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[-] LucasWaffyWaf@lemmy.world 4 points 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.

[-] TheAlbatross@lemmy.blahaj.zone 4 points 2 months ago* (last edited 2 months ago)

There are far worse out there, but about a year ago I injured my hand somehow. I couldn't close my fist, which made it hard for me to work and support my partner as I do a majority of the cooking and chores. I couldn't make a firm enough grip to use cast iron cookware. I was really concerned about this for a number of obvious reasons, so I went to the doctor.

I looked up an in network doc, call them up, confirm they take my insurance, double check that the kind of care I was looking for was covered. At my appointment they ask to do a physical as well, since I was due for one. During that they asked all the normal questions, the poignant one here being "do you smoke?" I replied "I have one or two cigarettes socially when drinking with some friends, which happens maybe once every other month or less." This changed the tone of the entire visit.

My concern about my hand was largely disregarded and the doctor began talking to me about smoking cessation and the dangers of tobacco. Gave me pamphlets, tried to ask if I'd consider quitting, asked if I've tried alternatives. I tried to turn things back to my hand and she wasn't interested. After I strongly insisted that was my sole medical interest, she gave me a referral.

I pay my copay up front and leave. I go to the specialist a few days later. He looks at my hand for 45 seconds and gives me a wrist brace and tells me to sleep with it on. I pay my copay and leave. Wouldn't ya know? That did it! My hand was working again.

I call the specialist to follow up on his care and say it worked well. He told me I need to speak with billing to settle my bill. I'm confused. Wasn't the copay for that? He says the insurance covered the visit but not the medical device (the wrist brace). So I check with billing and they want four hundred dollars. I'm flabbergasted. I check where they got the product, because surely it couldn't cost that. I found the identical product, brand and all, on Amazon for $13. I'm livid. I argue with them, they say they can't do anything.

I call the insurance and they say my policy was clear about specialists and medical devices. Dejected and feeling stupid, I just pay.

About a week later I get a call from the first doc saying I needed to settle up as well. I owe them five hundred dollars!!! How?? They say the bloodwork they did wasn't covered. I plead saying that's a normal part of a physical, no? They say yes, but I didn't come in for a physical, according to the billing, I came in for a smoking cessation meeting!!

I tried for weeks to get the doctor on the phone to rectify this but they wouldn't speak to me. My insurance company said they didn't cover bloodwork as part of that and the doctors office wouldn't change the billing.

I'm sick of doctors, I'm sick of insurance companies. If I get sick, I make chicken soup, drink tea, and scarf OTC drugs. I sprang my ankle fishing earlier this year. Did I go to a doctor? Absolutely not! I can't afford a $900 bill every time something goes wrong.

I pay $360 a month for this. Thankfully I make enough that this wasn't so damaging on my life, but I stopped buying as much meat and ate mostly beans for a year and didn't travel for my vacation. I had been hoping to visit my father across the country that year but we had to put it off. It changed my outlook on medical services drastically and I'll never be so honest to doctors again.

[-] lightnsfw@reddthat.com 2 points 2 months ago

This shit is why I haven't been to a doctor since high school.

[-] vinnymac@lemmy.world 1 points 2 months ago

I had a similar experience in the last year. They basically try to trick you into paying. They know exactly what they are doing too.

This one time a few years ago I literally went in for a check up (first time all year) to find I had a completely new doctor assigned to me. And I couldn’t even make this shit up if I tried. The new doctor was not in my network, they did not inform me during my visit, and he tried to get me to do shit (upcharge) that fortunately I outright refused the entire time we spoke.

When the bill came they tried to charge me out of network prices, and I basically fought them for six months saying that it was a surprise bill until they finally gave up. I don’t plan on ever going back to that office again in my life.

[-] JackbyDev@programming.dev 1 points 2 months ago

I think what annoys me so much about doctors is that they charge you afterwards. If you knew what you were doing was gonna cost $500 you wouldn't have chosen to do it. They know what your insurance is. They know what they charge. But they don't tell you until afterwards.

[-] fantine9@lemm.ee 3 points 2 months ago

My husband was diagnosed with ulcerative colitis in his early 40s. There was a medication that kept his symptoms more or less in control.

Then he lost his job. The meds ran out and it turns out they cost thousands of dollars without his work insurance plan. This was just before Obamacare, and there was no way we could afford unsubsidized insurance for him on my salary.

