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.
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.
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.
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.
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.
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.
Canadian here. Had an accident and took a ten minute ambulance ride in Minnesota. $1400.
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.
No joke: My mom burned herself with coffee really bad and we high tailed it back across the border to Sarnia before getting treated.
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.
My wife had surgery. However they didn’t prescribe painkillers until after the surgery.
I got her comfortable at home and ran down to pick them up … and was rejected as “drug seeker”. Wtf. It took a full day before I could convince them to fill it, and they kept wanting her to come in person when she just had surgery
I work in healthcare, and the response from the workers in my hospital to the UHC CEO assassination has been… pretty much the same as the response here on Lemmy!
Couple morale-high-horse folks pearl clutching about no one deserves to die or some shit; but 99% of us are on team Luigi.
We fucking hate parts of this industry, with a strong emphasis on insurance bullshit.
My two cents from the inside.
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.
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.
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.
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.
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.
Deny. Defend. Depose.
DDD
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.
Worked in insurance for a few months and saw someone with an $8000 deductible.
Was denied life-changing, medically necessary weight loss surgery because my company has less than 50 people employed.
I had to live with a failed gallbladder for a month and a half while the insurance decided if they were gonna pay for surgery. I lost 20lbs in that time because I couldn’t keep anything in my body. I almost died.
One health care facility near me doesn’t accept patients who work at or have previously worked at their competition.
Had my ankle reconstructed last year and the surgery alone billed for $16,000. A piece of foam for my walking boot billed for $150.
My headache medicine would cost me around $1000/month if I didn’t have insurance. With insurance it’s $40/month. My pharmacist helped me sign up for a discount card through the manufacturer so now it’s only $5/month somehow
Got some medical bills sent to collections before the bills ever reached me. By email or paper mail. Haven’t paid any of them and I don’t plan on ever paying them because fuck the people who just sent that shit to collections. Also medical debt is dumb and you just don’t have to pay that shit. They eventually stop bugging you about it and I haven’t seen it reflect on my credit score ever.
A 20 min ambulance ride, with amazing insurance was billed for $575.
My sister almost broke her spinal cord and the insurance gave us the runaround after the corrective vertebrae surgery.
The VA didn’t want to cover the cost of my grandfather’s leg amputations that were a direct result of contact with agent orange in Vietnam.
The VA doesn’t want to cover a coworker’s therapy and medication for PTSD caused by being stationed in the middle east for 4 years.
The VA won’t release my mom’s army medical records because she was part of experimental vaccines when she was in the army. She thinks it was anthrax vaccines, but can’t be sure because nobody will tell her.
If anyone still needs help with the VA you can reach out to your local American legion or other veterans organization and they can help break through some of the red tape.
I filled out a form wrong and didn’t have healthcare this entire year. I tried to fix it and my company told me sorry, the period for enrollment is over, wait until the end of the year to enroll for next year. Found out when I went to buy a prescription and they started asking me a bunch of questions and then charged me 150% of the normal cost. Good thing I stayed (relatively) healthy this year!
On a road trip, got food poisoning so bad that I couldn’t eat for 5 days, barely kept fluids down and was so weak that walking into an appointment, the doctor told me to go to urgent care.
They gave me an IV, did an ultrasound, and gave me some anti-nausea and anti-diarrhea meds, which barely helped. It still took 3 or 4 days before I started feeling better.
Insurance comes back with a 5K bill. They claimed that even though I had my regular prescriptions go through both before and after the trip, the trip claim itself was denied because it was “during a time when I did not have coverage”.
Took several months and phone calls of pointing out the before/after is approved without questions so there’s no way to claim I wasn’t covered during this one week. Every human I spoke to agreed with me, but it still took months.
Dad was prescribed a medication that fixed his health issue. Changed jobs and insurance. New insurance says that medication isn’t for that issue and that he needed to take a different medication that his doctor had previously tried and didn’t work very well along with nasty side effects instead. They argued about it. Now he’s stuck with the worse medication.
