Health insurance headache this morning...
blackredyellow
Posts: 5,889
So I had to have a test done this morning, and my doc suggested a lab to go to at a nearby hospital. I called the lab to set up an appointment and asked if they accepted Blue Shield of Northeastern NY. The lady told me that they did.
I get there this morning to find out that my insurance wouldn't cover it... The hospital takes our insurance (or son was born there), and the lab will take it for in-patient procedures, but not out-patient procedures. Actually, they take Blue Shield of NE NY, but they don't accept the plan number's prefix that we have... wtf?
Since I had to take medication before the appointment, the tech was great and tried calling around other labs to see if I could get in this morning, and either they didn't accept the insurance or couldn't fit me in on such short notice. I called the insurance company to see if they'd reimburse me, and after being on hold for 15 minutes, they said "no"... but I could file the paperwork and try to get a portion covered. Basically, I'd be out the money with the chance of getting some back after a bunch of phone calls... no thanks...
So now, I have to get another prescription, and do the whole process all over again... I know that my inconvenience is nothing compared to people who get screwed and stuck with hundreds of thousands in medical bills.
I don't in anyway have faith in our government to figure this out, but there's got to be a better way...
I get there this morning to find out that my insurance wouldn't cover it... The hospital takes our insurance (or son was born there), and the lab will take it for in-patient procedures, but not out-patient procedures. Actually, they take Blue Shield of NE NY, but they don't accept the plan number's prefix that we have... wtf?
Since I had to take medication before the appointment, the tech was great and tried calling around other labs to see if I could get in this morning, and either they didn't accept the insurance or couldn't fit me in on such short notice. I called the insurance company to see if they'd reimburse me, and after being on hold for 15 minutes, they said "no"... but I could file the paperwork and try to get a portion covered. Basically, I'd be out the money with the chance of getting some back after a bunch of phone calls... no thanks...
So now, I have to get another prescription, and do the whole process all over again... I know that my inconvenience is nothing compared to people who get screwed and stuck with hundreds of thousands in medical bills.
I don't in anyway have faith in our government to figure this out, but there's got to be a better way...
My whole life
was like a picture
of a sunny day
“We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses.”
― Abraham Lincoln
was like a picture
of a sunny day
“We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses.”
― Abraham Lincoln
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that sucks....kudos to you for checking before you had anything done...not everyone does that...I learned the hard way when my doc sent my to get some test done...I get a huge bill a month later...ugh...the office my doc sent me to was not in network...I even asked when I signed it, "do you accept my insurance"...they say "yes"...well they "accept" it, but that was about it...after some discussion, fortunately they waived the bill...but that was a few years ago...I'm pretty sure I would have been SOL if that happened today...
I hope everything works out...
a few years ago i went to a doctor and called asking if they took my insurance before i made the appointment...went to it, they copied my card, paid my deductible and a month or so later got a letter from them saying i had an outstanding bill! i called and they claimed they have never accepted my insurance and no one there ever told me different....
what are you but my reflection? who am i to judge or strike you down?
"I will promise you this, that if we have not gotten our troops out by the time I am president, it is the first thing I will do. I will get our troops home. We will bring an end to this war. You can take that to the bank." - Barack Obama
when you told me 'if you can't beat 'em, join 'em'
i was thinkin 'death before dishonor'
Thanks..
What gets me is that they take my provider, but not my plan... but if i was in the hospital and needed a test done, they'd take it then, but not as an out-patient.
I don't get why it's so complicated.
I have a crappy vision plan through work, but at least it covers some. I got new glasses a few months ago, and the coverage table that my eye doctor's office had for my insurance was so in-depth and complex, that neither the office manager or I could figure out what was covered and how much (for different lenses, frames, etc)...
X% for this lens after $X amount, but if this non-glare coating was selected, then see table 5 for the percentage of the additional amount, but the lens deductible amount would be lowered to $X, etc etc etc...
She had to submit it in the insurance company's system to find out what exactly they would cover. She said that called that computer a bingo machine, because it was anyone's guess what number it would spit out after everything was inputted.
was like a picture
of a sunny day
“We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses.”
― Abraham Lincoln
Because they know that if they make it so bewildering that nobody can ever hope to understand it and would have to spend hours or even weeks trying to get it straightened out... most people will just give up and pay and the insurance won't have to buy it, thus... better profits. It's a sick joke the way this industry operates. They make lawyers seem like compassionate, selfless individuals.
Government may not do it perfect, but the greatest thing to be said for government is that it would at least introduce some predictability and consistency to the process. Right now, you're playing roulette every time you try to make an insurance claim.
One suggestion, though, for everyone saying they called their provider to find out if the provider accepted their insurance.... it's best to call the insurance company directly. Otherwise you're just talking to someone who doesn't work for the insurance company and can't speak on their behalf but is trying to interpret their policies (and may not have much more experience doing so than you do). The providers basically just submit their claims to the insurance companies, wait to see if/what they get paid, and then bill you for whatever's left over. They may have a good idea about who usually pays them what, but the insurance company is really the best source of information on this.
kinda fucked up that in our system you have to clear it with the people you hired to cover these costs and THEY get to decide what's ok, not you and your doctor.
I couldn't agree more!
Let's not have a public option. That way insurance companies can screw us so good we scream. I can't tell you how thinking about that turns me on. Americans, by and large, are such idiots in opposing an option that will actually benefit them. They are like masochists that get off on being abused. I swear.
It seems everyone knows what is covered so I can ask my neighbor or almost anyone up front before even dealing with a doctor, plus it covers just about everything.
The government CAN handle health care and has proven it through Medicare and Medicaid.
Even the prescription plan Medicare put in place a few years back is working great. The first year it sucked and I thought "Oh no, we are going to be in trouble". But, they worked out the kinks rather quickly and its great, and covers just about everything.
I am on a lot of meds. They don't cover only one of the 10 scripts I am on, and that one I can do without. All the rest are paid for. I pay a $3.00 co-pay, no deductible.