• Dasus@lemmy.world
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    2 days ago

    ProPublica is doing a story and was asking for these on Bluesky at least. Wanted people to share their stories.

  • hactar42@lemmy.ml
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    3 days ago

    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.

    • CetaceanNeeded@lemmy.world
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      3 days ago

      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.

      • hactar42@lemmy.ml
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        3 days ago

        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.

        • CetaceanNeeded@lemmy.world
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          3 days ago

          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.

  • Nomecks@lemmy.ca
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    4 days ago

    Canadian here. Had an accident and took a ten minute ambulance ride in Minnesota. $1400.

    • BonesOfTheMoon@lemmy.world
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      3 days ago

      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.

      • Nomecks@lemmy.ca
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        1 day ago

        No joke: My mom burned herself with coffee really bad and we high tailed it back across the border to Sarnia before getting treated.

    • corsicanguppy@lemmy.ca
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      3 days ago

      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.

  • GooseFinger@sh.itjust.works
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    3 days ago

    I transferred to a new college and learned the first week of class that they required a few vaccinations I was missing. No problem, the on campus health center can provide them. I confirm with them that they accept my insurance, so I go get the shots.

    A few months later, I get a bill in the mail for over $3000. Apparently the health center wasn’t in-network, so I have no idea what they meant by “we accept your insurance.” I layer learned that if I had driven 10 minutes west across the state border, there was an in-network office where those two vaccinations would’ve been completely covered.

    I still haven’t paid a penny towards that bill, fuck them. I get daily phone calls from an unknown number, it’s probably collections, but I don’t know for sure since I never answer it. This was years ago and my credit score never took a hit. I’d rather die than reward these parasites with my money.

    I’m pretty sure I have a tumor growing on my hip too. I’d get it checked, but between student loans, insane cost of living, and rising costs of literally everything else, I can’t afford to right now. I’m a childless engineer with “great” health insurance and a roommate, so I’m relatively well off. I have no idea why shit hasn’t boiled over yet. Makes me want to depose some CEOs too.

    • viking@infosec.pub
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      3 days ago

      Get that tumor checked, now. If it’s something malignant, chances are “can’t afford” is the least of your worries.

      What’s the worst thing that can happen to the bill? Another collections call you never answer? Beats a premature death.

  • sudoshakes@reddthat.com
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    3 days ago

    I went for surgery that was to repair a urethral stricture, with the expressly stated reason for doing it as being able to be catheterized in a future spinal fusion procedure. I told every single member of my care team this information, and all knew about the spine instability. A Spondylolisthesis diagnosed by their same hospital system.

    I woke up in agony screaming before I could see. They put me in a position that allowed my back instability to shift. I was screaming to drop the bed. The nurse told me to calm down.

    When I was finally laid flat, I noted I could not feel my genitals and I could not feel about half of my legs or any of my feet. Totally numb.

    I was discharged from the hospital 3 days later with a walker because I couldn’t feel my feet and needed assistance to walk for a proc sure that never should have required it.

    They billed me $250 for the walker, and never followed my requests to ascertain why I was paying for a walker that was the resulting need of malpractice. This was sent to collections.

    I get phone calls weekly about a walker I should never have needed, and should not have been billed for as “outside of network” because it was not pre-approved for an urology procedure.

    Who in the fuck assumed a loss of leg function from an urology surgery? Who gets that pre-approved?

    Fucking cunts.

  • ChaosCoati@midwest.social
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    4 days ago

    My spouse had their lung collapse. Insurance denied it because we didn’t get advance approval for their lung to collapse.

    • spirinolas@lemmy.world
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      4 days ago

      This is scary, as an European. I had my left lung collapse too. Two years later my right one. After that I had to have surgery on my right lung (Pleural Abrasion) and a few months of physiotherapy after that. I also had a yearly appointment with a Pneumology MD for 5 years to follow the development of the lung until it was all fine.

      How much did I pay? You guessed it…zero. Now I wonder how much would that set me back in the US with or without insurance.

      • ChaosCoati@midwest.social
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        3 days ago

        I’m glad you’ve recovered! They did say it was more likely for my spouse to have a lung collapse again, which is scary.

        Luckily my spouse’s employer has someone whose whole job is to fight with insurance. She got insurance to admit that in an emergency we didn’t need pre-approval which brought our bill down some.

    • acchariya@lemmy.world
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      4 days ago

      Had something similar, failed to get pre-approval for a CT scan to diagnose a pleural effusion. Yes, I was supposed to wait 24-36h for someone unfamiliar with my case and likely not even a doctor to determine if a diagnostic test was nessasary.

      Edit DDD

  • captainlezbian@lemmy.world
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    2 days ago

    Mine are all boring shit like my insurance deciding how many relapses of cancer my mom was allowed to fight or them challenging my surgery a month before despite having gotten pre approval or needing pre approval at least once a year for a med I’d been on for a decade.

    But a friend had an actually entertaining one, she had trans bottom surgery and they paid for everything except for the “removal of the penis” which they demanded to know why it was necessary

    Edit: sorry thought it said health insurance story

  • vivavideri@lemmy.world
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    3 days ago

    Cigna dropped my medicine coverage. I had to to drop two name brands simultaneously to generic else i would be out 4k every 30 days.

    The switch was not pretty.
    Like, mental breakdown, life changing, never-will-be-the-same not pretty.
    That was…8 years ago. I imagine if it was something maintaining my physical health I certainly would have died. I mean, shit, I nearly did. Don’t get me started on the arm i broke as a kid, that didn’t heal correctly because a narcissist parent(RN) wanted to skip the er wait and had hospital buddies patch me up on the dl instead. A bionic arm sounds more feasible than actually getting it to where I could play strings again without pain.

