Getting HOSED by my health plan - anyone else?

[fauxgypsy]

When we looked at an Advantage plan for Dale, it looked like it would convert Medicare into a really bad private insurance. We were told to look for a supplement plan instead. I have my insurance through the state (administered through Blue Cross) and it is a constant argument to get prescription filled. The other day I received a notice from them that they weren't going to pay for my last PET scan (about 5300 dollars) because they deemed it medically unnecessary. I will have to appeal them and fight for it. I am not sick at this point but I have been and I wonder why I wanted insurance so much when they are one of the biggest sources of stress in my life.

[hutchibk]

Sounds like Medicare... telling me and/or my doctors that they won't pay for certain things because "they are not medically necessary" ~ welcome to rationing and expect it to increase outrageously until the end of time. Rationing will kill cancer patients, as it's designed to.

[pibikay]

Re my ealier post in this thread. The tpa has informed we areot eligible for reimbursement of tykerb abd xeloda as they were not
administered in the hospital by refering to some small prints.I am thinking of approaching the insurance ombudsman

[DianneS]

I used to live in the States. I was born there, but became a Canadian citizen several years ago.

It makes me sad and angry to see people fighting to get medical coverage or having premiums increased due to illness. That's the last thing a person needs when they are sick.

Here in British Columbia, Canada, my husband and I pay $109 per month for both of us. That covers all medical expenses. Lab, hospital, x-rays, everything. There is no co-pay. There is no deductible. There are no forms to fill out. Ever. I think this is a reasonable amount to pay. It is based on a sliding scale as well. Also, I have never waited for care. I know that's a popular myth perpetrated in the US but it's not true, at least where I live. We can choose which province we want to have care in if a specialist happens to be out of province. That's a huge benefit and it's free.

National socialized healthcare is definitely the way to go, having experienced the alternative for most of my 50+ years in the US. When we lived in the US, we paid for co-pays and that 20% added up. When I broke my shoulder in 2003 in the US (I was still living there) I had to wait 6 hours!! in ER for care before they even looked at me. That is inhumane. For comparison, when I broke my wrists in Canada and was not even a resident or citizen yet, the hospital took me right in. No questions asked. No forms to fill out. And I never got a bill.

I hope there are some real solutions to the medical issue in the US because what you have isn't working. I have a daughter living there and I worry about her not getting medical care because she can't afford the co-pays. People, not money, have to come first.

Best of luck to you, my heart goes out to all of you!

Dianne

[hutchibk]

So, back to Steph's original post... hope you check in and see some experiences and solutions.