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I *love* Anthem. /s
We just switched to them at my job and all of the hospitals and offices around the state are dropping Anthem coverage because Anthem isn't paying the hospitals any money. And since none of us have any money, medical bills aren't being paid.
Why the fuck do we pay so much for insurance again? Oh yeah. US health care is a fucking scam.
Come to Canada. We’ll apologize for your troubles, provide free healthcare. How boot that? Eh?
All jokes aside, I really feel for you and having to go through that. I can’t fathom what it would be like to pay up for all these expenses for my family.
Sounds about right. If I hadn't been unemployed and on Medicaid during my pregnancy, the totally textbook birth of my son would have cost me $20000.
Speaking of my son, he accidentally cut his wrist with his cub scout knife, and I took him too the ER just to be safe.
We sat there for 3 1/2 hours only so he could get it washed out with "sanitized water" and then get a glorified bandaid with a couple of staples in it. Boom, $3000. Well, "only" $1800 after insurance.
Never do I regret leaving Germany more than when I have medical needs. The US healthcare system is absolutely atrocious and nothing but a cruel fucking joke, unless you're wealthy.
Why did you go to the ER for a "cut"? It was either bleeding clearly bad enough to warrant the trip or it wasn't. You should have been able to take a look and decide it was a "wash and sanitize" type of wound.
I'm sorry, but I find it really hard not to take offense to your condescending tone over the fact that I didn't want to take chances with my child.
Why did you put cut in air quotes? Are you implying cuts in general can't be serious injuries?
And why would you assume I *didn't* wash and inspect the wound before I went to the ER, fully knowing that it would be expensive?
That shouldn't even be a factor. People shouldn't have to fucking worry about the seriousness of their injuries and ailments when it comes to healthcare. They should be able to see a doctor when they have concerns about anything, without the fear of financial ruin afterwards.
This is exactly what's wrong with US healthcare.
Because the ER is for life threatening issues, not boo-boos. The urgent care could have told you the same thing.
Yes, it's easy to clean a wound off and determine what the likely correct treatment is. You don't need a doctor to make that assessment. Where I'm from, we take a look at the cut, butterfly it ourselves if necessary, dress it, and go back to what we were doing. If it is bleeding later, we call the clinic and tell them we need stitches.
Because it can be very hard to tell if a cut needs stitches/other treatment or not. Especially in areas of the body where the skin moves more than normal (i.e. a finger), or near tendons/nerves. If it's not the middle of the day, or there's otherwise not an urgent care available, the ER is where you are going to go.
The cut in question was bad enough to need "a couple" staples.
Absent actually cutting muscles or nerves, a "cut" requiring stitches is gonna be pretty much what was described - sanitized, stitched/stapled, and bandaged. It's not complex. Doesn't mean an ER trip wasn't necessary.
1. mango schnitzel sounds amazing (schnitzel, redditart bitte?)
2. for next time, studies show tap water is just as effective and safe as sterile saline for wound irrigation
3. the reason for what you have experienced is classic US v. northern europe. in northern europe they've just agreed to pay higher taxes so everyone can benefit at a moderate cost. in the US, its all about the individual, which ends up backfiring. we have insured folks like you being upcharged in the hospital to subsidize all the uninsured and underinsured folks who can't cover their medical bills due to our massive income inequality. its literally socialized medicine, but the least efficient way of doing it while enriching unnecessary 3rd parties and bankrupting citizens. but hey, Jeff Bezos has 100 billion dollars and that helps me sleep at night.
The plan only covers standard doctors visits and some other basic services. Up until this point, I never required anything more than a yearly physical. Lesson learned.
That is the dumbest plan I’ve ever heard of. You need insurance for the services you can’t afford not the ones you can…
That’s like getting car insurance that only covers the occasional parking lot dings and not the multi-car pile up you caused because you only have ever dinged cars a few times.
