#U.S. healthcare

[alex21705]

Could use a little help, I've been having dental issues and can't afford the costs, please share and help if you can.

https://gofund.me/4a0d460a

[everydayesterday]

Rx Hell.

various things that are mentally taxing for me with regard to getting prescriptions filled:

auto-refills that don’t refill because you have no refills left and the pharmacy system doesn’t bother to tell you

“Too soon for refill” 

“This Rx will take a little longer to fill”

“We’ll contact your provider”

provider not responding to pharmacy (either within 3 days, or sometimes *at all*)

controlled substance renewals every 30 days (with provider delay in renewing)

controlled substance narrow pickup window (out-of-town trips require extra planning, coordinating provider authorizing pharmacy to fill early if needed)

controlled substances requiring in-person pickup, rendering mail-order pharmacies unavailable to you

trying to get an Rx transferred to a different pharmacy location because you’re out of town

transferring everything to a new pharmacy hoping desperately that this one will somehow be better

30-day refills instead of 90-day

refill dates being out of sync (requiring multiple visits to pharmacy)

rationing of medication because of the various delays across the board in getting refills approved and filled

pills that need to be split because they don’t come in your exact dose

the pharmacy technicians don’t even have to ask my name when I get to the window; they already have that memorized

the pharmacy magically being able to “run it through one more time” when pressed about why they aren’t able to fill the prescription

“Do you have any questions for the pharmacist?” for the same medications I’ve been taking for years (I think they’re required to ask)

durable medical equipment medical necessity forms (in addition to the Rx; renewed annually)

durable medical equipment authorization (in addition to the Rx and the medical necessity forms)

pharmacy not being able to provide certain DME, while providing others

new medications with new side effects requiring new medications

side effects not feeling important enough to complain to provider about (e.g., skin issues, weight gain)

prescription dose increases where effectiveness has “not been established”

putting $0.14 on your credit card because that’s your share of the Rx cost

“Price without insurance”

remembering to take your medication

remembering that you’ve already taken your medication

filling up your weekly pillboxes

taking pills at 3 different times of day

pills that should be taken on an empty stomach, vs.

pills that should be taken with food, vs.

pills that should not be taken with any other pills

medications that taste disgusting when they touch your tongue

always having your medications with you whenever you want/need to leave your house

printing out your list of medications every time you travel, and theoretically having them in their original containers instead of your weekly pillbox

worrying about drug importation rules when traveling to another country

being chronically ill in the first place.

I’m sure that I’m missing a few things.  Plenty of other folk probably have it a lot worse than this, especially with being able to get prescribed by the doctor and afford their Rx in the first place.  The whole system sucks.  

Edit:  

navigating pharmacy phone menus that don't have a direct button for speaking with the pharmacist (and they only use voice prompts instead of buttons) (because there isn’t a way to do what you need to do on the website)  

every month wrongly thinking "surely, 5 days is enough time for everyone to get things figured out" when setting a calendar reminder to get the Rx refilled  

provider: “We sent that form a month ago; please double-check with the pharmacy” vs. pharmacy: “We haven’t received that form; please double-check with your provider”

Another edit:

I can't get my Rx transferred to another pharmacy location, even though it's the same pharmacy chain and they can see all of my information and confirm my identity, because it's a new prescription even though it's something I've been taking for years and is only considered new because technically I have to receive a "new" script every month instead of it just being considered a renewal because it is a controlled substance (and so I can't pick it up early), and that "new" prescription is specific to one particular pharmacy location.

Another edit:

Although I paid for one insulin pen (and they have this transaction amount - $4.60 - on file), and received one insulin pen the last time I picked up, my insurance company has on file that I picked up eight.  So now the pharmacy has to watch security footage to confirm that I only picked up one.  I was only allowed to pick up one last time around because I was late in picking up my previous order so insurance decided they’d only cover a partial amount (I still don’t understand that part).  I even had to pay out of pocket for an insulin pen so that I’d have enough for summer vacation.  This country is fucked.

[underestimated-heroine]

You'll read the medical webpages about certain conditions and they're littered with phrases like "not very severe", "still lead a productive life", "not a lot of discomfort." Visit forums for people who have those conditions, talk to them personally, or experience them yourself, and you'll hear about how almost all of them cry multiple times a day, worry they physically won't be able to get out of bed in the morning even though they have to go to work, and a lot of "wait....not everyone's constantly in pain???" type sentiments.

[drgrlfriend]

I just got a bill for $150, and I was like, "That seems like a lot, let me look at what that's for." It was from an MRI I had a few weeks ago. An outpatient MRI, I walked in, got IV contrast, got the scan, and walked out an hour later. It cost $17,000. Insurance paid $16850, and I was responsible for the rest. The price tags on these things are *insane*, folks, because insurance pays a fraction. Do not pay full price, and if you are at all able, look into affordable insurance options, even if they have big copays or deductibles, so you have coverage for catastrophic issues.

