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Well, that's about what we expect, right?
#1
xxxxxx//www.cnn.com/2018/02/11/health/aetna-california-investigation/index.html (Replace "xxxxxx" with https: in your browser's address bar)

Quote:(CNN)California's insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients' records when deciding whether to approve or deny care.

California Insurance Commissioner Dave Jones expressed outrage after CNN showed him a transcript of the testimony and said his office is looking into how widespread the practice is within Aetna.

"If the health insurer is making decisions to deny coverage without a physician actually ever reviewing medical records, that's of significant concern to me as insurance commissioner in California -- and potentially a violation of law," he said.

Aetna, the nation's third-largest insurance provider with 23.1 million customers, told CNN it looked forward to "explaining our clinical review process" to the commissioner.

No opiates for you in chronic pain, no [email protected] for you with GAD or anxiety - Heck, no treatment, the Doctor isn't even going to review your file.

And the government remains puzzled as to why sites like this exist, or attribute them to abuse.

"First do no harm" my butt.
A tree is known by its fruit; a man by his deeds. A good deed is never lost; he who sows courtesy reaps friendship, and he who plants kindness gathers love.

-- Saint Basil








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#2
This made me so angry when I saw this story on CS This Morning. That poor patient...
Let us be thankful for the fools. But for them the rest of us could not succeed. ~ Mark Twain
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#3
I am so lucky to be insured at present, the costs are astronomical in The States. My father has a different, much cheaper health provider (still, so fortunate for America) and the disparity between the way we are treated is astounding. He is treated like a child by his doctors, given medications he does not need (they forced him to take Zoloft for over a year because he complained of fatigue, lack of focus, etc. which they labeled as clinical depression). FINALLY, a competent endocrinologist notices in his chart that his thyroid function is far below normal... not even so much as an apology from the psychiatrist that pretty much literally jammed pills down his throat.

Conversely, I see a psychiatrist outside of my insurance and he is extremely kind, compassionate, professional, and always presents options and allows me to choose what I feel most comfortable with. With regard to my insurance, since I pay such a high premium, I have never have had to file a pre-authorization or deal with any nonsense, whatever the doctor prescribes, they pay for.

Bottom line - you literally cannot afford to be poor in America, you will be treated as a third class citizen.
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#4
(06-13-2018, 12:54 AM)Chinchillin777 Wrote: I am so lucky to be insured at present, the costs are astronomical in The States. My father has a different, much cheaper health provider (still, so fortunate for America) and the disparity between the way we are treated is astounding. He is treated like a child by his doctors, given medications he does not need (they forced him to take Zoloft for over a year because he complained of fatigue, lack of focus, etc. which they labeled as clinical depression). FINALLY, a competent endocrinologist notices in his chart that his thyroid function is far below normal... not even so much as an apology from the psychiatrist that pretty much literally jammed pills down his throat.

Conversely, I see a psychiatrist outside of my insurance and he is extremely kind, compassionate, professional, and always presents options and allows me to choose what I feel most comfortable with. With regard to my insurance, since I pay such a high premium, I have never have had to file a pre-authorization or deal with any nonsense, whatever the doctor prescribes, they pay for.

Bottom line - you literally cannot afford to be poor in America, you will be treated as a third class citizen.
Have worked in health care for the last 20 years and it has gone to shit!!
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#5
It’s a sad state of affairs in this country in regards to health care. I have insurance through my job but my deductible is huge. My husband had pneumonia (his second time in months) and had to stay over night at the hospital. We put the cost on an interest free credit card and paying the bare minimum. It’s ludicrous. At the hospital they ran tests and gave him a bed. That’s all.
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#6
i used to do insurance billing and it's insane how difficult they make it to maneuver in the first place. even with my experience they make it absolutely ridiculous to figure out your coverage, referrals, etc. then add on people like this guy... people who make insurance decisions should have to pass an ethics test!
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#7
(10-30-2018, 10:45 PM)scorpiosunset Wrote: i used to do insurance billing and it's insane how difficult they make it to maneuver in the first place.  even with my experience they make it absolutely ridiculous to figure out your coverage, referrals, etc.  then add on people like this guy... people who make insurance decisions should have to pass an ethics test!

Reading an EOB is like reading a foreign language!
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#8
(10-27-2018, 04:02 PM)happyvibe Wrote: It’s a sad state of affairs in this country in regards to health care. I have insurance through my job but my deductible is huge.  My husband had pneumonia (his second time in months) and had to stay over night at the hospital.  We put the cost on an interest free credit card and paying the bare minimum.  It’s ludicrous.  At the hospital they ran tests and gave him a bed.  That’s all.
I’m so sorry this is happening to you. Deductibles are totally ridiculous they are so high you pray you don’t get. Twice with pneumonia that’s so hard. I work in the medical field so I know how expensive things are.
mxray 
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#9
In my state if you make under 16k s year literally all medical expenses are paid for. Having private insurance through a job is a handicap , for example any type of substance abuse treatment will not accept private insurance- you have to be on the state to get anything covered. I lost my job in april, and COBRA mandates I keep my jobs policy until next April. Meanwhile I'd like to do a month of rehab but I can't because the job policy doesn't cover it and I made too much between Jan 1 and April that I'm ineligible for state assistance.
Whatever doesn't kill you only makes you stranger[Image: lightbulb.png]
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#10
(11-16-2018, 07:53 PM)Rattzo Wrote: In my state if you make under 16k s year literally all medical expenses are paid for. Having private insurance through a job is a handicap , for example any type of substance abuse treatment will not accept private insurance- you have to be on the state to get anything covered.   I lost my job in april, and COBRA mandates I keep my jobs policy until next April. Meanwhile I'd like to do a month of rehab but I can't because the job policy doesn't cover it and I made too much between Jan 1 and April that I'm ineligible for state assistance.

I know this post is a bit older but if you are still seeking a month in rehab many facilities offer scholarships. I have worked in the field and have many friends who still do. Almost no facilities advertise this but many do. I know it differs state by state.

Some places are cash only. Some only take state insurance and private insurances are paying for less and less time.

I was just discussing this with a friend who works at a long term treatment center and they told me private insurance companies are horrendous to deal with and they end up not getting paid for people who clearly need help. 

I am unsure your location but would look for state run rehabs, they usually can/will help you out if you can get the right person on the phone.

I hope you are doing well and were able to get in somewhere.
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