scrappinspidey2
Pearl Clutcher
Posts: 2,511
Location: In the Parlor with the Fly
Mar 18, 2015 19:19:37 GMT
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Post by scrappinspidey2 on Feb 1, 2017 1:11:04 GMT
At the beginning of this year I had to switch insurances as our old one dropped us. We are on the ACA and for many reasons I hate it but there we are. Today during an appointment, my daughter noticed her finger was turning blue. 30 min later, after the appointment she tells me. At this point her hand is blue and cold. Nail beds are dusky. No other symptoms. So I look up urgent cares on our insurance website and head there. As a nurse this blue just doesn't look right. Get there and they won't see us. Says they take our insurance carrier but not our plan. If I want to pay out of pocket it will be 600 bucks just to take her to a room in the back.
Called the the insurance carrier. They send us 30 min in another direction to a different urgent care. Mind you I have passed a zillion of them already. We get there and they are closed. Great. Call the insurance company again and the poor lady who answered got an ear full. I did apologize but still. She calls a other one for us. Open till 9 and takes our plan and they are pediatric and will see her even though she turned 18 yesterday. So off we went. Walk in. Explain everything and they said we needed to go to the ER because they don't run labs. (Thinking raynauds). Didn't even really assess. We were still at the front desk.
So we we are now at the ER. Still leaning towards Raynauds per the doc but no tests back yet. Just triage. 90 minutes it took for me to find a place that would even look at her. Thank goodness it wasn't a real emergency (I would have called 911 no worries there but still). Happy birthday to my baby. Ugh
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MDscrapaholic
Drama Llama
Posts: 7,238
Location: Down by the bay....
Jun 25, 2014 20:49:07 GMT
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Post by MDscrapaholic on Feb 1, 2017 1:13:28 GMT
I'm sorry. That's so stressful.
I hope everything is okay with your daughter.
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queenofkings
Full Member
Posts: 283
Jun 26, 2014 15:26:41 GMT
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Post by queenofkings on Feb 1, 2017 1:19:52 GMT
How scary! Hope your daughter is doing better soon! My mom is on disability, and she broke her wrist a year or so ago. The only ortho doctor that took her insurance was like 90 (I'm sure that's a slight exaggeration, but she is over 60 and said he was OLD), and he didn't even set it properly. She still has issues because of it. I worry for folks with ACA insurance- no one wants to take it. The doctors offices say that it's because they don't pay. As it is, they are paying out the wazoo for practically worthless insurance. If you were dying or something it might make a difference but I don't see how it makes it any more affordable for people to be seen for routine things they need help with.  |
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Post by smalltowngirlie on Feb 1, 2017 1:24:30 GMT
I won't even start my rant, it is not worth it. The ACA is a joke, except for those with pre-existing conditions. Something needs to change. I think it should have started with the price of health care, not so much insurance.
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Post by hop2 on Feb 1, 2017 1:26:24 GMT
I hope your DD feels better soon
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scrappinspidey2
Pearl Clutcher
Posts: 2,511
Location: In the Parlor with the Fly
Mar 18, 2015 19:19:37 GMT
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Post by scrappinspidey2 on Feb 1, 2017 2:16:07 GMT
It is Raynauds. I will end up getting a huge bill because it won't be considered an emergency so they won't cover it and even if they did I highly doubt I hit that ridiculous deductible I have. *sigh* I start a benefited job on Monday. Here's hoping the benefits kick in quickly
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Post by SweetieBugs on Feb 1, 2017 2:33:04 GMT
Lynn, read you update, that really sucks!!!
