I'm on my soapbox at the moment, but it's easier to talk to people on here than people you see daily and don't feel like them gossiping about your problems behind your back. But basically, I just finished law school, no job yet because I don't have bar results, which come in 2 weeks. If I failed it (there is really now way to know if you passed or failed in my opinion until they tell you) I won't make any money beyond close to minimum wage until at least next May. Well about a month ago my wife developed severe chest pain and became unable to breath, so like anyone we went to the hospital. Well our lovely insurance today decided that not being able to breath and severe chest pain weren't cause for an ER visit and we got spotted a $1,200 hospital bill. If they had considered it an emergency we wouldn't have had a deductible, but because it wasn't our deductible kicks in. To beat all we pay the insurance company close to $400 a month and they paid out a total of $300 in claims for my wife and I this year. On top of that I was looking at the claims they had paid and they don't even pay our doctors what the doctors charge for the services rendered they pay the doctor what they feel is a fair price for what he did. All this is basically to say I'm under a ton of stress, and I hate insurance companies. Almost makes me want to vote to reelect Obama, just because I know the insurance companies hate him.

HT, I can understand your frustration. Perhaps my own recent story will help you.

 

I am 36 years old, in good health and visit the doctor only for checkups. However, back in June, I discovered a small knot on my breast. I called my doctor, who scheduled me an appointment. She told me that she was confident that it was a harmless cyst, but that we would schedule a mammogram, just to be safe, particularly since I hadn't had one yet (40 is usually the age that you get your first mammogram). Thankfully, it was as she thought and not cancer.

 

However, I got stuck with 100% of the bill. According to my insurance company, had it been routine, they would have paid 100% of it, as it would have been preventative. Since it was diagnostic, I was stuck with the bill. I've had more than one conversation about how pathetic their policy is. Wouldn't this push some women away from having the mammogram, knowing that they would have to pay for it? If it turned out to be cancerous, wouldn't the insurance company (not to mention the patient) be better off knowing it as early as possible?

 

I am firmly in the anti-insurance company camp. Over the years, I have made some people a lot of money, simply by having insurance that I thankfully hardly ever need. Then, when I need it, they let me down.

HT, how is your wife doing?

HT, I can understand your frustration. Perhaps my own recent story will help you.

 

I am 36 years old, in good health and visit the doctor only for checkups. However, back in June, I discovered a small knot on my breast. I called my doctor, who scheduled me an appointment. She told me that she was confident that it was a harmless cyst, but that we would schedule a mammogram, just to be safe, particularly since I hadn't had one yet (40 is usually the age that you get your first mammogram). Thankfully, it was as she thought and not cancer.

 

However, I got stuck with 100% of the bill. According to my insurance company, had it been routine, they would have paid 100% of it, as it would have been preventative. Since it was diagnostic, I was stuck with the bill. I've had more than one conversation about how pathetic their policy is. Wouldn't this push some women away from having the mammogram, knowing that they would have to pay for it? If it turned out to be cancerous, wouldn't the insurance company (not to mention the patient) be better off knowing it as early as possible?

 

I am firmly in the anti-insurance company camp. Over the years, I have made some people a lot of money, simply by having insurance that I thankfully hardly ever need. Then, when I need it, they let me down.

 

That is exactly how I feel. It seems so unfair, we don't abuse it. We don't just run for anything. But, somethings you just don't play around with, and if they aren't there for us now, where will they be when really need it and have to have chemo for cancer or something.

That is exactly how I feel. It seems so unfair, we don't abuse it. We don't just run for anything. But, somethings you just don't play around with, and if they aren't there for us now, where will they be when really need it and have to have chemo for cancer or something.

 

My father had a small stroke and heart attack a few years ago. They covered the treatment for the stroke, but not the heart attack. His insurance company won't pay for his heart medication, which is prescribed by his doctor. My dad was 75 when this happened, had never been admitted to the hospital in his life until that incident. Between that, some other family members with insurance issues and my own experience, I have a deep distrust of insurance companies.