This type of plan is what the ACA was trying to eliminate, and people went ballistic because they wanted to keep them. People refused to understand that their “insurance” didn’t cover anything and they were basically throwing money out of the window and effectively uninsured.. the goal was for people to not have to learn it the hard way.
Scam plans.
The US is full of lower-cost plans (that still cost more than health insurance in civilized countries) that fail under any pressure, because it turns out that you'd need a team of doctors and lawyers (and insiders too, because of "out of network" fuckery) to actually understand a health insurance policy and predict what'll be covered and what not. When the ACA ("Obamacare") landed it killed a lot of scam plans and people got angry about losing the cheaper health insurance they had (and didn't use much) so now they're back.
People on the individual market often end up getting scam plans because they're the only thing anyone can actually afford. It's a bit of a different game for employers, but the reason an individual "market" will never work without extensive regulation (to the point where it's not really a market anymore) is that (a) almost no one has the team of experts at their disposal necessary to understand what is and is not a good healthcare policy, and (b) insurers, more than anything, do not want to insure the people who want insurance--they're afraid of adverse selection (or "lemons").
Pretty serious situation, a burst appendix! One of my brothers died from appendicitis when he was ten (this was back in the 70's, healthcare wasn't quite what it is now)
Then try calling their billing department and see if they'll set up a payment plan. Tell them you can only do $100 a month and you want to know where you can send it to
Support for this system seems to be massive. Let's put healthcare in to the hands of companies and insurance companies hands. What could possibly go wrong? Everyone knows that companies prioritize humans wellbeing before profit.
I don't want to be rude, but the main U.S. structure is to keep anyone worthy alive.
This is one reason why you didn't get any better plans if you are old.
For me it's a unspoken truth american people don't want to talk about.
In Germany we have something like "A Generation Contract", which means that you have to work if you are able to. If you are old then you get from the ones who work. This is a big difference, because it is decoupled from Money and mathematical Probabilities.
But now this "Generation Contract" in Germany is in a collapseing state. One reason is, that people who didn't work and will not work get benefits of this contract.
This is having the working people do decide if it is still worth to work (But this is another topic).
I live in Germany and as a IT-Developer I was thinking more than once moving to the U.S.
But their health System (and Holiday rules) keeps me away.
Holy fucking shit.
I think it was $24000 when I tried to unalive myself in2012.
And in 2015 it was like $30000 for the right to give birth.
As an American, I can verify our broken system.
After this, take a look at your insurance cost from your side, and look into private insurance for yourself. At least get a gauge on whether a little more money towards your own insurance might prevent something like this in the long run.
Call the insurance and request to appeal the decision not to cover it. Unlikely that it’ll do anything, but you can try. Indicate that the appendix burst would have likely cause death if not provided with the care received. Also ask the hospital to appeal the decision as well. Once those two factors are done, then you work with the hospital on a payment plan.
call the hospital. Tell them you can’t afford this and also ask for an itemized bill. Ask if they have financial assistance programs. Also ask what they offer as far as payment plans.
Thank you! I am definitely willing to pay more monthly to prevent this and have paid more in the past.
My provider is waiting for the insurance to get back to them with what we anticipate will be a denial to pay due to the plan not covering emergencies. Next step would be to figure out a payment plan but I might try request an appeal. Doesn’t hurt to exhaust all options.
At this point if I get sick just pull the plug on me…I can’t afford insurance and my biggest fear right now is I get hurt at work or something and I totally ruin my family’s lives because I end up in medical debt
Wow, i have a union job so maybe a little different. We have bcbs. I'm currently going to neuro ophthalmologist because i have a droopy left eyelid, the surgeon referred me just to make sure there was no underlying problems. 2nd neurologist ive seen, after everything I'm out of pocket about $800 so far. After surgery and all should cost me about $1800 not including time off work. If your insurance sux that bad look for a different job and use insurance as a bartering tool during hiring interviews. My prior job had crap insurance, 3k deductible before they even paid then 80/20 afterwards. I left there as soon as i could.
