201
submitted 1 year ago* (last edited 1 year ago) by throwaway38575061@lemmy.world to c/mildlyinfuriating@lemmy.world

She literally called me at the time of the appointment to tell me she can't see me. She was so apologetic, but was like "I absolutely can treat you, but I'm not allowed by your insurance". Fuck this country.

Update: I went to urgent care. Before leaving home, I called to be sure they would accept my insurance (Aetna). They said yes.. After arriving for my appointment, they told me they do not accept my insurance. I will simply leave without paying.

Final Update: I can understand that that differences in physical biology demand different attention. That's not what I'm complaining about. It's the way it's set up. I was told that at my appointment. Why not just refer me to a specialist? The website could've even just referred me to urgent care (yes, my insurance requires a primary care physician's referral for urgent care, according to the urgent care facility). But, no, their goal is to obfuscate and irritate until the patient gives you and pays out-of-pocket.

I was able to receive care at a cost I could not afford. I won't discuss what I had to do to "find" the money to pay for care and prescriptions. That being said, the condition I was diagnosed with was more serious than a simple infection, and I'm glad that I saw a doctor. I need further treatment and just hope I can get insurance to cover any of it.

If you're an American reading this, please consider ways to get involved in organizing in support of Medicare For All in your community. Here is one resource I have found. We don't need to live like this. We deserve better. Stay safe and healthy, friends.

you are viewing a single comment's thread
view the rest of the comments
[-] nightscout@lemmy.world 4 points 1 year ago

So a few things. This is a CVS minute-clinic visit, not a visit to a general provider. The minute clinics have contracts with insurance companies that look a bit different in terms of what and who they are permitted by the insurance companies to treat. There are some really odd variations in these contracts by insurance companies for reasons that are not always grounded in science.

This, as you've noted, is an unfortunate reality of a for-profit health care system that is dictated by private companies, insurance companies, and mind-bogglingly complex contracts that sit between providers and patients. The most annoying part IMO is that insurance companies provide zero transparency into these contracts and the justification behind decisions. It's all "business decisions" at the end of the day, not decisions that are medically sound and in the best interest of the patient.

And for those wondering why OP maybe just didn't go to a "regular doctor" - the U.S. has a horrible shortage of general practitioners (primary care) physicians. This shortage is worse in some areas than others. And even if you're lucky to live in an area that has general practitioners, the waiting list to get into their practices might be long. This leaves many people relying on a "doc in the box" aka CVS Minute Clinic or some similar outfit. These doc in the box clinics often only have a nurse or nurse practitioner on site, with a supervising physician off side. They are for-profit entities and they work with the insurance companies to design their contracts to maximize profit.

If you ever find yourself in OP's physician, one easy way to get around this is to indicate that the visit is for something more general, like abdominal pain or unexplained fever. While the staff still might refer you off to another provider, it might be a good way to at least "get in" with someone.

Another option is to visit a local urgent care clinic if one is available and covered by insurance. These are often staffed by actual physicians so they can treat a wider range of conditions. Many often even have testing facilities right on site for a number of issues.

Finally, another option is to call your insurance company and see if they have an over-the-phone nurse consultant available. They can usually help direct you to the right location for treatment based on your symptoms and insurance coverage.

But yes, OP, I agree with you that we need something better. Medicaid and Medicare have slowly been expanding and my hope is that they will eventually expand enough to cover all Americans. it has been proven that they can still operate without completely decimating the insurance industry (see Medicare and Medicaid managed care). While I don't agree with for-profit health insurance, the reality is that they are a lobbying force that has to be worked with if we are going to get everyone universal coverage.

Source: Health policy professional by trade, extensive experience within the health care industry

[-] FierroGamer@vlemmy.net 3 points 1 year ago

How is the us a real place wtf?

[-] The_weapon_x@lemmy.world 0 points 1 year ago

First world country which treats its citizens as third world, that's what we live in. Follow the money, because if something isn't making money for someone, then we don't get it.

[-] EchoVerse@lemmy.world 1 points 1 year ago

A lot, and I do mean it, of third-world countries have better access to medical care and universal healthcare than the US.

load more comments (9 replies)
load more comments (9 replies)
this post was submitted on 25 Jun 2023
201 points (97.6% liked)

Mildly Infuriating

35398 readers
1466 users here now

Home to all things "Mildly Infuriating" Not infuriating, not enraging. Mildly Infuriating. All posts should reflect that.

I want my day mildly ruined, not completely ruined. Please remember to refrain from reposting old content. If you post a post from reddit it is good practice to include a link and credit the OP. I'm not about stealing content!

It's just good to get something in this website for casual viewing whilst refreshing original content is added overtime.


Rules:

1. Be Respectful


Refrain from using harmful language pertaining to a protected characteristic: e.g. race, gender, sexuality, disability or religion.

Refrain from being argumentative when responding or commenting to posts/replies. Personal attacks are not welcome here.

...


2. No Illegal Content


Content that violates the law. Any post/comment found to be in breach of common law will be removed and given to the authorities if required.

That means: -No promoting violence/threats against any individuals

-No CSA content or Revenge Porn

-No sharing private/personal information (Doxxing)

...


3. No Spam


Posting the same post, no matter the intent is against the rules.

-If you have posted content, please refrain from re-posting said content within this community.

-Do not spam posts with intent to harass, annoy, bully, advertise, scam or harm this community.

-No posting Scams/Advertisements/Phishing Links/IP Grabbers

-No Bots, Bots will be banned from the community.

...


4. No Porn/ExplicitContent


-Do not post explicit content. Lemmy.World is not the instance for NSFW content.

-Do not post Gore or Shock Content.

...


5. No Enciting Harassment,Brigading, Doxxing or Witch Hunts


-Do not Brigade other Communities

-No calls to action against other communities/users within Lemmy or outside of Lemmy.

-No Witch Hunts against users/communities.

-No content that harasses members within or outside of the community.

...


6. NSFW should be behind NSFW tags.


-Content that is NSFW should be behind NSFW tags.

-Content that might be distressing should be kept behind NSFW tags.

...


7. Content should match the theme of this community.


-Content should be Mildly infuriating.

-At this time we permit content that is infuriating until an infuriating community is made available.

...


8. Reposting of Reddit content is permitted, try to credit the OC.


-Please consider crediting the OC when reposting content. A name of the user or a link to the original post is sufficient.

...

...


Also check out:

Partnered Communities:

1.Lemmy Review

2.Lemmy Be Wholesome

3.Lemmy Shitpost

4.No Stupid Questions

5.You Should Know

6.Credible Defense


Reach out to LillianVS for inclusion on the sidebar.

All communities included on the sidebar are to be made in compliance with the instance rules.

founded 1 year ago
MODERATORS