His colitis got exponentially worse, and was treated only spotadically when I could scrape together a few hundred dollars for the doctor visit, where he might be able to get enough free samples of the med or a round of steroids to reduce the gut inflammation.

One night as we were lying in bed winding down to sleep, I heard him drop his magazine on the floor and start what I now know was agonal breathing. I called 911 and did my best with CPR, but his heart had stopped and in all likelihood he was dead before the paramedics arrived. He was 53 years old.

I found out from his death certificate that he had severe ischemic heart disease. It was undiagnosed because he hadn't had regular medical care for years because of the vicious circle of unmedicated symptoms/inability to work/no insurance.

That's my horror story. There's also my 4+year quest to be diagnosed with MS, being told by multiple doctors that if I lost weight I wouldn't be so fatigued I could barely move, or have vertigo, or fall down for no reason, or whatever symptom I had at the time. But hey, at least that story eventually ended with diagnosis and treatment... as long as I have my job and insurance, anyway.

[-] ChaosCoati@midwest.social 2 points 2 months ago

My spouse had their lung collapse. Insurance denied it because we didn’t get advance approval for their lung to collapse.

[-] spirinolas@lemmy.world 2 points 2 months ago

This is scary, as an European. I had my left lung collapse too. Two years later my right one. After that I had to have surgery on my right lung (Pleural Abrasion) and a few months of physiotherapy after that. I also had a yearly appointment with a Pneumology MD for 5 years to follow the development of the lung until it was all fine.

How much did I pay? You guessed it...zero. Now I wonder how much would that set me back in the US with or without insurance.

[-] ChaosCoati@midwest.social 1 points 2 months ago

I’m glad you’ve recovered! They did say it was more likely for my spouse to have a lung collapse again, which is scary.

Luckily my spouse’s employer has someone whose whole job is to fight with insurance. She got insurance to admit that in an emergency we didn’t need pre-approval which brought our bill down some.

[-] Nomecks@lemmy.ca 2 points 2 months ago

Canadian here. Had an accident and took a ten minute ambulance ride in Minnesota. $1400.

[-] BonesOfTheMoon@lemmy.world 2 points 2 months ago

Also Canadian, would drag myself across the border on a broken leg and throw myself on the mercy of the Niagara Falls hospital before I ever got near an American hospital. I'd be bleeding from my head wound and assuring the border guard I had no alcohol or tobacco and did not spend over my dominus.

[-] Nomecks@lemmy.ca 2 points 2 months ago

No joke: My mom burned herself with coffee really bad and we high tailed it back across the border to Sarnia before getting treated.

[-] corsicanguppy@lemmy.ca 1 points 2 months ago* (last edited 2 months ago)

Also Canadian.

While in Seattle on an H1, needed to go to Northgate for a routine maintenance procedure. (I'm a twin. Guess which procedure)

It's a well-developed thing, and so i tell the doc, "look. This has been developed for 10 years, it responds well once the pressure's off, don't cut me just gimme a local and draw it out with a horse needle." He agrees.

Next thing I know, "And here we have Mr Guppy, presenting with..." and a dozen kids are looking at a nekkid part of me. And they shoot the local.

And I feel the push of the scalpel cutting. Those motherfucking butchers. And butcher they did.

Had to pay $500 on the way out, and apparently that's a lucky thing even with my American insurance at the time.

Ultimately I came back to canada because the risk of a car crash ruining me financially for life was too much to bear. Fuck that.

[-] Dasus@lemmy.world 2 points 2 months ago

ProPublica is doing a story and was asking for these on Bluesky at least. Wanted people to share their stories.

[-] That_Devil_Girl@lemmy.ml 2 points 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 1 points 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 1 points 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.

[-] JackbyDev@programming.dev 1 points 2 months ago

What insurance company was it? 💜

[-] Dagamant@lemmy.world 2 points 2 months ago* (last edited 2 months ago)

Between my wife and I we make 200K a year. We have a roommate to help pay bills because between her chrones disease and our kids health issues we can’t afford to live. She has been without her chrones medication for 6 months because the humera was causing problems and the new prescription has been in limbo between pharmacies not wanting to deal with it or her insurance and her insurance continually sending her to pharmacies that don’t accept her insurance. Medication that is easily affordable and available in other countries is dangled just out of reach while she suffers.

