Gotta love those friggin insurance companies

[MrTom]

I won’t mention which one I use for my health insurance but I’d sure like to have a day in company’s upper echelon
with a ball bat.
I have copd and suffer from afib. For several years I’ve enjoyed meds that work on both fronts together but this year the insurance, in their infinite wisdom, decided to not support my primary inhaler so I had to hit up the doc for a replacement. This same doc suggested I use a “rescue” inhaler after the first “rescue inhaler I used, and it worked beautifully for me, was dropped from coverage a couple years back and I ended up with major league allergies to it. This most recent replacement inhaler, containing the same identical drugs as the other that caused issues, was one that was suggested by the company as a replacement. While at the doc for the first visit she suggested I start a statin as a maintenance med for cholesterol. My cholesterol wasn’t in the bad numbers yet but nearing it on one side so I said why not.

I got started with this new crap and after two days noticed a light , itchy, rash on my forearms that evening. By morning my hands had begun to swell and that rash had spread to my back and front of my thighs and my hands were so sore that I could not open a bottle of water. So off I go to the good doc again but I can’t see my primary so settled for another.

I had a nice visit and left with a heavy dose of prednisone by prescription along with sleep aide since prednisone tends to keep me up all night. Third day in on a twenty-day prednisone treatment and I can move my hands enough to work in the shop. The rash as all but gone and the tightness in the tendons has taken its leave, thank God. Damn, one doesn’t realize just how debilitating it is not have hand function without pain enough to bring tears to your eyes just picking up a friggin fork, until it actually happens to you. Now I need to go back and start a search for new meds that will actually work for me again. All this because some ignorant friggin buyer at the insurance company likely took a nice vacation and got a few thou stuffed in an envelope to use Mr. X’s new and improved inhaler and to drop one that actually worked.

This little episode probably cost the insurance company three times as much money as the idiots think they saved when all the blood work and office visits get tallied up. I had 7 very large vials of blood drawn and four of those had to be sent to specialized testing areas and I am sure that the testing wasn’t cheap.

While I despise government intervention, I would give anything to see these insurance companies get their nuts put in a vise and some serious pressure applied. Of course, that won’t happen since the pharmaceuticals and insurance companies are owned by the idiots [both sides of the friggin fence!] in Washington.

God I hate insurance companies and the older a person gets, the more they fk with you.

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[Jitterbug]

My mom had a broken leg, at about age 85.

Surgeon slapped up an X-ray of the repair, and I about passed out. Seventeen screws, to put her back together!

Strict orders from the surgeon- ZERO weight bearing, for a month. She wasn’t even allowed to touch the floor with the toe on her repaired leg… THAT kind of “zero weight bearing.”

So… Medicare cuts off her rehab coverage, because she wasn’t progressing at the rate their chart said. Chart says she should be ambulatory.

HELLO… what part of ZERO WEIGHT BEARING was unclear?

I had to file appeals, jump through all sorts of BS hoops, etc. before I could get her coverage reinstated.

Ridiculous…

 

[Dieselden454]

My mom had a broken leg, at about age 85.

Surgeon slapped up an X-ray of the repair, and I about passed out. Seventeen screws, to put her back together!

Strict orders from the surgeon- ZERO weight bearing, for a month. She wasn’t even allowed to touch the floor with the toe on her repaired leg… THAT kind of “zero weight bearing.”

So… Medicare cuts off her rehab coverage, because she wasn’t progressing at the rate their chart said. Chart says she should be ambulatory.

HELLO… what part of ZERO WEIGHT BEARING was unclear?

I had to file appeals, jump through all sorts of BS hoops, etc. before I could get her coverage reinstated.

Ridiculous…

The SOB's sure like to get there money , but when its there time to pay watch out ! like pulling teeth ! no good SOB's

 

[snapbang]

My $.02
My diabetes DR. wanted me to go to a foot Dr. For a baseline inspection and to make sure all is well. All is well. The Foot Dr. made his visual inspection and was pleased. The Insurance refused to pay for the visit stating the Dr didn't do anything so they weren't going to pay the visit. My wife argued with 3 different people over a week before the last one agreed they will pay for the visit. The first 2 stating the Dr. didn't do anything so they weren't required to pay for it.

My father always said the big print gives it to you and the little print takes it away.

