your medical insurance: awesome or totally not awesome?

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dear blue cross of california: fuck you and your "prior authorization" (they get to veto my doctor's decision about whether my medication is appropriate/cheap enough, and that can take 3-4 days from the time my pharmacy processes my prescription, regardless of whether i might actually NEED that medication). also, dear my pharmacy: fuck you for being closed on weekends.

Poll Results

huh? it's ok i guess 12
bane of my existence 7
awesome!!! 6
fuck you, i don't have any insurance 5
i'm britishes, we take what we can get3

get bent, Saturday, 24 March 2007 22:22 (fourteen years ago) link

I am currently uninsured, for all intents and purposes, even though I carry a major medical policy myself: $130 a month for a 5k deductible. I'll get a real plan as soon as my next job kicks in here (couple weeks). Mostly I try not to think about it.

gff, Sunday, 25 March 2007 00:30 (fourteen years ago) link

Pretty good with mine. Premiums affordable, good broad coverage, never given me any grief.

Ned Raggett, Sunday, 25 March 2007 00:46 (fourteen years ago) link

mine's OK, i guess. i have never really put the carrier to the test and (knock on wood) i hope that i never have to.

Eisbaer, Sunday, 25 March 2007 01:07 (fourteen years ago) link

Ours is crap. Ridiculously expensive catastrophic coverage that doesn't pay for office visits. It has paid for several surgeries, though, so I guess we've broken even.

Beth Parker, Sunday, 25 March 2007 01:11 (fourteen years ago) link


get bent, Sunday, 25 March 2007 02:57 (fourteen years ago) link

My answer is the same as Beth's, minus the surgeries, so I haven't come anywhere close to breaking even.

Rock Hardy, Sunday, 25 March 2007 03:01 (fourteen years ago) link

I am on my parents' medical insurance, which is awesome. I am getting kicked off in August and will have to get my own, which is horrible. I am applying for my dream position, but it requires outside medical insurance, which is just stupid (on my part).

Maria, Sunday, 25 March 2007 03:02 (fourteen years ago) link

I've heard medial insurance is frightfully expensive in the US. Well, compared to Australia anyway. I'd pay about US$45 a month which gets me an arse watering amount of extras. Which I never use.

Drooone, Sunday, 25 March 2007 09:08 (fourteen years ago) link

Working for a pharmaceutical company has its benefits - mine is free!

Hard like armour, Monday, 26 March 2007 01:15 (fourteen years ago) link

I just rely on Medicare, which has actually been fine for the most part. I'm fucked if i ever need an ambulance though.

Trayce, Monday, 26 March 2007 01:30 (fourteen years ago) link

god, that is major bullshit, about BC California terminating people.

horseshoe, Monday, 26 March 2007 01:32 (fourteen years ago) link


milo z, Monday, 26 March 2007 01:37 (fourteen years ago) link

Freedom has a price, in this case insuranc, but you have a choice. You are free. God Bless America

Srsly I dont understand the US system, from memory you still pay a large wack of yr tax dollar for health services... but then you must also have insurance ? DOES NOT COMPUTE : are you not paying twice? What % of yr tax dollar goes to health? How do you access that without insurance---is there a basic level of free state health care in US?

Kiwi, Monday, 26 March 2007 01:56 (fourteen years ago) link

Welcome to the wonderful world of the US, Kiwi.

There is no 'National Health Service' as such, or whatever you would call the equivalent in NZ, it should be noted.

Ned Raggett, Monday, 26 March 2007 02:01 (fourteen years ago) link

I assume you mean that we pay taxes that go toward medicare/medicaid programs for the poor that we can't use ourselves. Then we also pay higher insurance premiums in part due to all the uninsured people who wind up having to use the emergency room for basic care (emergency rooms can't turn people away)

Hurting 2, Monday, 26 March 2007 02:17 (fourteen years ago) link

No Im just saying I find it difficult to understand how the wolrds weathliest nation cant rationalise a national system through tax to pay for a basic standard of health care and then have others opt in for private cover for better service.

I wouldnt want to pass comment on the evils of the wealthy subsidisng of the poor, tax burdens confuse me, sufice to say you poor poor thing! Anyway youre telling me there IS free health care for emergency services for the uninsured?

Kiwi, Monday, 26 March 2007 02:34 (fourteen years ago) link

Believe me, I do not consider such subsidy an evil at all. But we could do a better, more efficient job of that AND give health coverage to a lot more people, I think.

Hurting 2, Monday, 26 March 2007 02:36 (fourteen years ago) link

And I don't understand why we can't have a national system either.

Hurting 2, Monday, 26 March 2007 02:36 (fourteen years ago) link

i did some research on the blue cross site and found out that my pharmacy is supposed to dispense a 72-hour emergency supply of medication if there's a delay because of "prior authorization" paperwork. they didn't, and i've had a very crappy weekend filled with wonderful ssri withdrawal side effects.

get bent, Monday, 26 March 2007 06:03 (fourteen years ago) link

my current insurance really sucks, but in a couple of months i will have better insurance. well, as much as it sucks that i had to pay a couple of grand this year for medical tests that i have to go through every six months, its better than paying something like $40,000.

basically, if i didnt have insurance, my parents and i would either be in deep shit or homeless or whatever. as horribly expensive that health insurance is, its better than paying for the tests, procedures, and medication themselves.... at least in my case.

t0dd swiss, Monday, 26 March 2007 06:12 (fourteen years ago) link

basically, with the insurance i used to have (and will have in a few months) saved me about $200,000.00 in medical bills. my current, shitty insurance still cut 80% off of my (thankfully cheaper) bills.

hooray for chronic cancer type things!

t0dd swiss, Monday, 26 March 2007 06:15 (fourteen years ago) link

Anyway youre telling me there IS free health care for emergency services for the uninsured?

