Jordana
Frequent Contributor (1K+ posts)
Member # 45305
posted
i just got a bill from my medical network for ten thousand dollars.
Because? In December, the Obama insurance company I pay 400 dollars a month to "sent a letter" stating that my medical network was "out of network."
I never saw this letter and frankly would have blown it off anyway since every time I've been "out of netwok" before the company would at least pay something.
In december I got a precertification letter to get an upper and lower GI. I had my appointment in January. Upper, lower, they removed polyps and did biopsies on them.
turns out I paid for that myself -- four thousand bucks.
Now a couple a months ago there was another letter saying that this insurance company was going out of business, totally, as of right now in 30 days.
It turns out the doctor I went to see yesterday did not take my insurance. This has been going on all year - I would go into a doctor's office and they would take my insurance card and check me in and NOT TELL ME THEY DID NOT ACCEPT IT.
Ten thousand dollars!!! My responsibility. Not to mention they did not help me at all, recognize my TBIs so I had to go to OTHER doctors for that who did not take insurance and pay for the prescriptions myself.
I feel immensely victimized at the moment.
Posts: 2057 | From Florida | Registered: Feb 2015
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
. . . The Division offers a toll-free Insurance Consumer Helpline to assist insurance consumers with insurance questions and inquiries or to file a complaint against your insurance company.
Our dedicated and experienced staff stand ready to advocate on your behalf and assist you with resolving your insurance concerns.
Please view our consumer guides, educational videos, insurance library and our online complaint portal for more information and resources. . . . -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- For others with similar issues, each state should have the same kind of a state government agency.
"Ombudsperson" . . . "insurance commissioner"
in a web search might help you find it or one similar. Make sure it is within the actual state governmental body of your state / state of the insurance carrier / state where care obtained. -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- John Oliver on "Last Week Tonight" recently did a full segment on medical debt. He listed an organization at then end that helps with medical debt issues.
He also took a large sum of debt on himself, founded his own organization. However, that was ONLY for the exact sum of he "package" of debt he bought to show how it can be done and how
unscrupulous groups buy up medical debt packages.
Be sure yours does not get bought up - likely too soon for them to hand it over to a 3rd party but do become aware of this practice - for your protection. It's scary to learn about but really necessary.
Again, at the end of that segment, he listed a group for people to connect with. Web search should find it for you.
Was within the last six weeks, I think.
I have empathy / sympathy but no energy for expressing such sentiments - coming up with the right words and all. Just know they are always with any practical suggestions. -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- You say your insurance coverage is under the ACA. Which exact insurance company, though? (Although even within each company, coverage packages vary widely) it might help others to reply in case they've worked with the same company.
By the way, this was not the way the ACA was envisioned. Insurance corporations insisted for these kinds of loopholes or they were not going to be involved. -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Jordana
Frequent Contributor (1K+ posts)
Member # 45305
posted
It's called Land of Lincoln Health - they got shut down by the State of Illinois. I have to apply for new coverage before Oct 1 and then renew again in January I think.
I *was* worried about the obvious problem that if your insurance company goes out of business you've lost your deductible for an entire year. Considering I paid for everything myself this is no longer a concern. Lol.
Posts: 2057 | From Florida | Registered: Feb 2015
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Jordana
Frequent Contributor (1K+ posts)
Member # 45305
posted
The one comfort in this is that I actually did need an upper and lower GI and they pulled pre-cancerous polyps out of me for the four thousand bucks. So at least I'm not growing cancer in my intestines at the moment.
The rest of the money I might as well have buried in my backyard and hoped it grew a money tree.
Posts: 2057 | From Florida | Registered: Feb 2015
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Keebler
Honored Contributor (25K+ posts)
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posted
- Do you live in Illinois?
Still, if they "got shut down by the State of Illinois" and, by their name, implied their corporation home is Illinois (?)
you might contact the appropriate agency to see if you have any recourse, even if you live in a different state.
If they were operating unlawfully and you thought you had coverage, that's fraud. An ombudsperson would have more detail. -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Jordana
Frequent Contributor (1K+ posts)
Member # 45305
posted
It's crazy, you know? If I were well enough to be on top of this crap I would not need Obamacare.
