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By lynchburgwildcats
Registration Days Posts
#471636
LUnpretty11 wrote:My mom has cancer and has had multiple scan request get denied by the insurance company because they saw them as "unnecessary". Even though the doctor is the one directly ordering them stating that she needs scans asap. This has been over the course of the last 18 months.

Four years ago she was able to request a scan herself and get a scan done without question or issue. Obamacare has now financially handcuffed insurance companies, which has led them to decipher what is "medically necessary". That's just dumb.

Also, my wife was involved in a car accident - vehicle flipped 3 times - and was taken to the hospital in an ambulance. The doctor said he didn't want to do any x-rays or scans because he said she was "too young and didn't want to expose her to radiation". Bull. Standard procedure is to get x-rays of whatever is hurting - in this case her neck - but the doctor did not believe it was medically necessary considering the cost involved. Btw, this particular hospital was Lynchburg General.

Edit*: My wife and I found out she had a fracture in her neck 2 weeks after the wreck thanks to a chiropractor visit where he took the x-rays. So she went 2 weeks without a neck brace of any sort. Thankfully she is healed and better, but I am still furious about the situation.

All things considered, my insurance is through my company so I don't see it there so much as I have personally experienced this nonsense through the care my family has received (or lack there of). Brace yourself, this will become the norm.
My mom had similar problems regarding her knee last year. Long story short, her knee specialist wanted to perform surgery because he deemed that as the only thing that would fix it. Insurance company said she had to several weeks of physical therapy at her expense before she could get surgery. She appealed it, insurance company denied the appeal. Doctor ended up having to personally call the insurance company to rip them a new one because physical therapy was only going to make it worse. They finally agreed to cover the knee surgery after that. Doctor sliced open that knee, turns out if she would have done what the insurance company said to do, she would have had to get a complete knee replacement, according to the doctor.

These insurance companies act all high and mighty like they know what is the medically best thing to do without ever meeting with the patients or anything.

And don't even get me started on the ordeal I had to go through with my insurance company over a freaking physical. Wasn't an injury or anything, but a physical! Insurance companies are such a hassle to deal with these days it hardly seems worth going to the doctor unless it's something really serious.
User avatar
By LUnpretty11
Registration Days Posts
#471639
It's not that they think they know better, it's that Obamacare is suffocating insurance companies with all these extra expenses and regulations.
All of these decisions are being made from a financial perspective.
Edit* they did the same thing with the scans for my mom. She needed PET scans, but they said she had to have a CT scan first. The part that made absolute no sense was that they would approve her for a PET scan after she got the CT scan. The PET is more detailed, which is why she wanted that. So instead of just ordering up a PET, they ended up covering the expense of a CT and a PET.
User avatar
By RubberMallet
Registration Days Posts
#471644
we are starting to run into precisely what obamacare was designed to exact. a fight from the insurance companies. a fight so infuriating that we the people begin to despise the system. angry at the law but moreso angry at the insurance companies. The insurance companies are companies. businesses reliant upon revenue to grow and to bring profit to its owners. People are like WAH WAH BIG FAT CATS BLAH BLAH BLAH. yoo hoo. guess who owns united healthcare? I DO and if you have a mutual fund, you are probably as well.
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By jbock13
Registration Days Posts
#471661
I know I'm alone but my premiums actually went down 36% at work for 2015. I mean I'll take it.
By JK37
Registration Days Posts
#471666
We are actually offered very good health coverage where I work.

*Monthly premium for family is $478/mo for health care, which represents a 14% increase over last year. BUT, vision and dental went down a little. So that's nice.
*Deductible is $3,300. Company provides a $2,500 health fund to help cover majority of deductible.
*I am responsible for 20% of all costs after deductible is met.
*Pre-tax options exist for monthly premium withholding, as well as health and child care savings funds.

*Interestingly, birth control is NOT covered AT ALL, due to my employer being a Catholic university.
User avatar
By Purple Haize
Registration Days Posts
#471681
JK37 wrote:We are actually offered very good health coverage where I work.

*Monthly premium for family is $478/mo for health care, which represents a 14% increase over last year. BUT, vision and dental went down a little. So that's nice.
*Deductible is $3,300. Company provides a $2,500 health fund to help cover majority of deductible.
*I am responsible for 20% of all costs after deductible is met.
*Pre-tax options exist for monthly premium withholding, as well as health and child care savings funds.

*Interestingly, birth control is NOT covered AT ALL, due to my employer being a Catholic university.
I know someone who can help you with that last item. Ha
By thepostman
#471682
Once I get out of the military health insurance is one of the things I look forward to the least. Especially with a family.
By ATrain
Registration Days Posts
#471763
thepostman wrote:Once I get out of the military health insurance is one of the things I look forward to the least. Especially with a family.
We're just waiting for the self +1 option to be rolled out here. You should get a civilian job in the federal government...with a military background, you'll have your choice of what you want.
By ALUmnus
Registration Days Posts
#471802
JK37 wrote:We are actually offered very good health coverage where I work.

*Monthly premium for family is $478/mo for health care, which represents a 14% increase over last year. BUT, vision and dental went down a little. So that's nice.
*Deductible is $3,300. Company provides a $2,500 health fund to help cover majority of deductible.
*I am responsible for 20% of all costs after deductible is met.
*Pre-tax options exist for monthly premium withholding, as well as health and child care savings funds.