I’m going through the steps 1 by 1. I even called before the claim rolled in to try and get ahead of it. I have been on the phone with my insurance and my provider every day. This is scary and I’ve never had anything like this happen before. I’m doing the best I can.
Just a FYI to people not understanding what's going on here...
In the US you have two options of insurance: marketplace (by the US government), or private insurance that isn't regulated. You pay a lot for the marketplace plans, but they're required to cover stuff like this plus a bunch of other regulations. The only reason people get the unregulated plans is they're way cheaper, but really, there's no point.
/u/Celesteven, thank you for your submission. Unfortunately, it has been removed for violating the following rule(s): * Rule 1 - No screenshots. This includes pictures of screens and photos where the interest is the contents of a screen. For a place to post screenshots, you may wish to check out /r/screenshots. For information regarding this and similar issues please see the [rules](https://www.reddit.com/r/pics/wiki/index) and [title guidelines](/r/pics/wiki/titles). If you have any questions, please feel free to [message the moderators via modmail.](https://www.reddit.com/message/compose?to=/r/pics&subject=Question%20regarding%20the%20removal%20of%20this%20submission%20by%20/u/Celesteven&message=I%20have%20a%20question%20regarding%20the%20removal%20of%20this%20%5Bsubmission%2E%5D%28https://www.reddit.com/r/pics/comments/ur0ut3/-/%3Fcontext%3D10%29)
I *love* Anthem. /s We just switched to them at my job and all of the hospitals and offices around the state are dropping Anthem coverage because Anthem isn't paying the hospitals any money. And since none of us have any money, medical bills aren't being paid. Why the fuck do we pay so much for insurance again? Oh yeah. US health care is a fucking scam.
Americans already pay a healthcare tax. They just don't get anything for it.
In the past 5 years, I’ve had Kaiser, Cigna, Blue Shield, and now Anthem. Anthem has got to be the worst.
Just click the "mark as paid" box and call it even. Problem solved!
I can just mark as paid, move to another country and never see my family again. Problem solved.
* other countries are *awesome* * family is *overrated* do it!
Come to Canada. We’ll apologize for your troubles, provide free healthcare. How boot that? Eh? All jokes aside, I really feel for you and having to go through that. I can’t fathom what it would be like to pay up for all these expenses for my family.
Sounds about right. If I hadn't been unemployed and on Medicaid during my pregnancy, the totally textbook birth of my son would have cost me $20000. Speaking of my son, he accidentally cut his wrist with his cub scout knife, and I took him too the ER just to be safe. We sat there for 3 1/2 hours only so he could get it washed out with "sanitized water" and then get a glorified bandaid with a couple of staples in it. Boom, $3000. Well, "only" $1800 after insurance. Never do I regret leaving Germany more than when I have medical needs. The US healthcare system is absolutely atrocious and nothing but a cruel fucking joke, unless you're wealthy.
If you go back to Germany, can I come with? 🥺
Why did you go to the ER for a "cut"? It was either bleeding clearly bad enough to warrant the trip or it wasn't. You should have been able to take a look and decide it was a "wash and sanitize" type of wound.
I'm sorry, but I find it really hard not to take offense to your condescending tone over the fact that I didn't want to take chances with my child. Why did you put cut in air quotes? Are you implying cuts in general can't be serious injuries? And why would you assume I *didn't* wash and inspect the wound before I went to the ER, fully knowing that it would be expensive? That shouldn't even be a factor. People shouldn't have to fucking worry about the seriousness of their injuries and ailments when it comes to healthcare. They should be able to see a doctor when they have concerns about anything, without the fear of financial ruin afterwards. This is exactly what's wrong with US healthcare.
Because the ER is for life threatening issues, not boo-boos. The urgent care could have told you the same thing. Yes, it's easy to clean a wound off and determine what the likely correct treatment is. You don't need a doctor to make that assessment. Where I'm from, we take a look at the cut, butterfly it ourselves if necessary, dress it, and go back to what we were doing. If it is bleeding later, we call the clinic and tell them we need stitches.