  • Dagamant@lemmy.world
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    3 days ago

    Between my wife and I we make 200K a year. We have a roommate to help pay bills because between her chrones disease and our kids health issues we can’t afford to live. She has been without her chrones medication for 6 months because the hummers was causing problems and the new prescription has been in limbo between pharmacies not wanting to deal with it or her insurance and her insurance continually sending her to pharmacies that don’t accept her insurance. Medication that is easily affordable and available in other countries is dangled just out of reach while she suffers.

  • ChillPenguin@lemmy.world
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    4 days ago

    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.

  • LucasWaffyWaf@lemmy.world
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    5 days ago

    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.

  • SwingingTheLamp@midwest.social
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    4 days ago

    I had major depression when I was younger. I couldn’t get individual insurance because it was a pre-existing condition. I couldn’t afford it, anyway, because getting and keeping a job was very difficult because, uh, depression? So, getting a job with a group plan was also out of reach. I had to research it and treat it myself, which, goddamn right I’m proud I managed.

    But now I’m middle-aged, single, and probably will never have the savings to retire. Eat a Grand Canyon full of Godzilla dicks, U.S. healthcrime system.

  • Rob@lemmy.world
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    4 days ago

    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.

  • TheAlbatross@lemmy.blahaj.zone
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    5 days ago

    There are far worse out there, but about a year ago I injured my hand somehow. I couldn’t close my fist, which made it hard for me to work and support my partner as I do a majority of the cooking and chores. I couldn’t make a firm enough grip to use cast iron cookware. I was really concerned about this for a number of obvious reasons, so I went to the doctor.

    I looked up an in network doc, call them up, confirm they take my insurance, double check that the kind of care I was looking for was covered. At my appointment they ask to do a physical as well, since I was due for one. During that they asked all the normal questions, the poignant one here being “do you smoke?” I replied “I have one or two cigarettes socially when drinking with some friends, which happens maybe once every other month or less.” This changed the tone of the entire visit.

    My concern about my hand was largely disregarded and the doctor began talking to me about smoking cessation and the dangers of tobacco. Gave me pamphlets, tried to ask if I’d consider quitting, asked if I’ve tried alternatives. I tried to turn things back to my hand and she wasn’t interested. After I strongly insisted that was my sole medical interest, she gave me a referral.

    I pay my copay up front and leave. I go to the specialist a few days later. He looks at my hand for 45 seconds and gives me a wrist brace and tells me to sleep with it on. I pay my copay and leave. Wouldn’t ya know? That did it! My hand was working again.

    I call the specialist to follow up on his care and say it worked well. He told me I need to speak with billing to settle my bill. I’m confused. Wasn’t the copay for that? He says the insurance covered the visit but not the medical device (the wrist brace). So I check with billing and they want four hundred dollars. I’m flabbergasted. I check where they got the product, because surely it couldn’t cost that. I found the identical product, brand and all, on Amazon for $13. I’m livid. I argue with them, they say they can’t do anything.

    I call the insurance and they say my policy was clear about specialists and medical devices. Dejected and feeling stupid, I just pay.

    About a week later I get a call from the first doc saying I needed to settle up as well. I owe them five hundred dollars!!! How?? They say the bloodwork they did wasn’t covered. I plead saying that’s a normal part of a physical, no? They say yes, but I didn’t come in for a physical, according to the billing, I came in for a smoking cessation meeting!!

    I tried for weeks to get the doctor on the phone to rectify this but they wouldn’t speak to me. My insurance company said they didn’t cover bloodwork as part of that and the doctors office wouldn’t change the billing.

    I’m sick of doctors, I’m sick of insurance companies. If I get sick, I make chicken soup, drink tea, and scarf OTC drugs. I sprang my ankle fishing earlier this year. Did I go to a doctor? Absolutely not! I can’t afford a $900 bill every time something goes wrong.

    I pay $360 a month for this. Thankfully I make enough that this wasn’t so damaging on my life, but I stopped buying as much meat and ate mostly beans for a year and didn’t travel for my vacation. I had been hoping to visit my father across the country that year but we had to put it off. It changed my outlook on medical services drastically and I’ll never be so honest to doctors again.

    • JackbyDev@programming.dev
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      4 days ago

      I think what annoys me so much about doctors is that they charge you afterwards. If you knew what you were doing was gonna cost $500 you wouldn’t have chosen to do it. They know what your insurance is. They know what they charge. But they don’t tell you until afterwards.

    • vinnymac@lemmy.world
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      4 days ago

      I had a similar experience in the last year. They basically try to trick you into paying. They know exactly what they are doing too.

      This one time a few years ago I literally went in for a check up (first time all year) to find I had a completely new doctor assigned to me. And I couldn’t even make this shit up if I tried. The new doctor was not in my network, they did not inform me during my visit, and he tried to get me to do shit (upcharge) that fortunately I outright refused the entire time we spoke.

      When the bill came they tried to charge me out of network prices, and I basically fought them for six months saying that it was a surprise bill until they finally gave up. I don’t plan on ever going back to that office again in my life.

    • acchariya@lemmy.world
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      4 days ago

      If we all just stop paying the insurance, and instead just put $50/month towards the exorbitant medical bills, boom, universal healthcare

  • That_Devil_Girl@lemmy.ml
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    4 days ago

    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.

    • papalonian@lemmy.world
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      1 day ago

      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.