Question about self pay? - Page 2 - ThinnerTimes

VanessaSFL · 06-11-2008, 05:44 PM

They sure can & they sure do.

Make sure there are zero road blocks with your insurance.Sometimes it is not your insurance but whether your employer wanted to include the benefit.

Parts Guy · 06-11-2008, 06:31 PM

Thanks for the comments everyone.

My employer apparently has excluded this type of surgery from there policy with there insurer. They have told me over the phone that even if I was going die the following day with out the surgery they still would not cover the surgery because my employer has excluded it from the policy. I am sure you can imagine how I feel about this when my coverage is over $600.00 a month for my family. To put the cherry on the cake my wife and I had our second child in April and my out of pocket expenses are already nearing 5K for "deductibles" and "coinsurance". I lose more faith every day in where we are headed.

The American people are getting rail roaded with regards to health care in general. I mean for gods sake we are the most powerful and richest country in the world but there are people that die every day here due the fact they are denied care and procedures because of the almighty dollar. It is disgusting and dis heartening to say the least.

Bob

BuCwiLd · 06-11-2008, 06:37 PM

Quote:

Originally Posted by Parts Guy

Thanks for the comments everyone.

My employer apparently has excluded this type of surgery from there policy with there insurer. They have told me over the phone that even if I was going die the following day with out the surgery they still would not cover the surgery because my employer has excluded it from the policy. I am sure you can imagine how I feel about this when my coverage is over $600.00 a month for my family. To put the cherry on the cake my wife and I had our second child in April and my out of pocket expenses are already nearing 5K for "deductibles" and "coinsurance". I lose more faith every day in where we are headed.

The American people are getting rail roaded with regards to health care in general. I mean for gods sake we are the most powerful and richest country in the world but there are people that die every day here due the fact they are denied care and procedures because of the almighty dollar. It is disgusting and dis heartening to say the least.

Bob

wow man my heart goes out to you.. does your wife work and if so have you tried to join her insurance? We are powerful but we are no longer the richest our dollar is of lower value than even the canadian (and they have universal coverage)

Parts Guy · 06-11-2008, 06:46 PM

My wife is staying at home until our newest child is 1 year, we looked at child care for him and his brother together and it was almost a wash when you consider her earnings against child care payments. We live ok on my paycheck but I do not have 30+k laying around so I going to have to credit card the whole deal and hopefully be able to make the payments.

I am also looking into a 401k loan at this point, I am just concerned about how I am going to make the payments with that kind of outlay. God forbid I do not have any complications because my insurance will apparently not cover anything related to the surgery at all. I tell you it gives me a really worm fuzzy feeling when I think about it.

Bob

BuCwiLd · 06-11-2008, 06:50 PM

Quote:

Originally Posted by Blue eyed G

Oh yes, I know many people that have been denied, so they have to appeal.

looks like im gonna have to get my boxing gloves ready then

Parts Guy · 06-11-2008, 07:36 PM

Quote:

Originally Posted by BuCwiLd

looks like im gonna have to get my boxing gloves ready then

Call your insurance company and find out if the procedure is "excluded" from the policy by your insurer. I was told that I could not appeal, the they do not cover it. End of story.

Oh well I probably charge the whole damn thing on my cards then file bankruptcy and start over. At least I will be healthier.

BuCwiLd · 06-11-2008, 07:41 PM

you can see my story on the 3rd page of this thread

Denied again!!!!

frances · 06-11-2008, 09:06 PM

Quote:

Originally Posted by Parts Guy

Thanks for the comments everyone.

The American people are getting rail roaded with regards to health care in general. I mean for gods sake we are the most powerful and richest country in the world but there are people that die every day here due the fact they are denied care and procedures because of the almighty dollar.

Bob

Then they are going to the wrong emergency rooms for their care. If a hospital accepts federal monies (i.e. Medicare) or state monies (Medicaid) it is ILLEGAL to refuse care to anyone. If there is a situation where someone is dying and a public hospital refuses care, they have ONE HECK of a lawsuit on their hands.

AS a matter of fact there was a case recently (Martin Luther King Harbor) in LA where they did not treat a woman and she died. Now they didn't necessarily deny treatment for money, but she still died. That hospital since lost its Medicare CMS contract and since has actually been closed.

They were found (not in the case I cited) to have violated the EMTALA law which is a basic law that says if someone has an emergency you MUST treat them. Then you can transfer them elsewhere after the emergency is over.

I guess you can tell that I work for a hospital so I get a little concerned when I hear that people think hospitals turn people away for not having a way to pay. If it is a TRUE emergency, and they are a public hospital - that simply isn't true.

And no, I am not a clinical person, just familiar with hospital rules and regulations dictated by the government.

BuCwiLd · 06-11-2008, 09:12 PM

yes they are obligated to provide care, but you will be bakrupt afterwards

Olusha · 06-11-2008, 09:24 PM

I was self pay but since I had my surgery done in Mexico, it was only $13,000. I saved an extra $1500 for complications because they said that was the average extra cost in case there were any.

I just crossed my fingers, said a prayer and hoped I didn't end up bankrupt.