 

[TransYank]

Yep. Wife has Asthma was under control somewhat for first 5 years or so. But has progressively gotten worst for the last 10. She wanted to work to 67 to max out SSI (Does Data entry for local woman's college). Been there for 15 years. Cleaning crew cleans offices at night cleaners are trigger for Asthma that leads to here throwing up in trash can several times a day by her desk. After acid reflux from throwing up causes several medical procedures goes to HR with letter from doctor about cleaners and perfumes. They stop using them for a few years. Then new people start cleaning, and they use bad stuff again. Wife goes to HR new people there also and is told not their problem and will make no special arrangements. Works with throwing up and coughing ETC. and when Covid hits fellow workers want her to be removed from her office because she may be infected with Covid. I told her for years to quit but she works until 64 then. She filed for SSI this year and of course there is a penalty because she isn't full retirement age. We file for Disability so she can get her full benefit (Asthma is list my SSI as a qualify disability}. They deny the claim because she should find another job where there aren't any triggers for here Asthma. Have appealed it twice and waiting on a trail with a real judge to decide case. Was told in Jan would be about 2years wait we are on the list. It has been almost 3 years since I filed the request. We are only talking $200 a month different $7200. total. Between government doctors and all the tests. Plus, lawyers that are involved for both sides. I sure you the American Taxpayers are getting rooked. Wish my name was Latino!

 

[phalanx]

TransYank,

In federal gov work they would have been required to make accommodations. Same for private sector I believe, disabilities act?

 

[TransYank]

Yes, I know and your correct about disabilities act. But my wife is a good Godly woman and would not leave me pursue that avenue. Loved her job and didn't want to ruffle any feathers. This is a private all womans college and everyone was always treated like friends and family. Then management was changed (old retired) and they get a new Dean about every 2 years. Most of the teachers and professors are new and stay about 1 year class enrollment has shrunk. Then they fire the Dean, and it all starts over.

 

[phalanx]

Sorry to hear that TransYank. Seems a lot of good places to work have gone that way. It's one of the reasons I retired last year.

 

[Hausser1]

I won’t mention which one I use for my health insurance but I’d sure like to have a day in company’s upper echelon
with a ball bat.
I have copd and suffer from afib. For several years I’ve enjoyed meds that work on both fronts together but this year the insurance, in their infinite wisdom, decided to not support my primary inhaler so I had to hit up the doc for a replacement. This same doc suggested I use a “rescue” inhaler after the first “rescue inhaler I used, and it worked beautifully for me, was dropped from coverage a couple years back and I ended up with major league allergies to it. This most recent replacement inhaler, containing the same identical drugs as the other that caused issues, was one that was suggested by the company as a replacement. While at the doc for the first visit she suggested I start a statin as a maintenance med for cholesterol. My cholesterol wasn’t in the bad numbers yet but nearing it on one side so I said why not.

I got started with this new crap and after two days noticed a light , itchy, rash on my forearms that evening. By morning my hands had begun to swell and that rash had spread to my back and front of my thighs and my hands were so sore that I could not open a bottle of water. So off I go to the good doc again but I can’t see my primary so settled for another.

I had a nice visit and left with a heavy dose of prednisone by prescription along with sleep aide since prednisone tends to keep me up all night. Third day in on a twenty-day prednisone treatment and I can move my hands enough to work in the shop. The rash as all but gone and the tightness in the tendons has taken its leave, thank God. Damn, one doesn’t realize just how debilitating it is not have hand function without pain enough to bring tears to your eyes just picking up a friggin fork, until it actually happens to you. Now I need to go back and start a search for new meds that will actually work for me again. All this because some ignorant friggin buyer at the insurance company likely took a nice vacation and got a few thou stuffed in an envelope to use Mr. X’s new and improved inhaler and to drop one that actually worked.

This little episode probably cost the insurance company three times as much money as the idiots think they saved when all the blood work and office visits get tallied up. I had 7 very large vials of blood drawn and four of those had to be sent to specialized testing areas and I am sure that the testing wasn’t cheap.

While I despise government intervention, I would give anything to see these insurance companies get their nuts put in a vise and some serious pressure applied. Of course, that won’t happen since the pharmaceuticals and insurance companies are owned by the idiots [both sides of the friggin fence!] in Washington.

God I hate insurance companies and the older a person gets, the more they fk with you.

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The wifer works in the commercial lines of various insurance companies. She has some stories...

 

[TransYank]

Hey guys on a lighter note. I'm a blessed man. hunted deer with muzzleloader and also rifle in Virginia, Maryland, Florida, Goergia. Killed a bunch. Since retiring 3 years ago have gotten a Spring Gobbler hear in Virginia every season. And hopefully going to hunt Goergia and Virginia with muzzleloader 12ga. SxS this year. Killed a bull moose in New Foundland this past September as well. Going to Colorado with my son this fall Mule deer and Elk. Good Lord willing I have enough points for Antelope in 2025 and heading back to Canada for Moose 2026 with my son...Plus getting a little bow hunting in here and there. Life is Good just to short.

