Can I afford to get sick or hurt?
What will happen to me when I need medical help? Does my insurance cover the procedures and care that I will need? What about if I don't have insurance? The link below tells of some horror stories. It is a long read so grab some coffee:
Having spent time as a CSR for Aetna I learned a lot about the business and heard many stories first hand from people, or members as we were told to refer to them, about their inability to pay for their medical bills even after they had been greatly reduced by the companies negotiated rates.
Because of the company's large size, they paid negotiated rates as much as 80% less for a given procedure. But there are some catches and loopholes that members were unaware of or unable to meet. One example was referrals. If they were told by their Primary Care Physician, PCP, that they needed to see a specialist they needed a referral before they could go to the specialist, depending on the policy they had. No referral no coverage. The member then had to pay the full price for the procedure. Sometimes the company would allow a referral to be sent in later if there was a short amount of time-lapse from the claim submittal to the complaint of the member.
There were some procedures that need pre-approval from a board of doctors that were on the payroll of the company. If this was not done then again the cost was up to the member at the regular rate. They would receive a bill from the doctor in the thousands of dollars and I assure you they were NOT happy campers!
Then there were those that had a lapsed policy and said they were unaware that the insurance was no longer in effect at the time of the procedure. When asked if they had not noticed that the monthly premiums were not being taken from their checks the answer was always No. Nothing we could do except refer them to their employer.
When the Affordable Care Act(Obamacare) took effect and they elected to switch to that and they lost their doctor some would call and complain but the company had nothing to do with that so some threatened to sue! I told them good luck. You have to sue the government and they had more clout and money than God.
My heart goes out to all that have problems with medical bills. As some of the stories in the link at the start of this blog, they can cause major problems. Do you want to eat and pay the mortgage/rent or pay the medical bill that is in arrears and stay out of court/bankruptcy? Hell of a dilemma, HUH!!
STAY HEALTHY
EASIER SAID THAN DONE
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