I hate insurance!!

Can anyone tell me what the point of having health insurance is?? I can't seem to figure it out.....

You pay some fucking company money monthly in the hope that if you have to go to the doctor, that company will pay for the majority of the bill. But when it comes down to it, they decide that they don't want to pay it...nevermind that your doctor says it's medically neccessary. They just don't feel that it matters. Well why the hell am I paying you again?!?!?

My favorite thing about insurance companies is when they claim to have not gotten a payment, and you send them a copy of the check that has been cashed and the UPS tracking and it's apparently not enough. "We're sorry ma'am...we'll get your policy effective again ASAP." Well....I think a month is a bit much.

Why do I pay monthly for nothing?? I go to the doctor...and then insurance won't pay for the appoinment or the medicine that I NEED. I'm sick and tired of people being too lazy to do their jobs...especially when my health depends on them. Do they not know this...or do they just not give a flying fuck?

FUCK YOU UNITED HEALTH CARE!!!!


*deep breath* 2, 3, 4........

Now why the hell don't I feel any better??

hehe I know how you feel, my problem isn't with health insurance though, I have had ongoing health problems for some time, with out it I would probably be brokoe and homeless...
My problem is auto insurance, I don't know about all states but in Colorado it is ilegal not to have it, so here I am paying $250 a month for 3 vehicles, and someone does a hit and run on my T-Bird.. mind you this car has been totally redone in the past and WAS in mint condition... but since it's a 91 they want to give me $500 and consider it totaled!
So I guess I can say...

FUCK YOU ALL AMERICAN FAMILY INSURANCE!

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I've work in the health field for over 20 years now and a BIG part of my job is dealing with health insurance companies from the hospital side. I've dealth with every insurance company in the US at one time or another.

Yes, you;re right, United totally sucks, for both the patient and professional sides.

Sounds like you have either an HMO or PPO plan, they rarely deny indemnity plan claims. I'd suggest looking into Blue Cross, Blue SHield or Healthnet. Sure, you'll find horror stories with them too, you'll find horror stories with them all, but from my side, dealing with thousands of claims yearly, I'd say these 3 companies support the patient the best. Pacificare's pretty good too but they usually have a smaller physician pool to choose from if you go HMO/PPO.

Unless you're in New York state, Blue Cross in new York, called Empire kinda sucks too.

Sorry to hear about your car Sensual! Auto insurance would be a whole other rant for me!

Thanks for the suggestions Jellin! Unfortunately, my last insurance company was Anthem Blue Cross & Blue Shield.....and they fucked me even harder than United has so far...and with no lube at that! Heh...couldn't resist! But anyways, I'll look into the other and see what it's about. Any thoughts on Medical Mutual? It's my husband's insurance and we're trying to get me put on his plan....but they seem to work slower than any other company in the world.

I feel like it must be said again.......

FUCK YOU UNITED HEALTH CARE

Anthem is a secondary payor that the blues (and others) sometimes subcontract to. Anthem's not too good either. I'd go for a direct Blue plan, not one through subsidaries.

Medical Mutual a small regional company, as such they micro manage accounts a lot more than the big boys. I'd always prefer to stay away from the small fry.

Thanks so much for your help and suggestions Jellin!!

Princess, I work for an HMO

It's ok, I don't take it personally

Get your doctor involved. Rant to him. Get up in his face even

My company is a managed health care organization for Medicaid recipients. When a claim is denied, a Medicaid patient can't be charged, so you bet that a provider is going to appeal that claim and do everything possible to get paid! Those denied claims can result in anything from non-covered services to delayed billing to incorrect diagnosis coding. Before you pay that bill, make sure that you have specific reasons as to why it was considered medically unnecessary. Talk to your insurance company too. If you can't get anywhere, appeal it yourself. Ask for a copy of your rights and responsibilities from your insurance company, if you don't already have a copy.

It stinks doesn't it? Health care is rotten in this country, but no one needs me to tell you that.

And if all else fails, well....what you said...

Lia

I hope you don't take it personally Liaden!! I really do know that the people work and blah blah blah.....just ranting cause I'm at about my wits end.