 

[Tony gilbert]

I won’t mention which one I use for my health insurance but I’d sure like to have a day in company’s upper echelon
with a ball bat.
I have copd and suffer from afib. For several years I’ve enjoyed meds that work on both fronts together but this year the insurance, in their infinite wisdom, decided to not support my primary inhaler so I had to hit up the doc for a replacement. This same doc suggested I use a “rescue” inhaler after the first “rescue inhaler I used, and it worked beautifully for me, was dropped from coverage a couple years back and I ended up with major league allergies to it. This most recent replacement inhaler, containing the same identical drugs as the other that caused issues, was one that was suggested by the company as a replacement. While at the doc for the first visit she suggested I start a statin as a maintenance med for cholesterol. My cholesterol wasn’t in the bad numbers yet but nearing it on one side so I said why not.

I got started with this new crap and after two days noticed a light , itchy, rash on my forearms that evening. By morning my hands had begun to swell and that rash had spread to my back and front of my thighs and my hands were so sore that I could not open a bottle of water. So off I go to the good doc again but I can’t see my primary so settled for another.

I had a nice visit and left with a heavy dose of prednisone by prescription along with sleep aide since prednisone tends to keep me up all night. Third day in on a twenty-day prednisone treatment and I can move my hands enough to work in the shop. The rash as all but gone and the tightness in the tendons has taken its leave, thank God. Damn, one doesn’t realize just how debilitating it is not have hand function without pain enough to bring tears to your eyes just picking up a friggin fork, until it actually happens to you. Now I need to go back and start a search for new meds that will actually work for me again. All this because some ignorant friggin buyer at the insurance company likely took a nice vacation and got a few thou stuffed in an envelope to use Mr. X’s new and improved inhaler and to drop one that actually worked.

This little episode probably cost the insurance company three times as much money as the idiots think they saved when all the blood work and office visits get tallied up. I had 7 very large vials of blood drawn and four of those had to be sent to specialized testing areas and I am sure that the testing wasn’t cheap.

While I despise government intervention, I would give anything to see these insurance companies get their nuts put in a vise and some serious pressure applied. Of course, that won’t happen since the pharmaceuticals and insurance companies are owned by the idiots [both sides of the friggin fence!] in Washington.

God I hate insurance companies and the older a person gets, the more they fk with you.

Edit
Reply
Quote

My wife's going through the same thing I sweat they want to take your money but if they have to pay they do there damnedest to not pay a dime

 

[Ernbar]

I feel your pain. Ever since that monstrosity called Obamacare was showed down our throats, the insurance rates have gone sky high and coverage shrinks daily. My wife retired last year and her insurance is almost 1K a month with a ridiculously high deductible along with a long list of bs rules. Later this year she will be eligible for Medicare coverage so the rate will be a fraction of what we pay now.
It’s a big mafia that the insurance and pharmaceutical companies are in along with bought and paid politicians allowing this crap to happen. Lots of pockets are being padded with our hard earned cash.
Then our friend affected by Agent Orange while serving in Viet Nam has to pay $500 a month for one medication and that’s with the VA discount. Yet illegals get free healthcare but our Vets gets screwed. We were forced to purchase health insurance otherwise get fined under Obama but illegals get free healthcare? WTF!
While on vacation in France last summer, my wife tripped and broke her shoulder. The 40 minute ambulance ride to the hospital was $220 and the ER x ray and Doctor charges was under $160. The same meds that need prescription here and cost $30 were over the counter in France at $2!
We elected to have the surgery done here in the US and out of pocket for the surgery alone was $4K. Throw in meds, follow ups and therapy for additional $3K.
Yes I know they have something like a 40% income tax charge on wages there but it seems like at the end of the day, we get screwed either way.

 

[Blackrock]

My mom had a broken leg, at about age 85.

Surgeon slapped up an X-ray of the repair, and I about passed out. Seventeen screws, to put her back together!

Strict orders from the surgeon- ZERO weight bearing, for a month. She wasn’t even allowed to touch the floor with the toe on her repaired leg… THAT kind of “zero weight bearing.”

So… Medicare cuts off her rehab coverage, because she wasn’t progressing at the rate their chart said. Chart says she should be ambulatory.

HELLO… what part of ZERO WEIGHT BEARING was unclear?

I had to file appeals, jump through all sorts of BS hoops, etc. before I could get her coverage reinstated.

Ridiculous…

No kidding!
For those that want Medicare for All they should take a hard look at the Indian Health Service to see what full control Government looks like --- and those same idiots think it will be "free"... We ALL pay the base rate premium for Medicare and some pay more, PLUS you need to have a Medigap Policy AND a part "D" plan for drugs. And if you do not sign up for a Plan "D" at retirement cuz you do not take prescription drugs when you do sign up they add a penalty to your premium that progressively increases for each month you delayed your sign up!! And for those cover all Part "C" plans, well you have to live in certain zip codes for a plan to be even available --- so if you live in a "fly over" part of the country, forget it

 

[bronko220002]

Our house in Florida is insured by Kin Insurance. This company is incredible. Two major claims in two years and no disputes or denials. I recommend them to everyone.