Health Insurance Sucks

We should just do away with insurance.  Medical professionals should charge what they charge and if they charge too much then people just won't utilize their services.  This whole insurance schema is a fraud and a sham.  Both a fraud and a sham.

I am about to submit my medical claims to my insurance agency for the THIRD TIME.  The first time, they rejected them all saying that I was supposed to submit all the claims to a different arm of the company.  So, I reprinted EIGHT MONTHS of claims for mental health sessions to this other arm only to find out a month later that they were all rejected because the provider is OUT OF NETWORK and, thus, should have been processed by the original agency.  WTF?  Now, I get through to the original agency and they say the claims as I sent them the first time in September were NOT rejected, they were counted against my deductible, which, I was told, is $200.  But WAIT, these claims were counted against my OUT OF NETWORK deductible which is $5K, which no one told me and I didn't think to ask.

PLUS, although I sent in claims for January through August, the representative on the line only had records of February through part of June.  So, I have to sift through all these damn claims and get the right ones and send them in AGAIN.

All this so that I can get 30% refund on my mental health expenses over $5000.  That's going to be like $600.  Which, although still useful, is nothing compared to how much therapy costs.  I guess now that I'll be in-network, it'll all become a lot more affordable and less inconvenient.  That's one plus to switching therapists, I guess.

But really, what are these health insurance providers doing?  Really.  They've inserted themselves into the medical/mental health relationships between patients and doctors and for what?  Would the cost of hospitalizations and doctor's visits even BE that HIGH if it weren't for insurance companies driving down how much the doctors get?  I still don't understand how a therapist charges $190 to one person and then, with insurance, gets a $25 co-pay plus $98 for the session?  What's the motivation for a therapist to even BE in-network?  More patients?  But more patients means more headaches with forms and claims etc...  The whole thing gives me a headache.

Off to go do some printing out of claims forms now.

Leave a comment

Add comment