tedicast Posted March 31, 2005 Report Share Posted March 31, 2005 Ok guys and girls..bear with me... I just need to vent for a bit. At the first of the year, we were told there was gonna be a change in our health insurance at work. That premiums were gonna be raised, and that our deductables were gonna go up. I wasn't too happy about it, and my wife and I shopped around, but getting health insurance on our own was way more than it was costing us now. The past 2 months I have been having stomach problems. Thinking it was just a stomcach virus, I pretty much dealt with it. Sunday it started up again, but the pain and tenderness in my abdomen was worse than before. I went to the DR. on Monday, and she did a bunch of tests, and said she was 99% sure it was Diverticulitis (infection in the large intestines). She was gonna start me on meds to try and treat it that way first, but she wanted me to go for a cat scan to be 100% sure. She wanted me to go that day, but needed insurance company approval. Told me she would call me the next day when it was scheduled. She calls me yesterday afternoon, and tells me the insurance company denied approval on the scan. Said she was gonna keep trying. She called me back about 5:30 last night, and told me they still didn't approve. She wanted to know how I was feeling. Told me if it was worse, or not any better, that I should go to the ER, and she would call ahead, and make sure I got a cat scan. If I went to the ER, and THEY did the scan, the insurance company had to pay it! Man was I P.O'ed about this whole deal. How can an insurance company turn down this request from my primary care physician. But, if I walk into any ER, they will pay for the same test!! Just makes no sense to me at all! To make matters worse, my wife goes for her yearly lasiks eye exam yesterday, only to fine that when out health insurance policy was changed, that they no longer cover eye care. Sorry for the long vent. It just really riles me up to have to pay so much more for something that I need to have, and to get less in return! Thanks for listening. Quote Link to comment Share on other sites More sharing options...
horst Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! John, sorry to hear about your insurance, sounds like a crock to me.If you got diverticulitis you really oughta get it taken care of quick bud, thats some nasty stuff.My father in law had it a couple months ago and hes still wearing a colostomy bag.He has to go back in for surgery the end of next month to get it removed.But if you screw around with it to long i think they said it can burst and thats a whole new world of hurt.Plus if you catch it early enough they mights be able to clear it up with antibiotics and avoid some major surgery.Take care!!! Quote Link to comment Share on other sites More sharing options...
tedicast Posted March 31, 2005 Author Report Share Posted March 31, 2005 Re: Health Insurance!!! Chris... The Doc is treating me right now with the most aggressive out patint meds there are for it. She said it is definately early on, and this should clear it up. She wanted the cat scan because she said diverticulitis is extremely rare is some one my age, and she just wanted to be sure it wasn't something else. she told me if the meds start working, than it is diverticulitis. If it was a tumor, or blockage the meds wouldn't touch it. Quote Link to comment Share on other sites More sharing options...
archerjg Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! My insurance will not cover some of the test and stuff that my doctor sends me for. It drives me nuts at times that I pay the money out for insurance and don't get a whole lot in return either. So far this year they have paid for everything. Archerjg Quote Link to comment Share on other sites More sharing options...
elkoholic Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! The reason they will pay for the ER ordered CAT Scan is because it is considered an emergency (and probably mandated by law) while the one ordered by your primary MD is considered diagnostic. If you take into account the cost of a CAT Scan you might think along the same lines as the insurance company. Personally, working in the health care field, I can see the collapse of the insurance industry as people and the companies they work for expect to pay in hundreds of dollars in premiums and receive thousands of dollars in benefits. Sadly, in your case it is something your insurance should pay for, but unfortunately because of the what I call the over use of the health care system, the insurance companies are paying for every time someone thinks a fart smells strange. Statistically, 70% to 80% of all tests performed are unnecessary. If auto insurance worked the way health insurance does your auto insurance would be paying for oil changes, tire rotations and radiator flushes. Health insurance should not be paying for routine care, and it is insane to think that you can pay in $1.00 for every $1,000.00 in medical expenses your insurance pays on your behalf. If you were to take into account the total cost of a CAT Scan (which includes paying a radiologist and other related costs) I am sure that it will cost more than your yearly premium. Not that all of that makes you feel any better, but it helps if you can look at it from a different perspective. I sure hope that you get to feeling better soon. Good luck. Quote Link to comment Share on other sites More sharing options...
tedicast Posted March 31, 2005 Author Report Share Posted March 31, 2005 Re: Health Insurance!!! I see your point elk, but it really sucks for us that don't abuse our health insurance coverage! Quote Link to comment Share on other sites More sharing options...
wtnhunt Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! Insurance through our employer is ridiculous under their group plan. I got myself and the kids on pretty much the same plan for about half the cost and they were supposed to be paying half. Scans can get to be pretty expensive. Hope you get it all worked out. Quote Link to comment Share on other sites More sharing options...
David_218 Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! [ QUOTE ] I see your point elk, but it really sucks for us that don't abuse our health insurance coverage! [/ QUOTE ] My health insurance has increased every year since I got it. This last round of increases made it go up to over $250 per month. I am now looking into a "Health Savings Account" plan HSA with a $5,000 deductable. My monthly premiums will be about half of what I am paying now. Quote Link to comment Share on other sites More sharing options...
Tominator Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! I hear you bud. Insurance companies have to be the most aggravating thing on this earth. Exactly when you need them, they're not there, or they fight you. It's a crock. I can't complain too much. One of the only benefits of being in a union is outstanding benefits. With all the medical problems I've had over the years, this insurance company I have now is pretty good, then again, between the school board and I, we pay over $500 a month for the coverage. Lately I've been getting denied claims on my kids. I called and said "what the heck?" and they told me I didn't confirm that these kids I was claiming are still my kids. Every year I have to let them know that I'm still married and that I still have 4 kids or they'll deny claims. Quote Link to comment Share on other sites More sharing options...
GWSmith Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! [ QUOTE ] I see your point elk, but it really sucks for us that don't abuse our health insurance coverage! [/ QUOTE ] At least you can complain about having what you have.....we pay 100% out of pocket. My wifes job is with a Temporary staffing Agency and mine is Part Time. Quote Link to comment Share on other sites More sharing options...
hutchies Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! I hate insurance companies and the bad part is that they raise rates every year when nothing ever changes. Quote Link to comment Share on other sites More sharing options...
David_218 Posted March 31, 2005 Report Share Posted March 31, 2005 Re: Health Insurance!!! [ QUOTE ] I hate insurance companies and the bad part is that they raise rates every year when nothing ever changes. [/ QUOTE ] I heard that one of the many reasons Insurance companies raise their premiums is because the Illegal Aliens slip into this country and they get their healthcare FREE!! Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.