist I normally see.
The reason that Anthem pulled out is because of the removal of CSRs (Cost Sharing Reduction) so even though I’ve been insured my entire life (without subsidies other than employer), I have lost all my healthcare resources and have of find an entirely new healthcare support group. I don’t even know where to start.
The Covered California website is shite, and I spent about an hour trying to come up with a password because they won’t allow dictionary words or names within the password. This is egregious. It also would not accept my phone number even though I entered it exactly in the format they required.
Fuck Republicans and Trump. I imagine I’m not the only person who is affected by this.
You might consider applying for Medi-Cal, if your income isn’t excessively high. From what I’ve seen verifying Medicaid benefits for a private health insurance company (coughAnthem*sorry), California has some of the most liberal eligibility requirements for Medicaid, and they offer a buy-in / spend-down program so if you’re over the income limit, you may be able to pay the difference and it might be lower than the premiums you’d get going with a private plan.
Also note that Medicare has open enrollment through Dec 7th if you’re disabled or over 65.
Good luck to you, hope it works out well. And please support Medicare for all - put me out of work! Please! I don’t want to keep reading stories like this about the company I work for (or emails from the CEO bitching because the Justice Department blocked his move to expand his near-monopoly into a full-monopoly.)
Nevada has a plan that is worst than Bronze but they don’t call it Copper.
wasn’t one of the major points of the ACA getting rid of a plan that doesn’t cover much and just takes your money so you can say you have “insurance”? :dubious:
We’ll get one once every large employer wants it (or rather, wants to be rid of the cost and inconvenience of insuring their employees). To be honest, I’m at a loss to explain why they aren’t demanding it now, but it’s only a matter of time.
Of the two people in the room when medical care are being discussed, neither of them know what the cost will be. When I tried to find out the cost of a straightforward non-emergency procedure my “$500” cost was understated by about $100, due to a medical code that I didn’t know was going to be included.
As bad as this is, we can delve into the fact that you can’t possibly gain an understanding of these out of pocket costs when you’re shopping for insurance. Years ago, when I switched to a High Deductible HSA plan (under my existing provider) the cost of one of my medications skyrocketed.
It is insanity to believe that the average American consumer can make anything resembling an informed decision on health insurance.