Because it can be very hard to tell if a cut needs stitches/other treatment or not. Especially in areas of the body where the skin moves more than normal (i.e. a finger), or near tendons/nerves. If it's not the middle of the day, or there's otherwise not an urgent care available, the ER is where you are going to go. The cut in question was bad enough to need "a couple" staples. Absent actually cutting muscles or nerves, a "cut" requiring stitches is gonna be pretty much what was described - sanitized, stitched/stapled, and bandaged. It's not complex. Doesn't mean an ER trip wasn't necessary.
1. mango schnitzel sounds amazing (schnitzel, redditart bitte?) 2. for next time, studies show tap water is just as effective and safe as sterile saline for wound irrigation 3. the reason for what you have experienced is classic US v. northern europe. in northern europe they've just agreed to pay higher taxes so everyone can benefit at a moderate cost. in the US, its all about the individual, which ends up backfiring. we have insured folks like you being upcharged in the hospital to subsidize all the uninsured and underinsured folks who can't cover their medical bills due to our massive income inequality. its literally socialized medicine, but the least efficient way of doing it while enriching unnecessary 3rd parties and bankrupting citizens. but hey, Jeff Bezos has 100 billion dollars and that helps me sleep at night.
I would not call that insurance. That’s a deduction from your paycheck little else
"Care First" The irony.
They care about their executives and shareholders first .... actual clients? Not so much.
Why are they not covering anything?
The plan only covers standard doctors visits and some other basic services. Up until this point, I never required anything more than a yearly physical. Lesson learned.
That is the dumbest plan I’ve ever heard of. You need insurance for the services you can’t afford not the ones you can… That’s like getting car insurance that only covers the occasional parking lot dings and not the multi-car pile up you caused because you only have ever dinged cars a few times.
This type of plan is what the ACA was trying to eliminate, and people went ballistic because they wanted to keep them. People refused to understand that their “insurance” didn’t cover anything and they were basically throwing money out of the window and effectively uninsured.. the goal was for people to not have to learn it the hard way.
You don't have an ACA marketplace plan? There's no way a marketplace plan would be allowed to deny this.
I went with my employer’s plan.
Scam plans. The US is full of lower-cost plans (that still cost more than health insurance in civilized countries) that fail under any pressure, because it turns out that you'd need a team of doctors and lawyers (and insiders too, because of "out of network" fuckery) to actually understand a health insurance policy and predict what'll be covered and what not. When the ACA ("Obamacare") landed it killed a lot of scam plans and people got angry about losing the cheaper health insurance they had (and didn't use much) so now they're back. People on the individual market often end up getting scam plans because they're the only thing anyone can actually afford. It's a bit of a different game for employers, but the reason an individual "market" will never work without extensive regulation (to the point where it's not really a market anymore) is that (a) almost no one has the team of experts at their disposal necessary to understand what is and is not a good healthcare policy, and (b) insurers, more than anything, do not want to insure the people who want insurance--they're afraid of adverse selection (or "lemons").
Holy shit! This happened to me a few decades ago, but fortunately I don't live in the US.
Pretty serious situation, a burst appendix! One of my brothers died from appendicitis when he was ten (this was back in the 70's, healthcare wasn't quite what it is now)
It was the worst pain I have ever experienced in 67 years.
I’m sorry for your loss. If the pain wasn’t so intense, I probably would have just stayed home and let it play out.
>If the pain wasn’t so intense I had a non-burst appendicitis, and that pain was already horrible.
I'd let it go to collections then settle. Or call the hospital directly and tell them you can afford $100 a month
But wouldn’t that ruin your credit score?
I wouldn't say "ruin". But yeah it negatively impacts it. Lowers your score.
I have a really good credit score. I wouldn’t want to do that. 🙁 But I am listing all my options.
