What is your recent health insurance horror story?

Yes, what is the monthly vs three month fulfillment thing about? I was asked that yesterday when signing up for a new plan. I didn’t tell them that I’m accustomed to getting a year’s supply at once when I’m traveling outside the US.

I'm currently living a health insurance nightmare. From the start, my insurance company has fucked up even the smallest things. I battled with them for months because they refused to cover routine doctor's visits, even though my doctor was in their network. The doctor's billing address is different from his physical address, and my insurance company only had his physical address on file, so they were claiming the doctor wasn't in the network. It was ridiculous.

Most recently, I had cancer surgery and was in the hospital for two nights. My insurance company is refusing to cover it, saying the hospital stay wasn't "medically necessary." I've appealed it three times, they've denied it three times, and now I'm appealing it to the Medical Board of Review.

Believe me, I can empathize with whoever offed the CEO of United Healthcare.

It is because they get a discount in buying generics and other meds in bulk, can fulfill the prescription with robots into pharmacists - LSS - it costs them less to do it that way. They are contracted out so paying for it at Acme costs them more money so they deny the coverage.

CVS is the worst, OMG. I feel terrible for the people who work there and have to deal with the blowback from the shitty decisions made by their CEO/upper management. I know they must get cussed at constantly for things beyond their control.

Public-private story, rather than the insurance company. I had a 6 month delay for knee surgery because my surgeon is attached to a "private clinic" in Switzerland and I have basic insurance. And my insurance company had no problem paying the surgeon for 6 months. But his chic clinic kept giving us the runaround for my surgery dates. Since I would be the hoi poilloi in the cheaper rooms. Finally I asked the surgeon to please do it at a public hospital and he agreed and the day after the surgery date was fixed the private clinic called me to come do it chez eux. 6 months of pain and limited mobility. Greedy dumbasses.

R4 CVS is LITERALLY Hell on earth.

Mark Cuban’s Cost Plus.

One trip to the ER for kidney stones ended up with 27 bills.

Separate bills from the hospital ER, radiology, anesthesia, GI (because they thought the problem could be GI at first), nephrologist--and on and on and on. Each one threatening to send to a private collection agency of I don't pay on time. I constantly contact my insurance to see if payment will go. Insurance promises me it will. In the mean time, all those separate entities keep sending me bills.

Insurance now claims it lost some claims or that they weren't submitted the correct way. I have to write them a letter, not just call. They don't acknowledge the letter so I have to call. Miraculously insurance finds it and re-calculates. Payment denied because request provided too late--but it was late because the insurance company lost the first request. and on and on and on and on.

I don't fucking give up. That's what the insurance company is banking on.

I'm going on five fucking days without HIV meds! Not good at all you know, and I'm looking for CD4s too, I switched my scripts from one store to another, this is fucking Walgreens, there was a shake up and they fucked it up and the pharmacist got snippy and bitchy, luckily I found my former GAY pharmacist and he's straightening things out, thank god. They are automating and want to send everything out from fucking Arizona!

Look, the problem is solvable. Just look at the United Healthcare situation. They were set to deny anesthesia in the middle of operations; the CEO gets assassinated, and voilà! Anesthesia fully covered once again.

Do the math.

I had a seizure once in the middle of the night. I was admitted and had an overnight stay. I was unconscious until the next day when I woke up, intubated. I had them remove the tube right away as I was choking. The Doctor came in told me the ran all sorts of tests but couldn't find anything so I asked to be released and they fought me like hell. They said the needed to run more tests I said no, they said they would call the DMV and make it so I could not drive unless they figured out what caused it, I said fine fuck off. The nurse came in later laughing. "You really pissed them off," she said. I told her I didn't need any more tests and she laughed again. "Honey they tested you for everything while you were out. From HIV to Herpes Brain Fever and two spinal taps."

I get the bill. 80K for one night. Thank god it was covered by insurance. I check the bill. They charged me for three meals I never ate (breakfast, lunch and dinner) remember I was unconscious. There was a 3000 dollar charge for a speech pathologist consultation. Again. I was unconscious, What fucking speech consultation could I have gotten., I called my insurer and told them about the fraudulent charges on the bill, they said they would look into it, but I could tell they didn't care. It is a fucking racket.

Appalled at this nonsense. Ireland, pay 3k per year gor top insurance, no deductible for all private and public hospital stays or procedures ans 25% deductible on doctor/consultant visits. I feel so sorry for you guys.

You pay for it too in Ireland too, nothing is free, the NHS is worse than America I think, we get good care, it's just the cost and bureaucracy from the insurance crooks. Insurance is inherently crooked.

It's all about the dollars

[quote] the NHS is worse than America I think,

In England, the Tories, 12 years in power, made it a point to weaken and break the National Health Service. The stated goal was to privatize. They worked to destroy the world's greatest health system. The new government is tasked with rebuilding it

Sounds like the Republicans of course, the rich and decrepit.

My COBRA ended so purchased a plan on Aug 1 last year from my state’s insurance marketplace. Anthem.

Turns out, my primary was not part of the network despite taking my employer’s Anthem plan.

And see, my plan required referrals from my primary to see specialists. I suffered an orthopedic injury, couldn’t get an appointment with a primary until well into the following year. So I couldn’t get treatment.

Oh, and the or8mary Anthem assigned me is a pediatrician. (They kept telling me I was wrong.)

Anthem customer care called every primary within 100 miles and confirmed my tale of woe. But they still wouldn’t budge and allow me to access care.

Each Anthem customer care rep I spoke with offered me a workaround which in every case proved a wild goose chase.

If you can’t use the plan, it’s fraud, right?