Please check in with YOUR story if you've ever had a BAD health insurance situation. Here's mine:

[RBInMaine]

I was in college. Had a college plan. Had a small claim for an office visit. The provider submitted the claim TWICE, and I submitted the bill to them once myself with a nasty-gram and followed up by phone before they finally paid it, which I was amazed they did, but at least FINALLY got an answer. I even had the provider's collector calling me. Talk about SHITTY BUREAUCRACY. And then people complain about the government. SHEESH. These insurance companies SUCK.

[RBInMaine]

1. Here's Another:

My step father retired before age 65 and had a small out-of-home business. Could only afford barebones insurance through AARP. Better than absolutely nothing, but not good. He had an injury. $4000 out of pocket. AARP does supplemental insurance and ok, but there you are. He now has Medicare. The healthcare financing system just SUCKS and we NEED the ACA. I bet he could have gotten a better plan through the exchanges.

[enlightenment]

5. I'm not sure I understand your posts.

Your OP talks about having a terrible time dealing with the insurance bureaucracy; this post talks about a plan that required your stepfather to pay $4000 out of pocket.

I'm confused about how the ACA fixes those things. People will still be dealing with the insurance company bureaucracy; the ACA makes sure of that by putting them at the center of the system - so logically, they will still be a pain in the ass to deal with, because we still have deductibles and co-pays and co-insurance and "percentage of reasonable and customary cost" - which have always been the big battlegrounds.

Many people will still be facing paying thousands out of pocket, too - there are many plans that pay nothing until the deductible is met (the cheap premium plans of course - the plans that people who don't have much money will gravitate toward) and many more that have pretty eye-watering co-pays and staggeringly different in-network/out-of-network cost differences . . . in other words, maybe your step-dad could have gotten a better plan but if money was the issue, then maybe not.

So, I'm not sure what you're saying. The ACA doesn't really change the first problem at all - and it will only alleviate the second problem for some.

[RBInMaine]

8. I didn't say the ACA would change the first issue completely, & with regard to the 2nd issue

Last edited Sun Nov 17, 2013, 07:26 AM - Edit history (2)

I'm speculating a bit without some further inquiry, but I don't think you are entirely accounting for the enhancement reforms. Insurance must meet new standards.

My posts have two intentions. One being that the healthcare insurance industry generally sucks, which is does, and we should not be defending them as they blame the ACA for cancelling plans. The next being that since we are stuck with it for now, at least the ACA offers some needed improvements. It is possible to have both views. This is not happening in a vacuum.

I don't think the ACA is the ideal program by any means. Medicare For All is and I really wish we could have that, but ACA is COMPARATIVELY better than the TOTALLY ROTTEN status quo.

[enlightenment]

13. Thank you.

I was simply asking for some clarification.

[RBInMaine]

14. Yup. I know it is a bit contorted, but then again this is a contorted situation all around.

[Turbineguy]

2. After my Mother died

her insurance simply stopped paying, even though the costs were incurred while she was paying premiums. We got stuck with $3400 in charges. This was her AARP connected plan. Needless to say, I'll be looking for another company when I get to medicare age.

[RBInMaine]

3. Yup. And there are THOUSANDS of stories like this.

[angstlessk]

4. Well NOT being insured can be a problem also...

I went to the hospital with a broken shoulder...they gave me a chest xray and a brain scan..when I asked why..they said since I fell I 'could' have hit my head...but I never said I hit my head..it was to increase the charges...nothing more...I never even got a bill for someone who read the brain scan...the SCAN WAS A SCAM!

Not only that..but the ONLY thing you can do for a broken clavicle is to put it in a SLING...hell never even had to go to the hospital....just needed aspirin and a sling!!!!!!!!!!!!!!!

[RBInMaine]

9. Yup, there are medical practice reforms that need to happen too.

[Karia]

6. Drive-through mastectomies

According to my insurance company, I was an "ideal candidate" for a drive-through mastectomy because I was young, fit, & healthy except for the breast cancer - and it was awful. I cannot bear to imagine what it is like for women who are older or who have other health issues. My insurance company limited the number of hours I could occupy a bed & hospital room, but I was not yet quite well enough to go home so the (kind & very apologetic) nurses helped me into a wheelchair and put me out in the hall near their station. A while later I was sent home, with tubes still in my body draining into boxes taped to my chest.

[littlewolf]

7. Good gravy that is horrible, that is legal?

me, sorry no horror stories, I was on my parents plan
that paid for 3 surgeries w/o complaint.

after 18 I was in the military, stayed 20 years
retired and still have the same insurance.

now I can tell you some horror stories about some of the Dr.'s
but not coverage.

I am thinking of getting some kind of supplement to go with
tricare.

[RBInMaine]

10. And that military care was PURE SOCIALISM that even the GOP likes. :-)

[RBInMaine]

11. Ya, like drive-through childbirth care. Disgusting. Sorry you had to go through that.

[blue neen]

12. That is so horrible.

I'm so sorry that you went through that. IMHO, a drive-through mastectomy should be considered criminal behavior on the part of insurance companies.

Your body is not given any time to adjust to the physical or psychological trauma.

I hope you're doing well now.

[Karia]

15. Thanks, I'm fine

The power of insurance companies to force drive-through mastectomies has since been curtailed in a number of states, including my own. But the attempt at getting federal legislation seems to be dying in committee.

[blue neen]

16. Here's a link to the most recent activity:

http://beta.congress.gov/bill/113th/house-bill/1531

H.B. 1531 seems to have bipartisan support. I don't understand why this bill cannot be passed. Maybe the Tea Party members in Congress would rather legislate trans-vaginal ultrasounds.

[annabanana]

17. My DH had an automobile accident about 10 yrs ago.

It was pretty serious. While they were repairing an abdominal wound, they discovered an umbilical hernia and repaired it. The insurance company declared it one of those "pre-existing conditions" and we ended up paying for it out of pocket to the tune of several thousand dollars.

What was the doc supposed to do? sew him up with the hernia still in there?

[Rosa Luxemburg]

18. My husband had to wait 8 weeks for radiation therapy at Hopkins after many battles

The HMO wouldn't cover him at first. After many protests and help from Hopkins staff we overcame the insurance company. We forced their hand. They came up with "it's the only place nearby that does that type of radiation therapy." Lame but at least he got his radiation and is still alive 10 years later.

[a la izquierda]

19. I have state insurance in a poor state.

The whole thing is horrendous and expensive. I'm wondering what ACA will cost me.

[CBHagman]

20. A stack of bills for a single biopsy.

I'd been careful to choose a hospital included in my plan. Little did I know that the lab wasn't actually part of the hospital.

On another occasion, I had perhaps 15 pages of notes on coverage, with lots of back-and-forth with various staffers at the insurance company.

Then there's the time that our then-insurer wanted to double what we were paying in monthly premiums (This was in the early 2000s). We changed to another insurer rather than face a 100 percent increase.

However, my friends and co-workers have even worse stories to share.