11–20 of 89 posts
I have MS and receive an Ocrevus infusion every six months. It's a labyrinth of a process. UHC (insurer) sub-contracts(?) to CVS Caremark to provide specialty drugs. CVS insists on calling me to confirm they can ship it to my house. F no! I'm not running an IV for myself. Sort it out with the hospital. Last go around, the hospital coded the drug as coming from their supply instead of CVS so I got a surprise bill for…
There are some good points in here. However, it feels disingenuous with the author being a former surgeon general. "the onus of the entire amount still fell on me due to my high-deductible health plan (HDHP)." I mean, yeah, that's how HDHP works. Anyone in healthcare should understand that.
I have MS and receive an Ocrevus infusion every six months. It's a labyrinth of a process. UHC (insurer) sub-contracts(?) to CVS Caremark to provide specialty drugs. CVS insists on calling me to confirm they can ship it to my house. F no! I'm not running an IV for myself. Sort it out with the hospital. Last go around, the hospital coded the drug as coming from their supply instead of CVS so I got a surprise bill for…
For $700, I'll start my own IV.
Earlier quoted context omitted.
I believe that's the way it works. And then you have to transfer to in network provider as soon as humanly possible (perhaps not as humanely possible...)
One of the problems here is that the patient can believe they're at an in-network provider — and be correct about that — and still get hit with "out of network" charges. One of the linked articles[1] explains it slightly better: > Surprise medical bills happen when a doctor or other provider who isn’t in a patient’s insurance network is unexpectedly involved in a patient’s care. Patients may go to a hospital that acc…
You want to know if a doctor is in network? Good luck, because the insurance company clearly states that they only provide that information on a best effort basis. The doctor can’t answer, as they refer you back to your insurance company.
You want an outpatient surgery? Great! Make sure your doctor and facility is in network, right? Oops, wrong again! You forgot about the anesthesiologist who you can’t pick ahead of time and is rarely in network. Good luck figuring that out later!
It’s intended to wear you down until you’re afraid of your “rating” aka credit score tanking enough that you just pay up.
There are some good points in here. However, it feels disingenuous with the author being a former surgeon general. "the onus of the entire amount still fell on me due to my high-deductible health plan (HDHP)." I mean, yeah, that's how HDHP works. Anyone in healthcare should understand that.
The problem is the current system is basically a giant jobs program. Healthcare spending is approximately 17% of US GDP. Politicians are terrified of rocking the boat on this, so the system will always remain broken.
I have MS and receive an Ocrevus infusion every six months. It's a labyrinth of a process. UHC (insurer) sub-contracts(?) to CVS Caremark to provide specialty drugs. CVS insists on calling me to confirm they can ship it to my house. F no! I'm not running an IV for myself. Sort it out with the hospital. Last go around, the hospital coded the drug as coming from their supply instead of CVS so I got a surprise bill for…
There are some good points in here. However, it feels disingenuous with the author being a former surgeon general. "the onus of the entire amount still fell on me due to my high-deductible health plan (HDHP)." I mean, yeah, that's how HDHP works. Anyone in healthcare should understand that.
Meanwhile, it's entirely possible to be out of 3000 dollars after an animal bite with a regular insurance plan. Nothing more than an x-ray and a couple stitches, and the out-of-pocket cost was 3000 dollars. One wonders where the premium goes.
The healthcare industry in the US sometimes gets me to seriously consider seeing a shaman next time I get sick
Aren't you assuming that the healthcare system operates for the good of the patients? From my point of view, that doesn't seem to be the case in the U.S.
It's the billing afterwards that's the issue.