Forums
New posts
Search forums
What's new
New posts
New profile posts
Latest activity
Internet Search
Members
Current visitors
New profile posts
Search profile posts
Log in
Register
What's new
Search
Search
Search titles only
By:
New posts
Search forums
Menu
Log in
Register
Install the app
Install
Forums
General Discussions
The Watercooler
This is why healthcare costs are so ridiculous
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Reply to thread
Message
<blockquote data-quote="CrazyinVA" data-source="post: 367062" data-attributes="member: 1157"><p>Oldest used feeding tubes for about a year at age 12 because of her Crohn's. Luckily, my insurance covered the tubing/bags/pump 100%. They would not, however, cover the nutritional liquid that went into the pump, which at the time was about $10 a can (she used 4 cans a night, 7 nights a week). They told me the reason was that if she did not need the tube 24/7 (she did her feedings overnight), it was considered a "nutritional supplement" and was not covered by my plan. Never mind that being on the feeding tube at night kept her out of the hospital for all that time, saving them thousands upon thousands of dollars. Fortunately, my self-insured employer at the time was a healthcare supply distributor, and we actually carried that product in our warehouses. So, they basically shipped it to me and wrote off the cost. Talk about lucky. </p><p></p><p>We also ran into issues with another Crohn's medication ... the "recommended dosage" for a 30 day supply , according to the insurance company, was less than what her dr. prescribed, therefore they wouldn't cover the difference (i.e., she was taking 3 pills 3 times a day, they said they would only cover 2 pills 3 times a day). I ended up fixing that by getting samples from the doctor, but we cut it close a couple of months.</p><p></p><p>Then there was the icing in the cake, the insurance company having no pediatric psychiatrists on their list of providers, and telling me, no joke, that Oldest "didn't really need a child psychiatrist," an adult psychiatrist could treat her just as well. I raised enough of a stink over THAT, that they let me go out of network. </p><p></p><p>These situations were all a long time ago, but I don't think the system has changed much (other than perhaps the child psychiatrist angle). I don't get how non-medical people make medical (and psychiatric) decisions at insurance companies. It baffles me.</p></blockquote><p></p>
[QUOTE="CrazyinVA, post: 367062, member: 1157"] Oldest used feeding tubes for about a year at age 12 because of her Crohn's. Luckily, my insurance covered the tubing/bags/pump 100%. They would not, however, cover the nutritional liquid that went into the pump, which at the time was about $10 a can (she used 4 cans a night, 7 nights a week). They told me the reason was that if she did not need the tube 24/7 (she did her feedings overnight), it was considered a "nutritional supplement" and was not covered by my plan. Never mind that being on the feeding tube at night kept her out of the hospital for all that time, saving them thousands upon thousands of dollars. Fortunately, my self-insured employer at the time was a healthcare supply distributor, and we actually carried that product in our warehouses. So, they basically shipped it to me and wrote off the cost. Talk about lucky. We also ran into issues with another Crohn's medication ... the "recommended dosage" for a 30 day supply , according to the insurance company, was less than what her dr. prescribed, therefore they wouldn't cover the difference (i.e., she was taking 3 pills 3 times a day, they said they would only cover 2 pills 3 times a day). I ended up fixing that by getting samples from the doctor, but we cut it close a couple of months. Then there was the icing in the cake, the insurance company having no pediatric psychiatrists on their list of providers, and telling me, no joke, that Oldest "didn't really need a child psychiatrist," an adult psychiatrist could treat her just as well. I raised enough of a stink over THAT, that they let me go out of network. These situations were all a long time ago, but I don't think the system has changed much (other than perhaps the child psychiatrist angle). I don't get how non-medical people make medical (and psychiatric) decisions at insurance companies. It baffles me. [/QUOTE]
Insert quotes…
Verification
Post reply
Forums
General Discussions
The Watercooler
This is why healthcare costs are so ridiculous
Top