[-] Stovetop@lemmy.world 1 points 2 months ago* (last edited 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.

[-] shittydwarf@lemmy.dbzer0.com 1 points 2 months ago

My childhood friend needed an operation, her family made a commercial for the local TV station trying to raise the money, but she died before they could get enough.

[-] SouthEndSunset@lemm.ee 1 points 2 months ago
[-] granolabar@kbin.melroy.org 1 points 2 months ago

Careful, apparently a lady got charged for suggesting health insurance company might be next.

National headline and all

[-] shittydwarf@lemmy.dbzer0.com 1 points 2 months ago

Also apparently the word manifesto is a bad word on Reddit now

[-] granolabar@kbin.melroy.org 1 points 2 months ago

Reddit is undergoing a serious scrab... There won't be much evidence of the genuine sentiment.

Shills are back doing politics shit.

Although they are getting called out for it for now it seems.

They will keep this up until Unity falls

[-] neidu3@sh.itjust.works 1 points 2 months ago* (last edited 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.

[-] ArtieShaw@fedia.io 1 points 2 months ago

Ah. COVID.

When the vaccine came out it was allocated in stages. Healthcare providers and the elderly were prioritized. As they should be. When it was finally available to the general public, the state released a website that helped you find the nearest pharmacy with doses. And it was guaranteed to be free.

I found one local pharmacy in a nearby village and we got our dose. They didn't ask for a copay, but did write down our insurance info. Two weeks later, we got a bill from United Health because we unknowingly used an out of network pharmacy for our 'free' shots.

Minor thing, but it's just an example of our garbage. I've never had a good experience with healthcare in the US. OK - scratch that. The time I needed stitches for a bad cut, the receptionist who was billing me whispered that "If you're any kind of 'medical professional,' you can remove them yourself and avoid another visit." Shit - I own stuff for sewing. That was good, although slightly painful advice.

Canada was wild, though. I visited a walk-in clinic for an abscess on my leg. No bill. I also visited the ER with chest pain. In both cases I felt like a criminal for leaving without giving them my credit card info.

[-] neidu3@sh.itjust.works 1 points 2 months ago* (last edited 2 months ago)

Staged rollout here as well (I think that was pretty universal). Due to traveling a lot, I asked the people at my local Village clinic (yeah, I live in the middle of nowhere), if it was possible for them to make a note that if they happened to have any leftovers doses in the group before me (such as if someone didn't want theirs for whatever reason), if I could have it.

I made it clear that I didn't want to jump the queue ahead of anyone before me, as I'm reasonably healthy, but I could really use being at least first in my group.

And I'm glad I did, because they obliged, and a month later I found myself back in the US, and this time I caught covid. I'm sure the vaccines was what caused it to be extremely mild, bordering asymptomatic.

Come to think of it, I've caught covid twice, both times in the US.

[-] captainlezbian@lemmy.world 1 points 2 months ago* (last edited 2 months ago)

Mine are all boring shit like my insurance deciding how many relapses of cancer my mom was allowed to fight or them challenging my surgery a month before despite having gotten pre approval or needing pre approval at least once a year for a med I'd been on for a decade.

But a friend had an actually entertaining one, she had trans bottom surgery and they paid for everything except for the "removal of the penis" which they demanded to know why it was necessary

Edit: sorry thought it said health insurance story

[-] GooseFinger@sh.itjust.works 1 points 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.

[-] viking@infosec.pub 0 points 2 months ago

Get that tumor checked, now. If it's something malignant, chances are "can't afford" is the least of your worries.

What's the worst thing that can happen to the bill? Another collections call you never answer? Beats a premature death.

[-] sudoshakes@reddthat.com 1 points 2 months ago

I went for surgery that was to repair a urethral stricture, with the expressly stated reason for doing it as being able to be catheterized in a future spinal fusion procedure. I told every single member of my care team this information, and all knew about the spine instability. A Spondylolisthesis diagnosed by their same hospital system.

I woke up in agony screaming before I could see. They put me in a position that allowed my back instability to shift. I was screaming to drop the bed. The nurse told me to calm down.

When I was finally laid flat, I noted I could not feel my genitals and I could not feel about half of my legs or any of my feet. Totally numb.