*Interestingly, birth control is NOT covered AT ALL, due to my employer being a Catholic university.
In my experience with three different employer-offered health plans, I've never seen anything that expensive. And I've had very good plans.
By thepostman
#471814
ATrain wrote:
thepostman wrote:Once I get out of the military health insurance is one of the things I look forward to the least. Especially with a family.
We're just waiting for the self +1 option to be rolled out here. You should get a civilian job in the federal government...with a military background, you'll have your choice of what you want.
I have 3 years left and we'll see what happens. I know that option is there and it will be something to seriously look into.
By Humble_Opinion
Registration Days Posts
#471816
ATrain wrote:
thepostman wrote:Once I get out of the military health insurance is one of the things I look forward to the least. Especially with a family.
We're just waiting for the self +1 option to be rolled out here. You should get a civilian job in the federal government...with a military background, you'll have your choice of what you want.
ATrain - where in the federal government do you work? Forgive my curiosity, but I think you and I both lived in the 757 for a while so I was just curious.
User avatar
By Purple Haize
Registration Days Posts
#471820
Humble_Opinion wrote:
ATrain wrote:
thepostman wrote:Once I get out of the military health insurance is one of the things I look forward to the least. Especially with a family.
We're just waiting for the self +1 option to be rolled out here. You should get a civilian job in the federal government...with a military background, you'll have your choice of what you want.
ATrain - where in the federal government do you work? Forgive my curiosity, but I think you and I both lived in the 757 for a while so I was just curious.
He has joined the Cult of SLY and now lives on the Commune at an undisclosed Texsas location
By ATrain
Registration Days Posts
#471826
Humble_Opinion wrote:
ATrain wrote:
thepostman wrote:Once I get out of the military health insurance is one of the things I look forward to the least. Especially with a family.
We're just waiting for the self +1 option to be rolled out here. You should get a civilian job in the federal government...with a military background, you'll have your choice of what you want.
ATrain - where in the federal government do you work? Forgive my curiosity, but I think you and I both lived in the 757 for a while so I was just curious.
I work for the Social Security Administration in Dallas, TX...Purple is secretly jealous that I live in the heart and soul of Texas (and don't let any Houstonian tell you otherwise). I used to live in VB and worked for the Commonwealth for 5 years before joining the feds.
User avatar
By RubberMallet
Registration Days Posts
#471832
i pay 800 bucks a month out of pocket after the companies contribution. 1500 deductible though. it didn't go up this year.
By ALUmnus
Registration Days Posts
#471868
That just seems crazy to me. Maybe I've just been fortunate or don't have a high enough salary to have to pay those rates, but I can't imagine having to pay that much. I complain about my costs, but that's pretty eye-opening for me.
User avatar
By Sly Fox
Registration Days Posts
#471869
I'm paying over $900/month with a $5k deductible and feel like I am getting a steal compared to most competing quotes.
By flamehunter
Registration Days Posts
#471875
Wow I am feeling fortunate. Roughly $400/ month with a $1200 family/$600 individual deductible.
User avatar
By Sly Fox
Registration Days Posts
#471925
There is a price to be paid for being self-employed and not buoyed by a group plan. But it is worth every penny.
By Humble_Opinion
Registration Days Posts
#471937
Sly Fox wrote:There is a price to be paid for being self-employed and not buoyed by a group plan. But it is worth every penny.
Part of the problem with this mess is that everyone who wants to be, but is not yet self-employed, is going to have an ever harder time getting there now. Simply allowing small business owners to pool their employees together would have solved so many more problems related to healthcare costs and coverage in the country than the 2,000+ pages of the ACA (not withstanding the 1,000's of rules/regulations coming on the back end).

Then again, we all know that this wasn't designed to help lower costs and increase coverage... it's a power grab.
By lynchburgwildcats
Registration Days Posts
#471939
I pay $100 a month just for myself but what I pay is basically a monthly donation to Anthem since my insurance is pretty much useless unless it's something catastrophic. I just have to bank on not having to go to the doctor for any reason to prevent getting screwed over.

For example: My doctor said I needed to get a physical when I turned 30. I consulted online to make sure she wasn't just saying it to get more money out of me, even though she has never done that before, I just wanted to be positive. So I got the physical. Anthem refused to cover it. Cost me over $500 freaking dollars. So guess who is going to ignore all medical logic and reason and no longer get preventative care unless forced to? Me.
By TDDance234
Registration Days Posts
#472004
I just spent the last 5 hours sorting out medical bills from two visits and a minor procedure on my back. I now am in the hole by about $5,000 and no idea how I'm going to pay everything.
By lynchburgwildcats
Registration Days Posts
#472008
TDDance234 wrote:I just spent the last 5 hours sorting out medical bills from two visits and a minor procedure on my back. I now am in the hole by about $5,000 and no idea how I'm going to pay everything.
Should have just sucked it up and lived through it. I had to get the entire right side of my body waist down. I'd been holding off for months, got it checked on when I went to get my physical so I could reduce the amount of shoving it up my you know what by Anthem.

I had what seemed like a nerve problem last year that I probably should have gotten checked out but I didn't because lord knows how much it could have ended up costing. After a few months it just went away, so guess I got lucky there.
By ATrain
Registration Days Posts
#472022
I pay roughly a little more than the artist formerly known as Shuk, but fortunately my plan includes free preventative care. I do pay more as a federal employee than as a state employee for health insurance however.
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