ETA:  I will add, the moral of this story is not “avoid the hospital.”  That MRI may end up saving my life.  We all need healthcare, and delaying and avoiding it puts you at risk of even greater problems down the line.

I feel like I should make a post about this because it’s not something that’s very well-known, and that Americans in particular may need to know about given the uncertain state of our healthcare system at the moment. I’ve wanted to write this out for a while, It’s kind of a long post, so sorry about that!

If you have an emergency and have to go to the hospital, you’ll owe the hospital a lot of money. (I got into a car wreck and broke my ankle and my arm. My hospital bill was around $20,000)

You’ll also owe the ambulance provider, if you need one. (My ambulance bill was about $800)

You may get separate bills from the anesthesiologist or surgeon. (My anesthesiologist bill was $1,700)

You may need follow-up appointments. (My orthopedic surgeon billed me for the appointments and his surgery together and it was about $1,000)

You’ve also got to pay for medical equipment you need afterward, like crutches or a walking boot. (Mine cost about $75)

Altogether, I ended up with almost $24,000 in medical debt from one car accident. That’s a really scary number for someone like me who makes $10/hr at a 12 hour a week job.

I got my debt down to $1075 by making some phone calls and submitting some paperwork.

The first thing I did was contact the hospital. They don’t make it easy to find, but many hospitals (perhaps most hospitals?) have financial assistance programs for people who can’t afford medical bills. I don’t make a lot of money, and I have bills to pay, so they were able to help me. I called the billing department and asked if they had any assistance programs for low income people who can’t pay their bills. I had to call multiple times, and I got transferred in circles by people who didn’t know what I was talking about. Finally, I got an appointment with someone in “Eligibility Services” (I don’t know what other hospitals call it, if it’s something different). I had to bring my pay stubs and copies of all of my bills. When I got to the hospital for the appointment, nobody knew what I was talking about so I had to wander a little to find where I needed to go. I spoke with the guy in Eligibility Services, and I waited for a decision on how much of the bill they would forgive. A month later, I got a call telling me it was totally forgiven.

I did the same thing for my ambulance bill and my anesthesiologist, but the process was a LOT easier. I just had to mail some paperwork and it was totally forgiven.

I didn’t bother with the medical equipment suppliers, since the bills came from separate companies and I didn’t feel like going through the process twice for $75. I was assured at the hospital that they had similar programs for debt forgiveness, so I could have probably avoided paying that too.

The only thing I couldn’t get taken care of was the surgeon/follow-up appointment cost, but they were able to put me on a no-interest payment plan.

Medical debt is scary because it’s something that can come from stuff that’s already really scary. I didn’t need the burden of $24,000 in debt on top of trying to get around on a crutch with a broken arm (it’s not easy, believe me!).. but I can’t imagine what it would be like with a bigger debt or a more severe medical emergency. I see lots of people in even worse trouble than I was in, both financially and medically. Please know that there are options for you when that GoFundMe doesn’t do enough. Even if your income is higher than mine, it’s worth a shot even for partial debt forgiveness.

[truthwars]

Trump's Vision for Healthcare: Dr. Oz at CMS

In a move emblematic of his unorthodox leadership style, President-elect Donald Trump has nominated Dr. Mehmet Oz to lead the Centers for Medicare & Medicaid Services (CMS). This decision underscores Trump’s confidence in selecting bold, high-profile individuals to drive transformative change in Washington. Dr. Oz, a renowned heart surgeon and health advocate, is best known for making medical…

[roseandbee]

Apparently when my doctor puts in labs to be completed within the next year in the system it means within two weeks of when the year is up or insurance won't pay for it. They need to work on their wording of shit. Among other things 😑

[whooshingnoise]

In news that will surprise no one in the U.S., my biannual dental was less expensive for me last year, when I DIDN'T have dental insurance.

Frills: x-rays, fluoride (I usually pay for the fluoride out of pocket anyway)

...and this is with the Tier 1 educator insurance.

[andnowanowl]

This has to be a fucking joke, right? People living on SSI are living in poverty. The healthcare system is almost useless at this point. Where the hell is the money ACTUALLY going?

[hernymills]

does anyone on this website know things about u.s. health insurance? i need to know if doing this inovalon personal health visit that my insurance wants me to do (or risk adjustment purposes I think) would be like the opposite of praxis or what

like also I wanna know if it might raise my insurance premiums but also i really wanna know if cooperating with like the incrementalism liberal healthcare 'reform' stuff would like... help anything? be a waste of time? be actively bad?

