Frigging Insurance Companies...

"Full of the sound of the Gran Fury, signifying nothing." (granfury)
10/14/2019 at 10:04 • Filed to: None

I had the last of my tests scheduled today, this time a couple of CTs, to ensure that my cancer is gone. But for some reason, despite knowing weeks ahead of time, my insurance company hasn’t approved them. WTF? I had my schedule at work modified to accommodate this and now I have to reschedule this and my next appointment with my oncologist.

I just want to get this over with. The news so far, from the colonoscopy mostly, is all good, and I just want to wrap up this ordeal . But now I have to wait, and wait again...

DISCUSSION (12)

Tekamul > Full of the sound of the Gran Fury, signifying nothing.
10/14/2019 at 10:20

It was obvious to me that once I hit my out of pocket max, they’ve been stonewalling as much as possible.

Additionally, they’ve been pushing back on payments to my providers, requiring multiple updates to submissions. I assume they’re hoping it falls through the cracks. All this just in time for them to ask for a 9% increase , plus a $1200 increase to the out of pocket max for 2020. Love it.

JawzX2, Boost Addict. 1.6t, 2.7tt, 4.2t > Full of the sound of the Gran Fury, signifying nothing.
10/14/2019 at 10:27

#THEFREEMARKETWILLFIXIT

#DOWNWITHSOCIALMEDICINE

#SINGLEPAYERISASCAM

#HEALTHCARECHOICE

#MURRICA!

//sarcasm

BigBlock440 > JawzX2, Boost Addict. 1.6t, 2.7tt, 4.2t
10/14/2019 at 10:45

implying that the health insurance market is “free”....

Full of the sound of the Gran Fury, signifying nothing. > JawzX2, Boost Addict. 1.6t, 2.7tt, 4.2t
10/14/2019 at 10:51

Good stuff, all of it, and s0000 o true .

Choice? Right -If I don’t like my carrier I’m free to change jobs, pay several thousand a month out of pocket, or do without.

As we’ve seen with PG&E, customers get screwed, as do the rank and file workers, whilst the top brass makes millions in bonuses. Some things in life should not be for profit.

Now that I’ve gotten used to snow since moving from SoCal to STL, I’m thinking that Canada wouldn’t be a bad place to be. Or maybe New Zealand. I like rain so maybe I could give the UK a try if it doesn’t implode...

And as far as I’m concerned, a healthy employee is a productive employee. Spend a little now for their health care and you can work your people even longer and get even bigger bonuses. But nowadays we need results THIS SECOND, and the long-term is someone else’s problem. And making a better society? That’s also someone else’s problem because it might affect my need for immediate reward (insert eye roll emoji here...)

OK, rant over. F or now...

Highlander-Datsuns are Forever > Full of the sound of the Gran Fury, signifying nothing.
10/14/2019 at 10:59

This is what happens when the insurance is the gate keeper to our medical necessities.

For Sweden > JawzX2, Boost Addict. 1.6t, 2.7tt, 4.2t
10/14/2019 at 11:26

Are you implying a government bureaucracy would have approved these tests without complaint?

TheRealBicycleBuck > Full of the sound of the Gran Fury, signifying nothing.
10/14/2019 at 11:33

I dealt with a similar issue involving my insurance and CT scans. I had to get on the phone with the insurance company to get it resolved. They claimed that the information the scan would provide is easily obtainable through a blood test. I had to remind them that the blood test for the markers was negative even when my cancer was active. There were several other objections which I had to contest before I finally accused the guy on the other end of the phone of practicing medicine without a license. That shut him up.

I thought that would be the end of it, but when I called to verify that my rescheduled CT was approved, there was no record of that in the system. In fact, there was no record that I had called at all. After some grilling, I discovered that their system only recorded a call if the person on their end marked it at the end of the call . If they decided the call didn’t go their way, they could just hang up and there would be no record. It turned out that the insurance representative had done this twice - once when my doctor called and again when I called. I told them I’d be glad to pull up my phone records and request my doctor’s phone records to prove that we had both called. I also told them that I would follow up with the state insurance commissioner if it was necessary.

That was the last time they gave me a hard time about getting CT scans. From that point on, if the doctor’s office called to get pre-approval, it was granted imm ediately.

