Preventive Medical Care Can Come With Unexpected Costs
17 replies, posted
[URL="http://www.npr.org/blogs/health/2014/01/21/264516647/preventive-medical-care-can-come-with-unexpected-costs"]NPR Link[/URL]
[quote=NPR]Take colonoscopy. The procedure is recommended for people age 50 and older by the U.S. Preventive Services Task Force, and thus should be covered under the law. But there's a hitch. Although insurers generally pay for the procedure itself, they may not pick up the hospital facility fee or the anesthesia charges, leaving patients on the hook for sometimes more than $1,000 in additional charges. Talk about a rude awakening.
Contraception is another sticky area. Most health plans are supposed to pay for all methods of birth control approved by the Food and Drug Administration without charging women anything out of pocket. But some insurers have not been paying for some forms of contraception, according to a recent study by the Guttmacher Institute, a sexual and reproductive health research and education organization.[/quote]
HMO's are god awful.
Every single nurse, doctor, nurse's assistant, technician, resident, patient, (and their family) and administrator that I have ever worked with, hates health insurance companies with a fiery passion and I don't blame them.
They make our lives a living hell (the facilities; hospitals, nursing homes, clinics) and they make it ten times harder, financially and psychologically, on patients/residents.
So old guys get fucked by a camera, right before being fucked by their obamacare policy....... They could at least buy you dinner first.
But I'm kind of confused about the birth control situation. It may be because I don't know much about the female aspect of it, but doesn't the pill work just as well as the patch or the ring? I understand that it goes against the law, but I guess I don't understand why it would be that big of a deal.....
[quote]Most health plans are supposed to pay for all methods of birth control approved by the Food and Drug Administration without charging women anything out of pocket. But some insurers have not been paying for some forms of contraception,[/quote]
Isn't that uhhh... illegal?
[QUOTE=sloppy_joes;43626136]Isn't that uhhh... illegal?[/QUOTE]
Technically yes!
[quote]But there's a hitch. Although insurers generally pay for the procedure itself, they may not pick up the hospital facility fee or the anesthesia charges, leaving patients on the hook for sometimes more than $1,000 in additional charges.[/quote]
Damn, if you get a colonoscopy you're going to be taking it up the ass.
[QUOTE=sloppy_joes;43626136]Isn't that uhhh... illegal?[/QUOTE]
Yes. The funny thing is, HMOs (though PPOs as well, though these are slightly better about it) aren't actually regulated the same way other companies are. This is a big deal with prescription drugs, because HMOs and PPOs don't have to cover these.
But wait!
Because contraceptives, for women, are prescribed, there comes the blurred line. Most insurance companies don't file paperwork specifically for contraceptives, instead, shoving that expense under prescribed medication, and that's totally legal. The other, more alarming part, is that these similar circumstances apply to hospital stays and nursing home admissions.
Oh the best part is when they twist the paperwork and make a simple procedure considered a "specialist visit." Too many times do we have a rehab case that gets payed less than expected by insurance because they consider it more "intensive" than it actually is. Not to mention the arbitrary as fuck dissonance they put between "critical care" and "noncritical care."
Oh you're having some jerky movement and sporadic eye movement and some facial difficulties that are minor? Well, you may have Huntington's, and hey, we can help you before it actually progresses further, but because we don't have enough "just cause" to run tests on you, insurance companies won't pick up the bill, and you can't pay for it. This means, you could have gotten some help before it was too late, and the symptoms too severe, but by the time insurance will pay for these tests, you'll be close to death anyway.
This is even worse with cancer patients; don't let them know you're predisposed or watch the premiums skyrocket. Our doctor's like to tell patients to complain about severe headaches and dizziness and such, even if they don't have them, just so we can get some legal way to get tests run on patients who are high risk of cancers, so we can catch it before it goes too far. If they feel ill, but not ill enough, and we have a chance to catch it early on, insurance companies just won't fly with it; if they do find out, premiums raised as well.
This doesn't even go into Medicare, Medicaid, and uninsured cases where we pay out of pocket almost completely.
I recently had a colonoscopy, and my insurance didnt cover ~$1000, ended up paying that myself
[QUOTE=Silence I Kill You;43626131]So old guys get fucked by a camera, right before being fucked by their obamacare policy....... They could at least buy you dinner first.
But I'm kind of confused about the birth control situation. It may be because I don't know much about the female aspect of it, but doesn't the pill work just as well as the patch or the ring? I understand that it goes against the law, but I guess I don't understand why it would be that big of a deal.....[/QUOTE]
The pill is also useful for women in ways other than as a contraceptive.
[QUOTE=RayvenQ;43626353]The pill is also useful for women in ways other than as a contraceptive.[/QUOTE]
Thats true. My current girlfriend only has her period when she takes the pill
[QUOTE=RayvenQ;43626353]The pill is also useful for women in ways other than as a contraceptive.[/QUOTE]
Well the vibe I got from the article was that companies are covering the pill and not the ring or the patch.
btw colonoscopies are actually cheap as fuck, the expense you're paying in excess is to cover those who do not pay their hospital bills, or because insurance companies gip us out of about half that; the price is purposefully extreme so that we cover our bases well enough that even if no one pays properly, we dont end up at a significant loss
plus anesthesia costs are out the ass (propofol being the big one)
[editline]21st January 2014[/editline]
[QUOTE=Silence I Kill You;43626380]Well the vibe I got from the article was that companies are covering the pill and not the ring or the patch.[/QUOTE]
actually they tend to cover none of the above; its not that insurance companies cover some, its that only some insurance companies cover all of them, and some cover none of them
it does depend on your plan too though
[QUOTE=sloppy_joes;43626136]Isn't that uhhh... illegal?[/QUOTE]
Nothing's illegal if you have enough money.
[QUOTE=Silence I Kill You;43626380]Well the vibe I got from the article was that companies are covering the pill and not the ring or the patch.[/QUOTE]
Except in the studies, while both have improved, the pill is less covered than the ring, but the fact is, by law they should both be covered 100%
[QUOTE=RayvenQ;43626420]Except in the studies, while both have improved, the pill is less covered than the ring, but the fact is, by law they should both be covered 100%[/QUOTE]
this is because the pill is considered a prescription drug (not covered loophole) whereas the ring is considered a contraceptive surgery (you pay a good deal for it in that case)
AAAhhhhhh, gotcha...
[QUOTE=FordLord;43626379]Thats true. My current girlfriend only has her period when she takes the pill[/QUOTE]
By takes the pill, I assume you mean during her placebo week? Many girls I know take it because it greatly reduces what otherwise would be greatly painful periods. As well as a shit load of other things that it actually helps with. It isn't covered by insurance for uses other than contraception control, though so people would have to get it from their doctors for contraceptive use.
I'm just thankful I'm in the UK, yes, the NHS may be slow and wonky at times, but at least its not costing you an arm and a leg to get basic fucking healthcare.
[QUOTE=RayvenQ;43626454]By takes the pill, I assume you mean during her placebo week? Many girls I know take it because it greatly reduces what otherwise would be greatly painful periods. [/QUOTE]
Never knew about the placebo week thing.
But without taking the pill, she never has her period. There was a stretch of 6+ months where she didnt take them, and she didnt have a period at all during that time. When taking it, she does have it regularly
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