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flute4peace
Drama Llama
Posts: 6,757
Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Feb 1, 2017 2:37:03 GMT
Please pardon my stupid question, but could you have gone back to the clinic you had just come from? (stupid question because I know you would have if you could have, just curious why you couldn't)
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scrappinspidey2
Pearl Clutcher
Posts: 2,511
Location: In the Parlor with the Fly
Mar 18, 2015 19:19:37 GMT
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Post by scrappinspidey2 on Feb 1, 2017 2:44:21 GMT
It wasn't a medical appointment she was at. If you mean the first urgent care that would charge us 600 just to sign in, I could have but I was not at all thrilled with how they handled the situation. They were really snotty because of the insurance I have and no I wasn't imagining it. My daughter picked up on it as well. Plus if it was 600 to walk in, what would they have charged to see a doc? Not to mention at least this will go against my deductible, lowering it somewhat. With the first one it wouldn't have. I can fight the ER charges as well because the third one told us to go there. It was a mess. I have never been turned away for care before
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flute4peace
Drama Llama
Posts: 6,757
Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Feb 1, 2017 2:46:20 GMT
It wasn't a medical appointment she was at. If you mean the first urgent care that would charge us 600mjust to sign in, I could have but I was not at all thrilled with how they handled the situation. They were really snotty because of the insurance I have and no I wasn't imagining it. My daughter picked up on it as well. Plus if it was 600 to walk in, what would they have charged to see a doc? Not to mention at least this will go against my deductible, lowering it somewhat. With the first one it wouldn't have. I can fight the ER charges as well because the third one told us to go there. It was a mess. I have never been turned away for care before Oh I misunderstood, I thought the initial apt you were at was medical. See, I told you it was a stupid question.  |
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scrappinspidey2
Pearl Clutcher
Posts: 2,511
Location: In the Parlor with the Fly
Mar 18, 2015 19:19:37 GMT
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Post by scrappinspidey2 on Feb 1, 2017 2:51:40 GMT
Not stupid at all!!  |
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sweetpeasmom
Pearl Clutcher
Posts: 2,832 
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Post by sweetpeasmom on Feb 1, 2017 3:19:08 GMT
Oh I feel you. Been there done that.
This time last year, ds sliced his finger open at school. It was about 15 mins before school let out. I got the call. I get him and trying to figure out where to take him since it was the first of the year and for the 3rd time, we've had to switch carriers. The pediatrician we had been at wasn't on this new plan, hadn't had a chance to choose a new one on the plan. I go the the urgent care close by and this plan didn't cover urgent care until the deductible was met. They couldn't even just take a peak at it w/o charging me like $250. So I was almost in tears at this point. I get a friend to look at it and it ended up not being that bad. But I was still so stressed out over it all.
I hope that your daughter is ok. Hugs mama!
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kate
Drama Llama
Posts: 5,667
Location: The city that doesn't sleep
Site Supporter
Jun 26, 2014 3:30:05 GMT
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Post by kate on Feb 1, 2017 3:36:43 GMT
That kind of thing makes me so sick. We're dealing with parallel stuff because of changes in my employer's insurance offerings (not ACA). I hate it. I don't think it's the ACA, though, I think it's the medical insurance industry.
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Post by Zee on Feb 1, 2017 3:38:31 GMT
The system is broken, as we all well know. I hope your DD gets answers and treatment, hopefully anything majorly expensive can be done after your benefits kick in. |
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Post by freecharlie on Feb 1, 2017 3:39:34 GMT
Ugh that does suck. I don't have ACA insurance, but we also have to be very careful about where we go. It has to be in our health system and there are at least two competing ones here. If we were to accidentally go out of network, it would cost a lot.
Luckily our deductible is $250, so we hit it fairly fast.
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Post by farmdpea on Feb 1, 2017 3:42:31 GMT
I"m sorry. That really sucks. |
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Post by Hayjaker on Feb 1, 2017 5:36:56 GMT
That kind of thing makes me so sick. We're dealing with parallel stuff because of changes in my employer's insurance offerings (not ACA). I hate it. I don't think it's the ACA, though, I think it's the medical insurance industry. My insurance through my job changed again this year and I am having to pick new providers because my established providers are not in the "network". For a doctor to get added to an insurance panel requires jumping through many hoops. I hate the insurance industry! |
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Post by anniefb on Feb 1, 2017 10:27:52 GMT
How scary. Hope your DD feels better soon.