Ht,

 

Sounds as if your insurance company is giving you a challenge that is perfect for a budding lawyer! Is there no recourse or mediation for customers who have claims rejected?

HT, how is your wife doing?

 

She is doing ok now, they weren't really sure what caused it when we were they but she has an appointment now with a cardiologist to do some more tests the ER doctor said we should have done. But since then things have been alright.

Ht,

 

Sounds as if your insurance company is giving you a challenge that is perfect for a budding lawyer! Is there no recourse or mediation for customers who have claims rejected?

 

I'm going to file my appeal Wednesday. I wanted to file it today when the bill came, but I learned our insurance company closes their phone bill lines at 4pm daily. And it will be Wednesday until I'm done working before 4 to be able to have a long drawn out conversation with them. I'm not above threatening lawsuits though, hopefully it won't come to that. This has just been a giant headache today. I was also told the hospital might cut some of the bill off if we pay cash up front. That would wipe out our savings but might be worth it to save a few hundred bucks.

I'm going to file my appeal Wednesday. I wanted to file it today when the bill came, but I learned our insurance company closes their phone bill lines at 4pm daily. And it will be Wednesday until I'm done working before 4 to be able to have a long drawn out conversation with them. I'm not above threatening lawsuits though, hopefully it won't come to that. This has just been a giant headache today. I was also told the hospital might cut some of the bill off if we pay cash up front. That would wipe out our savings but might be worth it to save a few hundred bucks.

 

Everybody wants to be the payor of last resort. Here's wishing you success.:thumb:

That is exactly how I feel. It seems so unfair, we don't abuse it. We don't just run for anything. But, somethings you just don't play around with, and if they aren't there for us now, where will they be when really need it and have to have chemo for cancer or something.

 

It just doesn't seem like "insurance." Maybe I am confusing it with assurance. Either way, it does in no way give me any sense of security when it comes to illnesses/accidents and medical bills.

 

I think that many people that frequent P/R have heard me talk about my friend (my age of 36) who had to have a double mastectomy 2 years ago. Her insurance company cancelled her policy with 2 chemo treatments left to go. Thankfully, she has survived, but I will just say that her finances and marriage did not. Very sad.

Everybody wants to be the payor of last resort. Here's wishing you success.:thumb:

 

That's very true too. But with the $400 bucks a month we pay and our $300 bucks they've paid out this year I feel like I deserve a little more return for my money when it's needed.

It just doesn't seem like "insurance." Maybe I am confusing it with assurance. Either way, it does in no way give me any sense of security when it comes to illnesses/accidents and medical bills.

 

I think that many people that frequent P/R have heard me talk about my friend (my age of 36) who had to have a double mastectomy 2 years ago. Her insurance company cancelled her policy with 2 chemo treatments left to go. Thankfully, she has survived, but I will just say that her finances and marriage did not. Very sad.

 

Ya I don't feel very assured with it either, so that's another problem. I'm not really insured for everything and I"m not assured they won't try and find a way out of paying when I need it.

HT + TB+ G: I think that stinks for both of you and hope you and your families come out of this okay.

 

What I think stinks about insurance is the "I don't know factor". When someone is ill, of course you are going to take them to the doctor or the hospital, but now nobody knows what is covered under their policy. The other part of the discussion that was mentioned that I think is a sham is the "discounted" charge. They-both the medical provider and insurance company act like they are doing you a big favor with their "discounted" charge. I wonder what the real cost is?

 

I do not support Obama at all, but think he was a little bit right on one issue- health care. I am not for government take over of anything, but the medical industry-hospitals, doctors and insurance companies all seem to make quite a good deal of money, and the people paying them have no idea what they are paying for or if they are covered, etc. Something needs to change in this system big time.

HT buddy that's rough man I hate to hear that. Insurance companies are some of the biggest crooks in America brother. Hopefully your luck turns around really quick man, starting with the results of the bar exam. :thumb:

HT + TB+ G: I think that stinks for both of you and hope you and your families come out of this okay.

 

Thankfully, I am fine. I appreciate the kind words.