ZHP Sparky, the 5th > Full of the sound of the Gran Fury, signifying nothing.
10/14/2019 at 13:36

I just don’t know why the corporate sector isn’t putting their full weight behind a national healthcare platform. Given the sheer amount of resources, effort, and cost it takes to manage all their health plans for employees you’d think they’d be first in line to not have to bother with it anymore. But I guess they see it as too good a “perk” to entice and keep employees with, and also to use it as a mechanism to blur compensation packages for comparison between competitors.

It will likely be a very long road to get there, and there will certainly be many hiccups (and attempts to sabotage it) along the way but just based on the level of money that gets spent on “healthcare” that goes not in to any kind of healthcare but simply in to shuffling papers, huge salaries to execs, and profit to shareholders is ridiculous. Our own health, and that of our friends and families, isn’t something to be speculating on investment income over.

I just got my US citizenship this year – but hey, I guess I could do it all over again somewhere else if it comes to that. My wife is curious about Europe someday…New Zealand looks pretty amazing to me too (pretty easy to migrate to if you’re young-ish and educated as well ), and I have some family there already.

ZHP Sparky, the 5th > TheRealBicycleBuck
10/14/2019 at 13:39

Sickens me to think that those tactics actually work in some cases – which I’m sure they do – and results in higher profit for the companies. As far as they’re concerned, it means they did a great job!

Full of the sound of the Gran Fury, signifying nothing. > ZHP Sparky, the 5th
10/14/2019 at 14:36

They don’t get behind it because it means change and are therefore afraid, even if that change would ultimately benefit them in the end. Medical insurance used to be a perk to attract the best and the brightest, but that was over a century ago and over the span of a century or more has gone from being something extra to a basic necessity. It also keeps us locked in to an employer, making it less likely for us to leave to pursue something that really interests us.

When it comes to benefits, I have never made a decision on which job to take based on the extra perks, and I’m willing to bet that this is the same for many people. Especially during times of recession w e apply for jobs and end up working for the company that agrees to take us; I don’t think the average person really has a number of companies wanting to hire us all at the same time. In my own experience I can say that I’ve taken jobs that may not have been ideal because I needed a job, and finally someone agreed to hire me. My current position started out like that - I was about to pack up and move back to my parent’s place when I got a call for an interview, and I’m extremely lucky it turned out to be with a good company with good (more-or-less, based on my current situation ) benefits. I’ve left jobs to work for competitors, and I’ve left jobs to start companies, but often times that was out of boredom with the then-current positions.

I’ve also taken bad jobs because they were in my area of expertise and I didn’t want to change, but I’ve gotten over that. The airline industry, my former line of work for decades , is notoriously incestuous and destructive to personnel, and as much as I may love commercial aviation (although not as a passenger or employee, oddly enough), I’m happy to have put it behind me.

There have been opportunities that I have passed up, and I’m grateful I did. One company I worked for went under, and a competitor knew I needed work and tried to offer me a salary that was considerably less than I was making, probably under the assumption that I’d be desperate for work. I politely declined and wound up finding a job in a much better industry, moved up through the ranks in a few years and made tons of money, allowing me to buy all the expensive cars I had dreamed of; this is how I got better BMWs, a Mercedes and a Porsche. That last job in this field may have given me a six-figure income but it was a meat-grinder, and like in a few other situations, I was happy to have been laid off, even if that meant a readjustment in my lifestyle. Such changes may have cost me my expensive cars and a fiancee, but I was probably better off in the long run, even if there was a lot of pain along the way.

I’ve h ad companies that were surprised to see me go, wondering what they could do to keep me, but I’ve had to tell them that it was too late; if I was so damn important to them, why did I have to announce my resignation for that to be recognized? That just tells me that they weren’t paying attention to the needs of the employees and therefore weren’t worth sticking with for the long haul because this would play out again and again as the years progressed every time I wanted a raise, promotion or change.

Grindintosecond > Full of the sound of the Gran Fury, signifying nothing.
10/14/2019 at 17:36

I wonder what A non profit insurance company would be like

Grindintosecond > ZHP Sparky, the 5th
10/14/2019 at 17:37

Half of insurance companies have stock in fast food companies.....they're not vested in your well being.