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Old 07-14-2018, 08:21 AM   #1
Antlers86
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Default What's the point....

Why pay for health insurance. Such a rip off. Wife had a medical scare a couple wks ago. Insurance covered 70% of $15k test but they required we pay another certain % up front for the test to be taken. We dropped the cash and went on to find out nothing. Last week was her only good week out of the last 6 wks. Now she is in the ER with major pain and still no freaking clue what's wrong. They just came into the room and said they were going to run the same dang test they did 2 wks ago which is another $$$$ out of pocket. I'm so sick of this. Wife is in pain, I work my butt off providing for her and our 3 kiddos. We pay for health insurance and yet still get raped when something happens. Yet I know some people that sit on their tail end at home 24/7 because they choose to do so and don't have to pay anything for medical emergencies.

Could use some prayers if you have a moment.
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Old 07-14-2018, 08:43 AM   #2
Outlaw_6
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Yep, insurance is really only for catastrophic injury these days, and even thing only for so much. Regardless, the insurance companies are gonna do everything they can get away with to keep from having to pay up.

Prayers sent.
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Old 07-14-2018, 08:47 AM   #3
sweetinlow660
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Prayers 86
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Old 07-14-2018, 08:49 AM   #4
hogslayer78
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Prayers up for your wife and family Jason. I agree with you on the insurance thing 100%. They bend us over everytime we use it and they bend us over every 2 weeks when it comes out of our paycheck!
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Old 07-14-2018, 08:50 AM   #5
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Prayers sent


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Old 07-14-2018, 08:53 AM   #6
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Prayers for yall Stay positive. What is your max out of pocket? You have to be getting close. then the rest of the year will (or should) be covered.
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Old 07-14-2018, 09:05 AM   #7
AntlerCollector
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Sorry to hear about your wife. Hopefully they will find something wrong and be able to fix her.





That being said, I don't think I would pay the same people to do the same test when they failed to find a problem with last time. Take her somewhere else.
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Old 07-14-2018, 09:15 AM   #8
spidermonkey
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Praying for your wife, you, and the family, brother! Praying that SOMEBODY figures out what is wrong with her. Good Huntin, and God Bless, Rusty
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Old 07-14-2018, 09:17 AM   #9
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Just think if you were a welfare recipient or an illegal you could.get the exact same treatment and test for 0 out of pocket.

Life ain't fair that's for sure.
Prayers up
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Old 07-14-2018, 09:23 AM   #10
Antlers86
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Thanks all. Trying to stay positive.

Quote:
Originally Posted by AntlerCollector View Post
Sorry to hear about your wife. Hopefully they will find something wrong and be able to fix her.





That being said, I don't think I would pay the same people to do the same test when they failed to find a problem with last time. Take her somewhere else.
She has been to 2 different doctors. First time in the ER in Athens. Other doctors are in Tyler.
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Old 07-14-2018, 09:23 AM   #11
jvswan
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Praying for you and your wife. Insurance sucks until you really need it, then sometimes it sucks again. You always want to believe that those guys are on your side, but nope. They are only on the side of making money.

I really hope the docs can figure out whatís going on. Not knowing is hard...
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Old 07-14-2018, 11:00 AM   #12
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What with all the hurricanes, flooding and fires nationwide, it’s probably going to get worse, not better. We pay for what happens to everybody. You are right, it sucks. Prayers for you.
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Old 07-14-2018, 11:42 AM   #13
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Prayers sent.
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Old 07-14-2018, 12:15 PM   #14
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Default What's the point....

Yep. I know some that have said they didnít have insurance and negotiated the price. Ended paying less than they would have using their insurance. Crazy


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Old 07-14-2018, 01:12 PM   #15
lnester
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Try Medishare, or just negotiate a cash payment option.

And I certainly would not run the exact same test. That's idiotic.

At the end of the day, the problem is with your doctors and their inability to solve the problem (******* there). It isn't with the insurance company. You have misplaced anger and blame.

