When Health Insurance becomes a ‘law’ with a penalty for not having it we expect that it will be handled fairly and based on what we are told. However, instead people are experiencing changes that are creating hardship and financial stress.
No-one can predict when an accident will occur or illness may strike changing life within minutes. We think this means our insurance will be what we need and appropriate security will be in place. American people were told how much better healthcare will be with more affordable costs and no loss of established doctors.
This was not true when suddenly people could not stay with a particular hospital and lost the care of doctors who were treating them. It was reported in the North East some people were required to drive over 2 hours to a hospital to be covered, instead of their local hospital. There have been significant changes regarding prescriptions. Some people have their prescriptions included in their general medical insurance while others have separate prescription insurance costs that consist of additional monthly premium, the co-pays and annual deductible.
I am going to list some examples that have been reported to me that are happening to people right now. This shows exactly how it is being handled below:
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There is an increase of failure to cover particular medications.Sometimes this can be challenged by a specific approval by the doctor to the insurance company or it requires an in depth appeal process involving the doctor and patient with lengthy paperwork, time limits for submission and questionable approval.
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Deductible has increased 300% for one person and co-pays have increased.
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A diabetic has been refused the one touch test strips, previously used for 16 years.
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A diabetic has been denied insulin and has to go through a step process first to see if it works.
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A patient has to pay for all ongoing regular blood work while insured.
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A patient is required to pay a new $174.00 deposit before being able to have a surgery.
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A patient with a powder medication went from $10.00 monthly to $80.00 monthly – the reason given by insurance is - a change of ‘tier’.
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Prescription costs for medications changing in price month to month varying unexpectedly.
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Medication ‘patches’ for acute injury pain denied while more harmful pill form is approved. Long appeal process for the patches to be approved. After being approved by Cigna Insurance to be covered, the cost was still over 200.00 for the prescription. A coupon from the doctor to guarantee cost of no more than $20.00 was rejected with the reasoning that Cigna insurance policy is listed under Medicare D ** even with separate premiums being paid for each and separate deductibles at the beginning of the year for each insurance**.
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Annual deductible increases, then it is added to most needed medication before regular medication co-pays set in, leaving most needed medication at high cost for one month (example $90.00)
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Patients on disability having to pay Medicare premium from their Social Security Disability check, additional monthly Insurance Premium up to $100 – 300 dollars for supplemental Health Insurance to cover what Medicare does not cover, Prescription Insurance Monthly premium for medications, Doctors co-pays, prescription co-pays and annual deductible.All combined, unable to sustain with disability income.
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Medication varying in cost wildly at the beginning of the year – the same medication fluctuating from $15.00 to $90.00.The insurance company claiming the cost is varying monthly ‘to them’, then states it is only varying during the deductible time frame.
There are also reports of many qualified doctors choosing to stop practicing medicine due to the complex changes that came about. People are having a more difficult time finding trustworthy doctors and productive treatment they are comfortable with. When people go to the emergency room, there is a set of costly tests put upon them, some of which may not be needed. Scans are being conducted and reports are not thoroughly discussed with the patient. Some patients choose to request a copy of the written radiology report to get the specifics. Often patients have to do a lot of work to track down answers because doctor’s offices are too over loaded to call back accordingly or keep track of their patient’s health fully. There is also serious lack of communication between physicians and specialists.
Health issues are stressful for anyone to experience. The additional changes coming about are creating financial hardships and the unknown is leaving it impossible for people to prepare accordingly as they are trying to heal. Many become stuck in a trap of stress hampering healing or increasing pain from chronic injury. Those who need help the most are suffering higher costs and yet are handicapped unable to work fully or at all to make up for the difference. Doctors are more interested to try giving medications than find the answer to an ailment or solution to cure the patient.
If you are experiencing costs or restrictions that you feel are unfair or harmful it is important to contact the appropriate people in your state. The community can also be notified contacting the editor of the local newspaper. We must not be taken advantage of or used to be tested in ways without proper care. We should be letting everything we can be known so there is not a false illusion for those who have not needed extensive help yet. We can communicate as best we can to let each other know what is happening while speaking up regarding any failures in the process.
Then we have this serious issue contributing to the problem:
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God Bless America