Anyways, I have my my doctor resubmit claims with different codes and all that, and sometimes it does work. But if I appeal it myself, it really seems like they barely even consider it. I've called and spoke with what my guess is close to every employee they have but they won't tell me why my claims were denied. My favorite line they give me is "We can't give you that information...you'll have to have your Human Resources Director call us, and we'll tell them." Now, I don't know much....but isn't that a privacy violation? Now granted, my mother is my HR Director (I work in a family business) and I don't care about her knowing...but WTF kind of logic is that......you cannot give the info to the person whose name the policy is under, but go ahaead and give it to what could be a complete stranger. If that makes sense...then I've definately got some learing to do.

But really my biggest complaint is not fixing my policy.....I sent all the info proving I paid my premium. Does it take over a month to fix that?? I could be wrong because I don't work in that field as you do....but to me, that seems like a REALLY long time.

Gah...how did I get to ranting again??

To sum up......I've tried most of those things and they don't work. But I appreciate the thought!!

And yes...health care in the US blows!! I really don't understand why we don't have a federal health care plan as Canada does...oh wait, yes I do, it's those damn greedy politicians and drug companies!!

*packs bags and gets ready to move to Canada*

I have heard that the federal health care system in Canada doesn't work very well in some ways either. Particullarly in long waiting periods for almost any kind of procedure and things like MRIs. How about it, all you Canucks? How do you feel about your health care system?

Insurance blows. I agree with you two too

On the topic of looking at other countries' blanket health care policys: I've heard that Japan has one of the best healthcare systems, it even looks that way considering that they have the lowest infant mortality rate in the entire world.

Plus, the clinics and hospitals there are a lot more personal. One thing I've never heard from a US doctor when leaving the hospital is "I hope you get better!" According to my sensei, that's common practice there.

==Chris

Absolutely!

Just in the past year, HIPAA (Healthcare Insurance Portability and Accountibility Act) regulations have expanded...no doubt you have had to sign a form stating you have received their policy. It doesn't matter who your HR person is. They do not have a right to your personal health information unless you specifically sign a form stating you give the [named persons] access to that information.

In my job, I'm the one who goes out to doctor's offices and reviews their charts and ensures that quality standards are being met. It gives me great pleasure to tell a doctor they have to shape up or ship out. I am so consumer/member/patient oriented that I'd be approving every test and procedure there is, so it's a good thing I don't do that.



Keep up your ranting. If you need more information/need to file a complaint, I'll be happy to point you in the right direction. You do have rights. And see? This is coming from one in the bizness!

Like I said....what you said


Lia

<--- is moving to Japan



Lia

well.....if you belong to your employer group plan...its not gonna do you any good to shop to another healthcare TPA.....it would be very costly to take a a private policy. As far as your say in your employer group plan....it doesnt matter who they pick....the administrator will accommodate what ever your employer is wanting. Your employer picks the plan. Thats what most people dont understand. Your employer tells the TPA what they wanna spend and able to spend and the TPA will then work it out. It also depends on the providers of service in the area if a PPO or HMO will work. Enuff are on board then its really the way to go....if not enuff participate well then it really sucks. I have worked in insurance since 1989. So I could prolly take a look at your plan and see if you are using it to the fullest. Sometimes ppl have a great plan but just dont know the rules. Sometimes not....but I would be willing to chat with you about it. ....no charge....lol.....and insurance is a rip ..... anyone thinking about taking out a life insurance policy....thats is one of the biggest rips ever!! You will never collect on that....if your doing it for loved ones.....so many things can void it. Say you fall on hard times...and you cant make that payment ....you defult...all that money you sunk previously...lost....nothing you can do either. Anyhoo had to get in on this thread cuz well it is how I make a living.


smooches

come talk to me....i bet i can help you out!

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Believe it or not, here in the US saying things like that to a patient leaves physicians open to possible malpractice suits. I know I know, sounds stupid, but it's true.

Thanks for the offer Jolene!! I'll track you down inworld sometime soon!!