neil

The only way I think to deal with these things where you know that it's out of network and call them about it beforehand is to get an approval number. If you kick up enough fuss they will often change their minds on stuff too.

Ash UK/US

I didn't get an approval number but I did get the name of the person I talked to etc and wrote them a letter saying I had called blah blah blah and still refused to cover it. It ended up costing $90, not that it broke the bank but that wasn't the point.

Jerseygirl

I had bloodwork done...received a bill from the insurance company for $200 for one of the tests my doctor had requested. I called them and they said in their opinion the test wasn't necessary.

lj2

What was the end product of this dispute? Surely they can't penalise you for this as you aren't a medical expert... Surely it's up to the doctor treating you, who knows your case as to what he needs done...

Giantaxe

What makes me laugh is such situations are so commonplace, yet Americans think "socialized medicine" is evil incarnate.

Redwing

I had a similar experience, so I filed a complaint with the state health commissioner. Insurance paid.

Jerseygirl

I had other things going on at the time...so very out of character for me I let it drop and paid it.

Well done.

scrubbedexpat091

They compare it to the Canadian system typically and well up here its not that grand, yeah every is covered for basic health care but to actually get that care can be difficult and time consuming depending on what you need done.

Prescriptions are not typically covered, vision not covered for most etc.

In an emergency it would be grand, but for day to day health care its a royal pain in the arse depending on where you are due to lack of doctors and other health care workers and budget constraints.

Janek66

Not only that....one of the first things Reagan did back in the 50's was start a campaign daemonizing Socialized Medicine.....put the fear of god in to the American people by saying how long we had to wait for a bed etc etc....

As for this .....I had bloodwork done...received a bill from the insurance company for $200 for one of the tests my doctor had requested. I called them and they said in their opinion the test wasn't necessary.......so full of their own self importance!

Ash UK/US

I had a similar thing happen to me, I got a bill for $400 from the lab, argued it out with my insurance company. They paid $40 and the rest of written off as network 'discounts. :curse:

hobbes79

Thing that ROYALLY pisses me off about my coverage is stuff they just decide isn't covered. And these are the sort of notifications we get when this happens in our "itemized" bill:

MEDICAL SERVICES $200
MEDICAL SERVICES $67
MEDICAL SERVICES $132
MEDICAL SERVICES $34*
MEDICAL SERVICES $45

* This isn't covered by your insurance

Errr, well I'll be buggered if I know what that was!? We're with Blue Cross, and are pretty good, but that just irritates the flying crap out of me!!

Giantaxe

I'm convinced they reject stuff of the flimsiest of pretences knowing full well that some people won't pursue it. Nearly every non-primary care claim I've had in the last year has involved me having to argue with my insurer to get them to pay something or other.

Ash UK/US

I scrutinize every single statement/bill. I have found several errors, I also have thought a lot of people miss it or don't bother sorting it out. Funny there is never errors in my favor