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momto4kiddos
Drama Llama
Posts: 5,156
Jun 26, 2014 11:45:15 GMT
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Post by momto4kiddos on Feb 1, 2017 11:34:11 GMT
I won't even start my rant, it is not worth it. The ACA is a joke, except for those with pre-existing conditions. Something needs to change. I think it should have started with the price of health care, not so much insurance. Not sure this is entirely on the ACA as far as plans go... The plan she has dictates where she can go. We bought the same exact plan through our states site that we had prior with a small business insurer. I completely agree that the system is broken, but I do believe the ACA offers regular insurance policies that you could buy elsewhere. It is reynauds. I will end up getting a huge bill becuas4 it won't be considered an emergency so they won't cover it and even if they did I highly doubt I hit that ridiculous deductible I have. *sigh* I start a benefited job on Monday. Here's hoping the benefits kick in quickly Sorry for her diagnosis. Hope she is feeling better soon. I'd fight the bill, you really didn't have options at that point. Hopefully at least they'll reduce. My ds was out of state and went to ER and got billed for it because it was out of network  It was on a Friday night and he was several states away, of course it was out of network! They ended up covering it. Worst they can say is no! |
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Post by smalltowngirlie on Feb 1, 2017 12:47:30 GMT
My issue is the price we are now paying for a lesser policy than what we had in the past. Also, the number of headaches and the amount of time it has taken me to get DH and DS signed up. I was on hold for literally and hour and a half the other day trying to get our situation figured out. The person I was talking to said, and I quote, "I hate when I see this screen." I don't think she meant to say it out loud for me to hear, but still it was not something I wanted to hear. The condensed version of my issues: Apply for health plan.
Wait, wait, wait 
Call and see what is happening - Application did not go through please reapply 
Apply for health plan.
Wait, wait
Call- we need to reset your account since you moved and it looks like you have 4 applications open, please wait at least 24 hours before reapplying 
Wait
Apply for health plan - get confirmation email 
Call a couple days later, application processed sent to provider
Get a call from the county we used to live in - "You have no active applications, you have 4 applications from previous years, you can't get insurance through the exchange, let me see what I can do" 
Call exchange - "Hate this screen" please hold for application specialist - hour and a half later, I need to leave so hang up
Get emails through out the week from person at old county - can't get through to anyone in the exchange.
Get confirmation letter in the mail
Get bill for plan we chose
Waiting for insurance cards, but still question if they will work on not.  I started this is December, we think coverage will start today, but I will be making more phone calls to confirm. It really should not be this difficult. |
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Post by mikklynn on Feb 1, 2017 13:25:23 GMT
O.M.G. I would have lost my mind.
I'm glad it's diagnosed.
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Post by myboysnme on Feb 1, 2017 13:44:23 GMT
Your story scares me to death. I have very expensive blue cross blue shield just so I can go anywhere for what we need. But in just 2 months my son turns 26 and he has to get his own insurance, but he is a full time student so I will be paying. I hate that we might not be able to afford good insurance for him. It is so scary.
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Post by kitkath on Feb 1, 2017 16:21:09 GMT
Your story scares me to death. I have very expensive blue cross blue shield just so I can go anywhere for what we need. But in just 2 months my son turns 26 and he has to get his own insurance, but he is a full time student so I will be paying. I hate that we might not be able to afford good insurance for him. It is so scary. Check with the university. We just took our daughter off our plan and put her on the school's plan. She has much better insurance now and has an easier time finding doctors. We pay $165 per month for her. |
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Post by myboysnme on Feb 1, 2017 16:34:14 GMT
Your story scares me to death. I have very expensive blue cross blue shield just so I can go anywhere for what we need. But in just 2 months my son turns 26 and he has to get his own insurance, but he is a full time student so I will be paying. I hate that we might not be able to afford good insurance for him. It is so scary. Check with the university. We just took our daughter off our plan and put her on the school's plan. She has much better insurance now and has an easier time finding doctors. We pay $165 per month for her. Thank you! I found out he qualifies for basically nothing - he is in what they call an insurance gap. He doesn't qualify for Medicaid, he doesn't make the $12K+ a year required to get a marketplace plan and federal discount. He is totally private pay, So the school insurance may very well be the way we will have to go. The plan that is comparable to what he has now under me will cost $380 a month and a $1000 deductible plus copays. |
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Post by jenis40 on Feb 1, 2017 16:42:21 GMT
I am sorry for what you went through. This is a major problem with healthcare today.
Now imagine you are a cancer patient trying to navigate this system while you are exhausted and constantly sick from chemo. While some days you can't even get out bed to get to the doctor/hospital or whatever appointment you had that day and then be expected to fight the insurance company to pay for something. Imagine watching your spouse doing everything they can to pay the bills and keep a roof over your head while they change your sweat soaked sheets, prepare food you won't keep down and then hold a bucket for you to vomit in. Imagine your elderly parents willing to sell their house or empty their retirement accounts in order to pay for treatment that might save their adult child. Imagine watching a fellow cancer fighter die while fighting their insurance company to pay for a treatment that saved your life.