I was discharged from the hospital 3 days later with a walker because I couldn’t feel my feet and needed assistance to walk for a proc sure that never should have required it.

They billed me $250 for the walker, and never followed my requests to ascertain why I was paying for a walker that was the resulting need of malpractice. This was sent to collections.

I get phone calls weekly about a walker I should never have needed, and should not have been billed for as “outside of network” because it was not pre-approved for an urology procedure.

Who in the fuck assumed a loss of leg function from an urology surgery? Who gets that pre-approved?

Fucking cunts.

[-] vivavideri@lemmy.world 1 points 2 months ago

Cigna dropped my medicine coverage. I had to to drop two name brands simultaneously to generic else i would be out 4k every 30 days.

The switch was not pretty.
Like, mental breakdown, life changing, never-will-be-the-same not pretty.
That was..8 years ago. I imagine if it was something maintaining my physical health I certainly would have died. I mean, shit, I nearly did. Don't get me started on the arm i broke as a kid, that didn't heal correctly because a narcissist parent(RN) wanted to skip the er wait and had hospital buddies patch me up on the dl instead. A bionic arm sounds more feasible than actually getting it to where I could play strings again without pain.

[-] hactar42@lemmy.ml 1 points 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 0 points 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 1 points 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 1 points 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.

[-] ChillPenguin@lemmy.world 1 points 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.

[-] fsr1967@lemmy.world 1 points 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.

[-] SwingingTheLamp@midwest.social 1 points 2 months ago

I had major depression when I was younger. I couldn't get individual insurance because it was a pre-existing condition. I couldn't afford it, anyway, because getting and keeping a job was very difficult because, uh, depression? So, getting a job with a group plan was also out of reach. I had to research it and treat it myself, which, goddamn right I'm proud I managed.

But now I'm middle-aged, single, and probably will never have the savings to retire. Eat a Grand Canyon full of Godzilla dicks, U.S. healthcrime system.

[-] john89@lemmy.ca 1 points 2 months ago

Take solace in the fact that some people you'll never know are richer because of your suffering.

[-] SwingingTheLamp@midwest.social 1 points 2 months ago

I'm doing my part!

[-] Chozo@fedia.io 1 points 2 months ago

I've got cluster headache. Only medication that had any noticeable effect was Prednisone. Not even that expensive of a drug, but more than I could afford out of pocket. Insurance wouldn't cover it because they considered an oxygen mask to be a more appropriate treatment, even though I'd been using them for months with no improvement, and O2 only works for a small percent of people with cluster headache, anyway.

Couldn't afford to get the meds. Not legally, at least. A coworker was taking Prednisone for a different condition, and managed to convince his doctor to double his dosage, and I paid him for the difference, until he stopped taking it altogether. Ended up having attacks again, and missed enough work because of them to get fired. Between the pain and losing my job, that was easily one of the lowest points in my life.

I wouldn't wish our healthcare system on my worst enemies.

[-] transientpunk@sh.itjust.works 1 points 2 months ago

If you have a pet, you may be able to convince the vet to prescribe them Prednisone

[-] Chozo@fedia.io 1 points 2 months ago

Hadn't considered that! Sad that that's probably the most viable option if I needed to get it again.

[-] JackbyDev@programming.dev 1 points 2 months ago

My dog has anxiety and is taking Xanax and Prozac (I forget which exactly, and they're the generic of course) prescribed by a vet and filled at a human pharmacy.

[-] transientpunk@sh.itjust.works 1 points 2 months ago

And usually way cheaper too

[-] lennybird@lemmy.world -1 points 2 months ago* (last edited 2 months ago)

Shitty physical therapist twice raised what I owed per visit because of their clerk's incompetence. Not just for future visits but retroactively for visits I already had. (Edit: I should say this was possibly fraud and if I had a lawyer it may have been worth pursuing).

I knew I was screwed when the clerk pronounced tier as tire. Oh well, lesson also learned for me: Always conduct a three-way, recorded conference call with provider and your insurer before provided service.

Another fun fact; Per KFF, 50% of Americans forego medical attention for free of medical debt. Naturally, this snowballs leading to them inevitably going anyway for a more costly, complex procedure. Our system is top-heavy with specialists for this reason, lacking adequate preventative care and rapid accessibility.

this post was submitted on 13 Dec 2024
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