Prayers sent.
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Old 07-14-2018, 01:51 PM   #16
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If you don't mind me asking, and if not too personal, what are her symptoms? Maybe someone on here has, or has known, someone with similar symptoms/issues, and what the diagnosis was. Somebody on here might also be able to refer you to a highly recommended doctor that specializes in diagnosing and treating people with her same symptoms. I learned awhile back, that all doctors that specialize in a particular field of medicine are not always the ones you should pick. My wife broke her radial head in her arm several years ago, and we went to the ER right away. After X-rays, the ER staff referred her to a general orthopedic surgeon, who wanted to go in and pin all of the broken head and bone fragments back together. Co-worker referred us to an orthopdeic surgeon in the Houston Medical Center that specialized in hand and arm injuries. He removed all of the broken bone fragments and replaced the broken radial head with an artificial head. She has full use of her arm now, and her occupational therapist, who knew both doctor's capabilities said her recovery would not have been nearly as successful had she chosen to go with the first surgeon's recommendation. Just something for the OP to consider as he has to travel down this difficult road of first trying to diagnose and then treat this issue.
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Old 07-14-2018, 02:16 PM   #17
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Prayers sent
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Old 07-14-2018, 02:23 PM   #18
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I know you are frustrated with insurance but it sounds like finding what is wrong with your wife is a bigger hurdle. The entire health system is so convoluted. In this example it shows why things are expensive. Your wife already had a test run but another provider runs the same test. Maybe they thought things had changed, couldn't get the results from first test, etc. But they have to cover themselves by running the tests and somebody has to pay for that again. That has nothing to do with insurance. If healthcare systems could talk and you could see results no matter where it was taken would decrease duplication. Physicians and hospitals have so many metrics that their reimbursement drops if things aren't done a certain way. So everyone is covering their own rump and the patient gets caught in the middle.

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Old 07-14-2018, 04:39 PM   #19
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Man I hope your wife is ok, that has to be very frustrating. I hear you on the insurance, most of it is not worth the paper its written on, my guys were complaining to me about no insurance and so and so offers benefits blah blah blah, I gave them all about a 3.00 an hour raise over a 1 year period and told them to go buy their own if they wanted it.
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Old 07-14-2018, 05:05 PM   #20
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Prayers sent....I won't get into my "RANT" on MEDICARE (me) or my retired wife's TEACHER RETIREMENT INSURANCE in TEXAS!!...….

Physicians order tests, more tests, duplicate tests many times to just plain COVER their butt's due to law suits! But again...there are just some plain BAD clinicians....do your research and you can many times discover who to go to.

Insurance companies are NOT in the business to provide care, they are in the business to MAKE $$! TOTAL BS!!!
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Old 07-14-2018, 05:41 PM   #21
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Update. We have actually been home since 1pm. Rested as last night was a long one. Dr that was on call was fantastic! He found 3 issues immediately. Main thing causing all the pain was a ruptured cyst leaking fluids into her pelvic area. Sharp pain and she could barely walk. They gave her meds and released. Meeting with a referred specialist Monday to see if they want to surgically removed it. Most cases no but they might. Hopefully it will close off and dissolve.

Forking over $$$$ after you have already paid $$$$ over and over is frustrating. We aren't struggling thankfully but just returning from vacation 2 wks ago playing catch up and spending 3 times what we did on a trip over medical sucks. Deductible should be really close.

Inester good point on Medishare. We actually are going to look into it. Cases like this would have been covered. We have heard great things about them through a couple church families and friends.

Appreciate all the prayers. Just thankful to know what has been putting her in this much pain. Sad seeing someone you love 100% one day and tremendously hurting the next.
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Old 07-14-2018, 05:54 PM   #22
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Hate to hear you folks are having to deal with both an illness and getting ripped off by insurance and medical providers. Prayers up that the follow up visit goes well and your wife heals 100% ASAP
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Old 07-14-2018, 05:56 PM   #23
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Ran into something like this several years back. Was diagnosed with Atrial flutter by one DR. Wanted another opinion, Second Doc wanted to do the same tests as the first. Brought him the results if the first. These are your records. Yours to use. Now in your case the Doc may have wanted a different view or something and that may be a good thing.
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Old 07-14-2018, 10:15 PM   #24
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Prayers up for yall!!!!!