Jeeeez.
Posts: 2057 | From Florida | Registered: Feb 2015
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- You would still need insurance coverage.
This is not at all the vision for the ACA, but what corporate haggling demanded. It is the greed and corruption of the individual insurance corporations. As long as the insurance corporations are involved, the patient has little voice.
And, it's not just the insurance groups, most medical care centers & doctor groups are also incorporated. Some do have different ethical mission statements but that can depend on which way the wind blows and their own operating costs, too.
The film: "The Corporation" is a must see and better explains their mission and first priority to shareholders / stakeholders. -
[ 08-31-2016, 05:26 PM: Message edited by: Keebler ]
Posts: 48021 | From Tree House | Registered: Jul 2007
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Jordana
Frequent Contributor (1K+ posts)
Member # 45305
posted
I ponder this a lot -- do I really need insurance coverage?
If I had a heart attack or a stroke or something that's the only time I would actually need it because the ER is expensive.
They got my gallbladder out when it was infected ( thanks Lyme) and they got polyps out of me but pretty much every test I've taken, every Lyme doctor, every abx prescription, all the herbal tinctures and supplements, bee venom therapy, plus the things I'm thinking about trying like HBOT were all my expense and I am still not better.
I did the rounds with the regular docs and basically sat in their offices in a chair while they told me they had no idea what was wrong with me while I racked up an unbeknownst 500 dollar bill.
I've been looking in the marketplace for the CATASTROPHIC option. Otherwise I've ended up paying for at least nearly all of this myself.
Posts: 2057 | From Florida | Registered: Feb 2015
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
By Stewart Cowley - 1982 -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Jordana
Frequent Contributor (1K+ posts)
Member # 45305
posted
Lol Keeb.
Posts: 2057 | From Florida | Registered: Feb 2015
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me
Frequent Contributor (1K+ posts)
Member # 45475
posted
Geez, Jordana. I'm so sorry. You don't need this right now. No one, healthy and especially ill, should have to go through this.
Money and insurance companies and pharmaceuticals and all that . . . So much to say about all of it, but to sum it up, it's sad and tragic. Something must be done to stop this madness.
I'm sorry.
-------------------- Just sharing my experiences, opinions, and what I've read and learned. Not medical advice. Posts: 1431 | From USA | Registered: Mar 2015
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posted
It's just disgusting, maddening and criminal what is happening with health care insurance Jordana!
I have a great distaste for all of the insurance bull slip trickery. >:{
I have a friend whose daughter needed some hospitalization that they "thought" was covered by the insurance. Turns out that the particular dept. that gave the care was outsourced and not covered by insurance at all to the tune of some ridiculous amount of money - tens of thousands of dollars! UGH
Keebler- hahahahahahahahahahaha! I just bought a used copy from Amazon. Thanks!
Posts: 764 | From Northwest | Registered: Sep 2014
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Jordana
Frequent Contributor (1K+ posts)
Member # 45305
posted
Man...
What the hell kind of affordable care act is this?
Posts: 2057 | From Florida | Registered: Feb 2015
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randibear
Honored Contributor (10K+ posts)
Member # 11290
posted
I went to er recently. it was packed. out of at least 25_30 people only two had insurance. husband had broken hand so I had a reason.
so who pays?
-------------------- do not look back when the only course is forward Posts: 12262 | From texas | Registered: Mar 2007
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posted
"We have to pass the bill before we will know what's in it."
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96223 | From Texas | Registered: Feb 2001
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Jordana
Frequent Contributor (1K+ posts)
Member # 45305
posted
One of the greatest disappointments of my life is this medical betrayal I experienced this year.
I learned that healthcare works like a car dealership. Rope em in, get them to sign, sell them things they don't really need and then check their credit. Make sure your every move is legally protected.
It's hard to unsee.
Posts: 2057 | From Florida | Registered: Feb 2015
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randibear
Honored Contributor (10K+ posts)
Member # 11290
posted
yeah we forget most medical personnel are contractors at the hospital not employees.
only employee is probably the janitor!!!!
-------------------- do not look back when the only course is forward Posts: 12262 | From texas | Registered: Mar 2007
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