Originally Posted by
Timbo
My 14yr. old daughter broke a bone in her foot last year at gymnastics practice, so I take her to the ER, Xrays show the break, they put her in a hard cast for a month, then the inflateable velcro boot.
Then I got a bill for over $2,500, for the ER, the Xrays, the cast, and get this, the boot...that alone cost $375!!
We had a baby early last year, that meant for the rest of the year every sick visit was paid in full by us and my son hit his deductible so that was $1000 there. Then my daughter had an ER visit, $1500 and we owed $950. I think between all our visits we paid $3K or $4k out of pocket before you count premiums.
It'd been half that if the Children's Urgent Care center hadn't told us (10 minutes to closing) that we needed to go to the ER and have a plastics guy repair it. We went to the ER guy did it, not plastics. The trip was unnecessary.
Suspicious? yes.
Now I have a huge bill coming because my son had a respiratory virus. Required an ambulance ride... $$$$$$... and multiple days in the hospital.... $$$$$$... every doctor that saw him said he looked good but he had to sleep the night without ever having O2. So they'd keep him for days to wait and see.
The double whammy hits you though in that when a dependent or spouse is in the hospital you have to PD. So not only on our insurance are you going to get hit by a sky high bill but you also lose income and have to go to the bank.
I think if a spouse or a dependent is hospitalized, easy to verify, it's a sick call.
Originally Posted by
Bucking Bar
It is very bad that we have only one option other than those administered by UHC.
UHC knows they do not have to compete for our business. UHC knows they've lobbied and gotten exemptions to regulation, which makes them immune to our attempts to get help from the Agencies which should ensure this is a fair exchange between consenting parties.
UHC does not just suck. They're unaccountable and know from their position of monopoly power that you're impotent to do anything about their malfeasance.
Under law, you should be able to get a copy of your policy and review it. With UHC, they will claim their contract is with Delta, not you. Therefore they do not have to respond to you. That leaves you dealing with a department at Delta which mostly does not exist after bankruptcy. Further, I'd guess you put your career at some jeopardy when you finally find someone over there to talk to (who is also powerless to challenge UHC) and get angry.
In our case, UHC's coverage was worse than having none at all. Our kid's bill was 400% higher because of the in network contract UHC has with our local hospital. UHC could not explain why their contracted rate was so high. Further for one procedure the "out of network reasonable and customary cost" was $374. "In Network" that same "reasonable and customary cost" was a little over $1,800.
UHC refused to let me see any of the contracts. I refused to pay the higher version of "reasonable and customary." Eventually the CFO of the Hospital was fired and his replacement proudly posted on his Facebook page the news of his promotion and his election as President of his Neighborhood Association. With that information I informed him that I would have a process server deliver my lawsuit to him at his neighborhood's Christmas Party.
We should not have to resort to jerk moves like that to avoid getting ripped off, but since we don't have the ability to lobby congress, a guy's got to be creative to ensure fairness.
To make sure I have this right, imo it sounds like UHC likes to get it's hand in the Delta money pie and take as much as you can which is a benefit to UHC and the hospital and a loss to Delta. The only problem is we pay a huge portion of that, so they're screwing us and our employer.