Bisch


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Old 07-14-2018, 10:38 PM   #25
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Thanks for the update. Good to see some answers, at least. Prayers for healing.
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Old 07-14-2018, 11:11 PM   #26
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Quote:
Originally Posted by lnester View Post

And I certainly would not run the exact same test. That's idiotic.

At the end of the day, the problem is with your doctors and their inability to solve the problem (******* there). It isn't with the insurance company. You have misplaced anger and blame.

Prayers sent.
No... it's not idiotic. Things can change in just a few hours. Wanna know how many times a CT scan doesn't show appendicitis one day and then the person is worse the next day, comes back to the ER and they redo another CT and whoa, there it is... Just wasn't bad enough to show on the first scan. ALL THE TIME. Things can change quickly and there may not have been anything to see the first time so it's not the idiotic doctors either... sounds like you have some misplaced anger yourself...
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Old 07-14-2018, 11:13 PM   #27
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Jason, glad yall have some answers. Hope she starts feeling better soon. I had many ovarian cysts when I was younger and they always ended up resolving on their own. I hope this is the case with your wife as well, whatever type of cyst she has.
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Old 07-15-2018, 07:09 AM   #28
AntlerCollector
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Thanks for the update Jason. I woke up this morning and had y'all on my mind. Glad to hear they have diagnosed an issue.

Last edited by AntlerCollector; 07-15-2018 at 07:11 AM.
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Old 07-15-2018, 11:16 AM   #29
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....soooooo Obama didn’t make health care free?

Glad they found issue, and pray for a quick and full recovery
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Old 07-15-2018, 11:28 AM   #30
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Appreciate all the prayers!

Quote:
Originally Posted by nursejenn View Post
Jason, glad yall have some answers. Hope she starts feeling better soon. I had many ovarian cysts when I was younger and they always ended up resolving on their own. I hope this is the case with your wife as well, whatever type of cyst she has.
Thanks NJ! Exactly what it is. They said some are more painful than others. Hopefully it resolves on it's own quickly. She meets with a specialist tomorrow to find out what they want to do.

Quote:
Originally Posted by AntlerCollector View Post
Thanks for the update Jason. I woke up this morning and had y'all on my mind. Glad to hear they have diagnosed an issue.
Thanks Jeff! She is a little better this morning. Pain meds keeping her good.
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Old 07-15-2018, 11:40 AM   #31
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Quote:
Originally Posted by flywise View Post
Just think if you were a welfare recipient or an illegal you could.get the exact same treatment and test for 0 out of pocket.

Life ain't fair that's for sure.
Prayers up
First, I hope your wife get better quickly.

Second, it is the same politicians that have praises sung for them that allow this to happen.

Insurance is exactly what they want it to be. A money making business. The house always wins.

Insurance used to be better than it is now. Companies used to provide it as incentive to work for them. Not so anymore.
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Old 07-15-2018, 12:56 PM   #32
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Hoping your wife feels better quickly.

With regard to your insurance and bills, do not pay a bill just because they send it. You can request an itemized statement and then have your insurance audit and explain why things were or werenít covered. Even then, you can typically settle for much less than they are asking. My wife racked up over a million in medical bills and while the insurance picked up a good amount of it, we found over $30k in errors and at least that in double billing. Itís a racket but if you have patience it can be settled out amicably and you should be able to save some money.
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Old 07-15-2018, 01:31 PM   #33
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Prayer sent.
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Old 07-15-2018, 01:45 PM   #34
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Sounds like y'all "86" this. Wishing your wife a speedy recovery.
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