[publichealthinfo]

Important post on why labs should always be run by hospital employees- PSA

[fandom-hoarder]

Why. Is it so difficult. To understand. There are TWO, SPECIFIC needle sizes, and they BOTH need to be the SAME QUANTITY as the GODDAMN SYRINGES? 🤦‍♀️🤦‍♀️🤦‍♀️🤦‍♀️🤦‍♀️

It's almost worth contemplating buying them without a prescription just to skip this fucking headache.

It's like people are hearing something completely different from what I'm saying. This is the fourth time I've tried to resolve this in a week. I specifically said I don't need syringes due to the previous fuckup; they called in syringes and talked about syringes in the voicemail they left. I WANTED to talk to them first--I said that in my message 🙃 Why didn't my phone ring when they called?? A question for the ages! It rings any other time than when I need it to.

They didn't even prescribe a needle size we use!! It's too small for uptake and too big for injection. What is GOING ON? Am I having a stroke? 🤯

[black-crested-jaybird]

@ghostpalmtechnique is not exaggerating about rescission. My partner has a genetic condition that didn't start causing problems until he was well into adulthood. We knew what was going on, because his mother has it. But we also knew that if he went to the doctor before I had been at my job long enough to qualify for health insurance, he would be denied coverage for at least a year, if not longer, under the preexisting condition clause. We were really lucky that I got promoted to full-time around the same time his symptoms began to manifest and I was able to qualify for health insurance.

But even after I moved to the insurable position at my job, it was still six months' wait before I was allowed to sign up for health insurance. So he went six months before he was able to even begin looking for treatment for a degenerative condition that left him in constant, debilitating pain and barely able to move, incurring irreversible physical damage all the while.

And when we did get the coverage, and he went to the doctor? Very soon after he was diagnosed and started treatment, he began to get phone calls from friends, acquaintances, in some case from people he had not spoken to in years - all of whom had been contacted by the insurance company, which was trying desperately to find evidence of any kind of prior diagnosis or treatment so they could kick my partner off of the list of the insured.

The American healthcare "system" is a greedy, exclusionary nightmare that bleeds people dry even when it's working. We desperately need universal health care so that everyone has access to affordable preventive care and treatment.

But it used to be so much worse before the Affordable Care Act.

i think a big reason that I get frustrated with the "liberals have never made anybody's lives better" is that in the US it used to be legal for insurance companies to charge you more if you were sick or even just straight up deny you the ability to sign up for them if you already had a "pre-existing condition", and this was only stopped by the passage of the ACA during Obama's term. but a lot of people who talk about politics on here are too young to really be affected by that since they would have been on their parents insurance (which the ACA required insurers extend until you're 26). and this was all done via politicking and not blowing up insurance CEOs mansions or whatever.

I'm not saying that the ACA fixed insurance forever, god no. but "you can't deny someone insurance for being sick" is a massive change and people don't realize it!

Most adults want the law’s prohibition on insurers from denying coverage based on pre-existing medical conditions to stay. Two thirds (67%) of the public say that it is “very important” that this provision remain in place, including most Republicans (54%) However, only about 4 in 10 people (39%) are aware that that provision is part of the ACA.

[marmelade-sky]

"why are you as a european so passionate about the u.s. elections?"

many reasons obviously, but especially because i had an ectopic pregnancy earlier this year. very much wanted, so it was a shock to hear the bad news. ectopic pregnancies are extremely dangerous if they can't be located, and mine couldn't be located for two whole weeks. so i lived in fear of my tube suddenly bursting for that entire time, on top of grieving a pregnancy loss.

eventually they managed to locate it in the upper corner between my uterus and my tube. my choices would have been: surgery, which would have meant losing both my right tube and a chunk of my uterus, or a hefty dose of a drug that induces, you guessed it, abortion. And of course I decided to take the drug.

And while i was hooked up to the IV, neon yellow liquid dripping into my arm, all i could think of was how fucked every person experiencing this under a new trump administration will be. the idea of anyone being in a similar situation and having no safe access to this medical care while going through this pain is horrifying. this pregnancy was wanted, and losing it was traumatic. I was pro choice before, but this ectopic pregnancy made me feel even more strongly about it. abortions are necessary health care. all abortions are health care. and if your political activism stops at voting for the one person out of two options who doesn't want to ban and demonize this health care, what the fuck are you doing.

[roseandbee]

More fun with U.S. healthcare, personal version:

I, a 25+ year chronic low back pain patient, get notice of denial of a lower spine MRI ordered by my physician of 15+ years, the day before the test is scheduled.

[ivygorgon]