I was lucky. I had a "Cadillac " insurance plan through my job. They were complying with ACA rules regarding transplants ahead of schedule. I watched what my fellow cancer fighters went through and it wasn't pretty. Everyone should have access to the care I had. No one should be bankrupt because of their health. This is why I support universal healthcare.
Sorry for the hijack.
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scrappinspidey2
Pearl Clutcher
Posts: 2,511
Location: In the Parlor with the Fly
Mar 18, 2015 19:19:37 GMT
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Post by scrappinspidey2 on Feb 1, 2017 16:49:39 GMT
I'd fight the bill, you really didn't have options at that point. I plan on it. My calls to them should be recorded anyway and on that last call I told them that if this urgent care didn't work out I was taking her to the ER. 90 minutes spent traveling all over kingdom come just to find a treatment center is a bit uncalled for. The hospital staff was so amazing. I was a woman on a ledge by the time I got to them. I hate hate hate using the ER For non emergent things. Im a nurse myself. If your arm isn't falling off, we don't go to the ER, but last night I felt I had no other choice. I apologized left and right to them for coming in and they were sweet. They had the best sense of humor (my kind anyway) They treated my daughter very well and didn't make us feel stupid for coming in or like we were wasting their time. Luckily for us they were not busy at all so we weren't there very long. The one doc was very excited because she was his first Raynauds diagnosis lol. He was young and cute  Told her she might have peripheral Smurfitis. We adore him. The older doc was just as good. Talked to her about school, asked her about college, gave sage advice. I told him I suspected Raynauds but as a nurse Im not allowed to diagnose per the state He cracked up and whispered to my kid.....your mom is pretty smart and she was absolutely right  Thats a rare moment I intend to treasure for ever The nurse was my favorite. She recommended bilateral amputation and being that I myself was a nurse, I could handle it on my own and do the wound care My daughter pipes up and says...well that will solve my ambidextrous problem (she is ambidextrous and sometimes has a hard time deciding which one to use) While many may view this as poor taste humor, it was exactly what I needed to ratchet down my anxiety levels and I highly appreciate what the staff did. There will be a letter to the head of their department forthcoming. |
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mlana
Pearl Clutcher
Posts: 2,525
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Post by mlana on Feb 1, 2017 22:58:33 GMT
My issue is the price we are now paying for a lesser policy than what we had in the past. Also, the number of headaches and the amount of time it has taken me to get DH and DS signed up. I was on hold for literally and hour and a half the other day trying to get our situation figured out. The person I was talking to said, and I quote, "I hate when I see this screen." I don't think she meant to say it out loud for me to hear, but still it was not something I wanted to hear. The condensed version of my issues: Apply for health plan.
Wait, wait, wait
Call and see what is happening - Application did not go through please reapply
Apply for health plan.
Wait, wait
Call- we need to reset your account since you moved and it looks like you have 4 applications open, please wait at least 24 hours before reapplying
Wait
Apply for health plan - get confirmation email
Call a couple days later, application processed sent to provider
Get a call from the county we used to live in - "You have no active applications, you have 4 applications from previous years, you can't get insurance through the exchange, let me see what I can do"
Call exchange - "Hate this screen" please hold for application specialist - hour and a half later, I need to leave so hang up
Get emails through out the week from person at old county - can't get through to anyone in the exchange.