Uh-uh. No.

Medicaid is insurance for poor people. And I mean poor. I had a friend with AIDS who was denied coverage because his car (a 4 year old pickup which he bought before his diagnosis) was worth too much money. It was worth under $10K, and it was leased.

Medicare is insurance for senior citizens.

These are the programs that our taxes are funding. Hillary Clinton fought the good fight way back when, but if there's one principle that American politicians hold dear, its that health is not a right, it's a privelege that comes with wealth.

Jesse, Monday, 26 March 2007 07:23 (fourteen years ago) link

I work for a restaurant that is part of a group that takes in over $15 million dollars a year. We have no insurance. The owners/investors say that they want to provide a group* health care plan, but "there is not sufficient interest"! This despite the fact that it's a daily topic of conversation at work.

*For those from distant shores--a GROUP insurance plan is provided by your employer, usually subsidized. The greatest benefit to it is that you may not be turned down for being a high risk or for pre-existing conditions (though if say you have cancer, they can refuse to provide benefits for this malady for a certain period--motherfuckers).

INDIVIDUAL insurance policies are available for those whose employers don't provide a group plan, but you have to be a model of health in order for the company to take you on. Case in point, one fellow ILXor tried to buy an individual plan but because he was taking Paxil, he was denied. He shopped around and found that the only insurance he could purchase was a (expensive) catostrophic plan (huge deductible, good for only major problems. Like decaptiation.)

Jesse, Monday, 26 March 2007 07:30 (fourteen years ago) link

I had a friend with AIDS who was denied coverage because his car (a 4 year old pickup which he bought before his diagnosis) was worth too much money.

Upon review, I think this didn't come out right. What I meant was that he was unable to work, and he needed his vehicle to get to doctor appointments (1.5 hour drive). Since it was leased, he had no equity to put into another car.

And the reason he was unable to work was only partially his health. If he had started earning more than 12% above poverty level (this is on a state-by-state basis, and it was in a Red state) he would be disqualified for Medicaid. So he wound up finding jobs earning money under the table.

All this was directed to Kiwi and other non-Americans. Apologies to Americans.

Jesse, Monday, 26 March 2007 07:37 (fourteen years ago) link

my insurance is okay. It's better than some I've had in the past but I still average $300 a mth on health costs even with insurance. However I've gone long periods without it which is very bad. I have chronic health issues and when unemployed had to pick and choose which of my essential medicines I could afford. not good. Because of my health issues my job choices have always been limited to the type where I could get full health coverage. (rather than temping, full-time bartending, things that allowed me freedom to travel, etc.)

Ms Misery, Monday, 26 March 2007 16:33 (fourteen years ago) link

ten months pass...

dear blue cross of california: fuck you and your "prior authorization" (they get to veto my doctor's decision about whether my medication is appropriate/cheap enough, and that can take 3-4 days from the time my pharmacy processes my prescription, regardless of whether i might actually NEED that medication)

Oh, get bent, I feel your pain today.

My insurance company has decided that although my doctor says I need 30 pills a month of one of my expensive prescriptions, they will only give me 25.

Even missing one of these pills causes problems. She's going to appeal but that will take a few weeks. In the meantime I don't know what I'm going to do.

I was crying at my desk just now which is made doubly worse as I left my makeup bag at home.

I really didn't need this. Stress makes my condition much worse. Perfect.

Bonita Applebum, Tuesday, 12 February 2008 15:59 (thirteen years ago) link

thirteen years pass...

Ran into the prior authorization thing for the first time, on my new migraine meds. I just started a new job and was counting on the meds to keep me employed. What I was not counting on was that these pills are EXPENSIVE and premera does not want to pay for them. So first refill, they blocked it and insisted on a PA, which my doctor's office ignored because they didn't think I needed it. Now I'm waiting to find out if I get the meds, and if I don't get them I genuinely don't know what will become of my job. The doctor's office texted me, "It looks like they may approve it. Fingers crossed." Indeed.

If the prescription stays blocked and I can't find something else that works in time to keep my job, I'll be all right. I'm lucky. I have enough savings to get me through most of the year, my parents are another safety net, and there are other jobs I could do, just not this one. And even with all this privilege, it is absolutely fucking terrifying to realize how easily one bad call from an insurance company can upend my life. Horrifying glimpse into the nightmare of the American health care system.

Lily Dale, Tuesday, 14 September 2021 22:52 (four days ago) link

Hoping you get good news.

Taliban! (PBKR), Tuesday, 14 September 2021 22:59 (four days ago) link


Lily Dale, Tuesday, 14 September 2021 23:07 (four days ago) link

gah that sucks. i just went to the dr for the first time in forever and got bloodwork. the bill was like "$1000, insurance plan discount $898." these are joke prices!

certified juice therapist (harbl), Tuesday, 14 September 2021 23:10 (four days ago) link

Hearing test
Estimate: $48
Bill: $1,880

I'd almost rather pay it than have to call Cigna.

Hideous Lump, Wednesday, 15 September 2021 06:12 (three days ago) link

I just cannot wrap my head around the con that is american health insurance. I hear stories like insurers holding off for months on approving a payout, so the year ticks over nd your deductable resets.

And how the reason you pay $500 a month is because if you do, the doctor bills the insurer $1500, where as if you are billed directly the same exact freaking procedure is like $10000. Because They Can.


Stoop Crone (Trayce), Wednesday, 15 September 2021 06:30 (three days ago) link

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