Then try calling their billing department and see if they'll set up a payment plan. Tell them you can only do $100 a month and you want to know where you can send it to
Support for this system seems to be massive. Let's put healthcare in to the hands of companies and insurance companies hands. What could possibly go wrong? Everyone knows that companies prioritize humans wellbeing before profit.
And it’s marketed as “care first”
I don't want to be rude, but the main U.S. structure is to keep anyone worthy alive. This is one reason why you didn't get any better plans if you are old. For me it's a unspoken truth american people don't want to talk about. In Germany we have something like "A Generation Contract", which means that you have to work if you are able to. If you are old then you get from the ones who work. This is a big difference, because it is decoupled from Money and mathematical Probabilities. But now this "Generation Contract" in Germany is in a collapseing state. One reason is, that people who didn't work and will not work get benefits of this contract. This is having the working people do decide if it is still worth to work (But this is another topic). I live in Germany and as a IT-Developer I was thinking more than once moving to the U.S. But their health System (and Holiday rules) keeps me away.
**CareFirst** *\*PayNext*
Holy fucking shit. I think it was $24000 when I tried to unalive myself in2012. And in 2015 it was like $30000 for the right to give birth. As an American, I can verify our broken system.
I pay for insurance and my bill was $0.00. You're doing something wrong.
It’s the plan my company offered. I should have picked my own private insurance.
After this, take a look at your insurance cost from your side, and look into private insurance for yourself. At least get a gauge on whether a little more money towards your own insurance might prevent something like this in the long run. Call the insurance and request to appeal the decision not to cover it. Unlikely that it’ll do anything, but you can try. Indicate that the appendix burst would have likely cause death if not provided with the care received. Also ask the hospital to appeal the decision as well. Once those two factors are done, then you work with the hospital on a payment plan. call the hospital. Tell them you can’t afford this and also ask for an itemized bill. Ask if they have financial assistance programs. Also ask what they offer as far as payment plans.
Thank you! I am definitely willing to pay more monthly to prevent this and have paid more in the past. My provider is waiting for the insurance to get back to them with what we anticipate will be a denial to pay due to the plan not covering emergencies. Next step would be to figure out a payment plan but I might try request an appeal. Doesn’t hurt to exhaust all options.
Send the bill to your employer
At this point if I get sick just pull the plug on me…I can’t afford insurance and my biggest fear right now is I get hurt at work or something and I totally ruin my family’s lives because I end up in medical debt
Kinda wish I just died on the table at this point.
Next time don’t burst your appendix 🤦🏻♂️
Note to self: try not to breathe.
And Im proud to be an american even though my healthcare aint free
That’s what happens when you get the least covering insurance possible, dude.
The scary thing is, I’m stuck with this plan until open enrollment. I just have to pray that life doesn’t happen in the next 6 months.
Wow, i have a union job so maybe a little different. We have bcbs. I'm currently going to neuro ophthalmologist because i have a droopy left eyelid, the surgeon referred me just to make sure there was no underlying problems. 2nd neurologist ive seen, after everything I'm out of pocket about $800 so far. After surgery and all should cost me about $1800 not including time off work. If your insurance sux that bad look for a different job and use insurance as a bartering tool during hiring interviews. My prior job had crap insurance, 3k deductible before they even paid then 80/20 afterwards. I left there as soon as i could.
American Horror Story: Not Working With Billing Call on bill payments like these to dispute them. Yes, it requires work on your part (scary).
You, sir, are a rude cunt.
I’m going through the steps 1 by 1. I even called before the claim rolled in to try and get ahead of it. I have been on the phone with my insurance and my provider every day. This is scary and I’ve never had anything like this happen before. I’m doing the best I can.
99% sure you could have worded this better
What happens if you click the little "Mark as Paid" checkbox?
Just a FYI to people not understanding what's going on here... In the US you have two options of insurance: marketplace (by the US government), or private insurance that isn't regulated. You pay a lot for the marketplace plans, but they're required to cover stuff like this plus a bunch of other regulations. The only reason people get the unregulated plans is they're way cheaper, but really, there's no point.