Tuesday, June 26, 2012
Why I Think Medical Care is a Scam
Do not get me wrong, I am sure that not every person does this. I have friends and family that work in the doctors office. I do not hold their occupation against them. For everyone else that is playing the devil's advocate, shame on you. If it is anything that America needs to be fighting against is the hospital. These are the people that are supposed to take care of you when you are sick. Instead, we are either going further into debt or just not going in to see the doctor.
I will tell you what I know based on my history of visiting the doctors office. We will start with a low income without insurance. I began working at minimum wage jobs and no insurance. I think that this is a time that is easier because I did not have anything to pay for, but a car. I was eligible for free medical care based on my income. I could easily make an appointment without the hassle of making several phone calls for a different doctor. I was eligible for a free annual exam and free depo shots. Yay, low income.
Moving on in life, I am getting paid more. Therefore, I had to start paying a small fee for an annual exam or occasional illness that I could not cure myself. Granted, the doctors office still has payments based on income. I am still eligible, but I have to pay unless it is within my insurance's network. Which brings me to the next issue, insurance.
When I was working for DirecTv, I paid for Aetna. Even though Aetna is a big pain in the ass, they are the best health insurance company. I was making too much money to be eligible for low income. This did not matter because Aetna pretty much covered everything. I had a co-pay of $25 (It has raised since then I am sure). My annual exams were covered with a co-pay. When I had an emergency visit, they practically paid the entire bill.
The disadvantage of Aetna is that the list on their website is not entirely up-to-date. They are nonchalant about this situation but saying, "What? I do not understand....whatever do you mean?" They refer you to the doctors office to make sure that Aetna is accepted. When you call the doctors office to ask, they refer you back to the insurance company. Ultimately, you are ping ponging for hours until you end up in a padded room. I cannot tell you how many times I had to do that until I started yelling at them. I finally obtained a doctor, but she was a pediatrician.
Then, I was not working for DirecTv. I had another emergency and had no choice but to enroll with COBRA. I'm glad it was only temporary because they wanted $200 a month. Someone who does not have a job cannot pay that kind of bill, that is ridiculous! Things spiral more and more out of control after this mind you.
Chaos happens. I go through one job, lose that job, get a new job. United Health Care is the new insurance company that I have to cope with. They have the same behavior as Aetna and cost way more. Oh, this gets better. I do not make enough money to even have the insurance and the information is even harder to retrieve. At this point, I qualify for low income medical care.
So, I am calling around again for more information about my insurance. United Health Care would give me an answer along with a tangent. They consistently gave me additional information that I did not ask for to make it even more confusing. I thought it was pointless to use them because I qualified for cheaper health care...so I thought.
Doctor offices are now double crossing patients into coming to their office. As a consumer, this is really bad because consumers should have the option to shop around. The medical field industry has made this impossible. This is how I found out.
Because the insurance company was not giving me a straight answer, I call locally for a doctor. I called Southwest District Health. I talked to billing and the lady told me it was going to be $75. "Great!" I think, why was I paying so much for insurance to have a high bill? Southwest District Health is a scam. They scammed people so they could build that new fancy building outside of Nampa.
After the appointment, they tell me it was $175. I was shocked. This was discounted based on my income, even after I called an asked about it. They ignored me when I questioned them about it. I let them give me the shaft, I paid the bill and never went back. I continued to pay for my insurance for another two years without using it. I couldn't use it because I could not afford to.
Why not cancel it? This is another area where they get you. At Hewlett Packard, you get decide once a year if you want to make changes. So, I could not cancel my health insurance even if I wanted to. If I run into a financial issue (and payroll is next month), I cannot cancel the insurance so I can have food on the table.
I finally get the gumption to start calling names on the list provided by the United Health Care website. Again, I am calling them to make sure the visit is covered. Again, I am referred to the doctor's office. Again, the doctor's office refers me to United Health Care. This happens with Aetna as well and I know the routine. People who make minimum wage and do not have insurance are lucky. Finally, I got fed up with phone tag and started to scream at United Health Care. I finally start getting answers.
The company pays $500 toward a medical bill. This was one piece of the puzzle that I could not get. The lady on the phone says it is like a gift card. If I use that up then I have to start paying money. Okay, this information would have been useful two years ago. The annual exam is covered, no co-pay. Nice! (Still skeptical after fighting). I was exhausted after this, I think this process lasted between one to two hours. What is even worse, I felt hopeless. No appointments were available for at least two months.
I waited for a month to finally make an appointment. I was too busy with college, work, taking care of the house, caring for pets. I called Women's Health Clinic. I asked them if they still accepted United Health Care. They referred me to United Health Care. I told them I will not and the situation about how I have to play phone tag. I will not do it again, I am forcing people to *gasp* get off their fat ass and do their job.
I get an appointment set up. The wait was originally two months, but it was changed to three weeks. The day of the appointment, I called billing. Is there a co-pay? Check my insurance, no the appointment is today. No, and anything that is not covered is paid for by the company. Great, see you in an hour.
I drive all the way from Nampa to Boise. Long story about why I will not visit doctors in Nampa. Anyway, I arrive early. I do my appointment. I get the annual exam and want to check other stuff. They lied to me. I get to the front desk after the doctor visit. "Annual exam is free. These tests are not going to be covered," lady stated as though she was expecting a conflict. She got one and she made a very cocky face when I chewed her out. This pissed me off even more.
"I called you guys. There was a reason I called you people! I called your office twice to make sure I would not have a bill. I do not have any money. If I was told otherwise, I would not have come here!" She lacked empathy and had the most bitchy look on her face. "Give me your supervisor!!" She went ahead and summoned her supervisor as she reluctantly reached for the phone for security.
The boss finally comes and brings me to the office. As we make it to the office, I am chewing her out. Then another person who was the supervisor of Women's Health Clinic. I tell them how awful it is that I am tricked into coming when I have insurance and I do not have enough money or time for this. I am eligible for discounted health care. I spend hours calling. I spent money on insurance for two years and used it for the first time for this? I am told to be responsible. I was responsible the entire time. I made the phone calls that I was supposed to make and nobody did their job. This was the SECOND time I was fooled into going somewhere thinking I would be covered.
The supervisor of the billing department was making calls as I reamed the supervisors up one side and down the other. I was balling by the time the billing person came back. She told me that I was covered, so it was what I was originally told. I was told $1,000 is paid by some company, no idea who I thought HP paid $500...whatever.
After all of this, I am skeptical. If I get a bill, I have to call the billing department again. I will not pay it. I will let it go to collections.
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what I do all day is decipher insurance and what the insurance pays and what the patient is to pay. It is not easy and you should have been referred to someone in billing. next time you come over we will go online and look at your insurance policy. lets have dinner and drinks while I explain to you what it means. This is why they pay me the big $$.
ReplyDeletelove you ma
Thank-you, mom. ☺ I actually got the answer from the billing department. Then after my appointment, the lady at the front desk was the one that told me I had to pay and got snarky after I told her that I was told my employer covers it. I got the answer again from the billing department. The supervisor stated that they are supposed to get at least one payment...they should be made aware of when someone had been calling them to make sure that a payment does not have to be made.
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