Why, our health care system is the best in the world

[skygazer]

I'm never sure what part of it people are talking about when they say that but navigating the insurance aspect certainly can't be it.

I'm insured through my employer. The insurance is through Blue Shield of California. My family doc tells me I need to see a podiatrist. I dutifully go to the Blue Shield of California web site to find one in network and get the name of one in town. I go see her.

I get a call today from the billing department of said podiatrist's office. Apparently, she is NOT on my insurance's network because while everything else is covered by Blue Shield of California, podiatry is not. It is covered under another plan.

This is noted in very, very small print on the back of my insurance card, along with about 67 other lines of incredibly tiny writing consisting of addresses to send billing inquiries to. It is not noted on the front, and there is nothing on the Blue Shield of California website that indicates that some companies may have exceptions regarding... whatever. Because this podiatrist is on the regular Blue Shield of California network, the front office people who took my card did not know that I was not covered either. I am apparently supposed to know this by sheer osmosis.

The guy in the billing department was very nice. He mentioned that this happens a lot (I'm sure it does) but that the insurance will refuse to pay anything and that I am going to get stuck with a large medical bill that I can't afford (he will bill the insurance but when they refuse to pay, he will then bill me at the cheaper walk-in rate and set up a payment plan - helpful but I still can't afford it). And now I have to see yet another podiatrist.

I am not sure why anyone thinks that health care can get any more complicated and expensive than it already is. I am also not sure why anyone would want to keep such a cumbersome and inefficient system in place. Unfortunately what we got in the way of reform won't solve any of the issues I just went through and the amount of red tape people have to go through and that doctor's offices have to deal with to keep their billing straight is one area where it seems like a vast amount of money is wasted.

:nuke:

[grantcart]

1. People who say that have never lived outside the US

[Lydia Leftcoast]

2. .. and have this post World War II idea that countries outside the U.S.

all have lower living standards than we do.

It was true in the 1950s and 1960s. It isn't anymore.

[jtrockville]

3. Not just complicated and expensive.... choice is not in our hands.

The company I work for is not in the health insurance business, or any other health-related business. Yet I am bound by their choice of health insurance plans (and consequently, their choice of doctors for me).

Why should my employer have to spend resources evaluating health insurance plans? Why can't they simply concentrate on their core business?

I would prefer to choose my own doctor. I wish the "reform" gave me autonomy in my choice of doctor.

SINGLE PAYER NOW
MEDICARE 4 ALL

[sinkingfeeling]

4. Do you also have the plan that does cover podiatry? I'd go to my HR department and find out why

podiatry isn't covered or how to get the coverage.

[DBoon]

5. I've taken great care to go to doctors in my network

and for one routine procedure still got a bill for $3,000 or so because the *facility* wasn't in the network.

Fortunately, the medical provider "took care" of that one

[eppur_se_muova]

6. I only clicked this link to see what country you were in ... nt

[NotThisTime]

7. Yes, it's a covered benefit because you can't get it because you do not have

WTH do they tell you it's a covered benefit for if they aren't going to pay for it, when your doctor says to get it??? Then you ask BCBS to give a pre-authorization for it, and they don't do they either because your plan doesn't require it, so every single time you go to the doctor you do so at your own financial peril... It's a complete sham...

I have a serious pre-existing condition BCBS would drop me for in a heartbeat if they could, but they can't, instead they deny, deny, deny and I appeal, appeal, appeal, and then STILL get stuck with some bills... the system is outrageous...

I feel for you skygazer... you always think your insurance is great until you actually need to use it.

[librechik]

8. ...if you don't count the 27 countries ahead of us on quality, cost and outcomes.