Get confirmation letter in the mail
Get bill for plan we chose
Waiting for insurance cards, but still question if they will work on not. I started this is December, we think coverage will start today, but I will be making more phone calls to confirm. It really should not be this difficult. Have you contacted someone who sells insurance for living? Specifically someone who sells health insurance? We have Kaiser thru ACA. Before going thru ACA, we had a company policy with KP and we were told the price for 2016 was going to be $2500/month. I contacted the insurance agent who had originally set us up with KP, and she took care of everything for us. She filled out all the paperwork and helped me select a plan that not only took care of our needs but also came with a decent subsidy. When I was notified that last year's plan was changing and would cost half again as much for 2017, I called her again and, again, she handled everything. Our new is still with KP and has a few things different than last year's, but will still cover a lot. Again, we qualified for a decent amount of subsidy, though that will decrease if our business stays good. the longest part of signing up this year was me calculating which plan would work best for us, given our situation. She also walked us thru choosing a senior plan for my mom that will work both where she lives and where I am so she can visit me and have work done up here, where we have more (better!) doctors. Again, Laurie took care of all the sign up details. If you haven't spoken with an insurance professional, I urge you to do so. Laurie's services didn't cost us a dime and she's always available via phone or email for any questions I might have. Marcy |
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Post by Lexica on Feb 1, 2017 23:12:28 GMT
I also have Kaiser through ACA and I love it. I have frequent mandatory appointments due to my chronic pain issue, a lot of prescriptions due to the fibromyalgia, and everything is taken care of through Kaiser, right in the same building. It is the most convenient health care I have ever had. I started with Kaiser through my last place of employment and liked them enough to request them through the ACA signing up process. I don't know where you live, but if Kaiser is a possibility at all, I would check into it. They are awesome. There is a 24-hour urgent care a few miles from me and a new hospital a few miles in the other direction.
I am waiting to see what will happen with health care now before I decide where to move. I would gladly stay with Kaiser, but doubt I could afford it without supplemental help. Especially once my disability payments end and I am on straight social security.
I'm sorry you had such a traumatic hassle getting care for your daughter.
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Post by LisaDV on Feb 1, 2017 23:36:41 GMT
That sucks. I hate insurance. I would fight them if they don't want to cover it.
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Post by smalltowngirlie on Feb 2, 2017 1:10:57 GMT
My issue is the price we are now paying for a lesser policy than what we had in the past. Also, the number of headaches and the amount of time it has taken me to get DH and DS signed up. I was on hold for literally and hour and a half the other day trying to get our situation figured out. The person I was talking to said, and I quote, "I hate when I see this screen." I don't think she meant to say it out loud for me to hear, but still it was not something I wanted to hear. The condensed version of my issues: Apply for health plan.
Wait, wait, wait
Call and see what is happening - Application did not go through please reapply
Apply for health plan.
Wait, wait
Call- we need to reset your account since you moved and it looks like you have 4 applications open, please wait at least 24 hours before reapplying
Wait
Apply for health plan - get confirmation email
Call a couple days later, application processed sent to provider
Get a call from the county we used to live in - "You have no active applications, you have 4 applications from previous years, you can't get insurance through the exchange, let me see what I can do"
Call exchange - "Hate this screen" please hold for application specialist - hour and a half later, I need to leave so hang up
Get emails through out the week from person at old county - can't get through to anyone in the exchange.
Get confirmation letter in the mail
Get bill for plan we chose
Waiting for insurance cards, but still question if they will work on not. I started this is December, we think coverage will start today, but I will be making more phone calls to confirm. It really should not be this difficult. Have you contacted someone who sells insurance for living? Specifically someone who sells health insurance? We have Kaiser thru ACA. Before going thru ACA, we had a company policy with KP and we were told the price for 2016 was going to be $2500/month. I contacted the insurance agent who had originally set us up with KP, and she took care of everything for us. She filled out all the paperwork and helped me select a plan that not only took care of our needs but also came with a decent subsidy. When I was notified that last year's plan was changing and would cost half again as much for 2017, I called her again and, again, she handled everything. Our new is still with KP and has a few things different than last year's, but will still cover a lot. Again, we qualified for a decent amount of subsidy, though that will decrease if our business stays good. the longest part of signing up this year was me calculating which plan would work best for us, given our situation. She also walked us thru choosing a senior plan for my mom that will work both where she lives and where I am so she can visit me and have work done up here, where we have more (better!) doctors. Again, Laurie took care of all the sign up details. If you haven't spoken with an insurance professional, I urge you to do so. Laurie's services didn't cost us a dime and she's always available via phone or email for any questions I might have. Marcy I did contact some of the providers in our area and they said we needed to go through the exchange, and thise that are not part of the exchange were way too much for us. |
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It was on a Friday night and he was several states away, of course it was out of network! They ended up covering it. Worst they can say is no!
Told her she might have peripheral Smurfitis. We adore him. The older doc was just as good. Talked to her about school, asked her about college, gave sage advice. I told him I suspected Raynauds but as a nurse Im not allowed to diagnose per the state 
Thats a rare moment I intend to treasure for ever 
