Health insurance nightmare

[BTR]

Go to Oklahoma on 12/02 for a work conference. 12/05 I’m not feeling well. 12/06 I can’t breathe and go to the ER in Oklahoma. Flu turned into pneumonia then respiratory failure. On bipap 3 days. Took a week to get down from 6 liters nasal cannula. Hospital will discharge when I can do 2 liters or less. Well that happened this last Friday. Insurance processing closed over the weekend. Monday they get the order for temporary home oxygen. Deny, it came from the Oklahoma hospital which is out of network. Retry today. Denied again. Appealed. Oops, algorithm made the decision, just need primary doctor’s ok. She’s closed and tomorrow is Christmas. I fly home tomorrow but have to go straight to a local hospital as all I have is a portable concentrator for the flight which I had to buy out of pocket for $3300. Blue Shield.

 

[Tank]

YEP!!! There's a reason we gave up fighting blue shield for two years trying to get my wifes heart issue addressed. They kept denying a specialist, denying what she needed (surgery) we finally found a specialist in Athens and paid out of pocket. 100% success. Shown a HUGE spotlight on how broken the american medical system is. Owned by pharma, controlled by insurance companies, dr's are just shills. It's a business of fucking people out of money and business is good!!

I'm sorry to hear you're sick. Don't fuck around with Pneumonia. Real pneumonia will kill a mother fucker. Quick. I nearly died from it about 13 years ago. Pneumonia went sepsis and then pleurisy. kidneys shut down. Was not good at all.

Anyway, fuck insurance companies and the medical system. They're criminals. There's a reason people flock to various other countries for reproductive help, cancer treatment, cardio care, etc. US system is broken.

Get better.

 

[JFMFG]

Go to Oklahoma on 12/02 for a work conference. 12/05 I’m not feeling well. 12/06 I can’t breathe and go to the ER in Oklahoma. Flu turned into pneumonia then respiratory failure. On bipap 3 days. Took a week to get down from 6 liters nasal cannula. Hospital will discharge when I can do 2 liters or less. Well that happened this last Friday. Insurance processing closed over the weekend. Monday they get the order for temporary home oxygen. Deny, it came from the Oklahoma hospital which is out of network. Retry today. Denied again. Appealed. Oops, algorithm made the decision, just need primary doctor’s ok. She’s closed and tomorrow is Christmas. I fly home tomorrow but have to go straight to a local hospital as all I have is a portable concentrator for the flight which I had to buy out of pocket for $3300. Blue Shield.

Good god. Health insurance is predatory. Best of luck to you. Praying for a fast recovery.

 

[Mr. C]

Definitely sucks to hear.
Especially when you read they made 70 B Billion in profits last year.

 

[Xtrmwakeboarder]

Fuck the insurance companies. Legal scam artists.

Hope you’re on the mend and get this all sorted out

 

[poncho]

I never saw the shooting of that healthcare CEO as personal but more a barometer of how people feel, I know it's not the same but I pay good money for pet insurance and those cocksuckers fight me for every dollar.

 

[monkeyswrench]

Do you know anyone around who has a concentrator or bottle setup? We've had to do some hustling for a friend that ran into something similar. Fly a flag, someone may be able to help.

I hope the trip home is uneventful, and you feel better soon. Sucky holiday, but will be better at home.

 

[lbhsbz]

That reminds me of any dealings I had with my old insurance through work....everything was a gigantic pain in the ass.

I've had Kaiser for the last 5 years and I can't really come up with a single thing to complain about. They've been stellar. Even out of network, they paid a 1/2 million bill and approved whatever the docs asked for, whole thing cost me about $1600.

 

[HNL2LHC]

Best to you getting better and home. We have to pay out of pocket each MRI for the wife. At the last minute they typically cover it. Was just thinking that the issue was us for some reason. Looks like it is a bigger issue. Thanks Obama for starting the big F up in the system.

 

[CLdrinker]

Now all we need is a location

 

[4Waters]

Insurance CEO's and board of directors salaries should be capped and no bonuses allowed. If you want that shit then get out of Insurance.

 

[oldman]

Mom's on medicare We've been living the nightmare for 12 months now, On Hospice off of it, Dr's calling for procedures only to have them denied.

81 years old and triple bypass 15 years ago, it's a struggle every day.

I feel your pain

 

[Singleton]

Insurance CEO's and board of directors salaries should be capped and no bonuses allowed. If you want that shit then get out of Insurance.

BoD salaries are limited. Public companies average 125k a year. The lowest is around 75k a year, up to 500k, plus travel expenses. Currently working with a search firm for BoD potential. My landing spot is the audit committee.

Some allow RSU’s and stock options, but most organizations limit that.

 

[Wedgy]

Hope and pray Y'all get on the mend and get the insurance squared away.
Whenever you may be. Hold each other tight. Pray hard. On the prayer chain.
Dominate. Christmas and 2025.

Medicare/Humana in Lubbock West Texas. We have lots to be thankful for, the excellent medical care here is a godsend.

The reaching out signal flare is a great idea. Who we are, and what we do.
Go to Inmate hotline, engaged. Good one Kevin. I don't have a clue.

I do know UHC, BC/BS, Osamacare suck. Didn't do squat about price. Fed takeover of 20% of the economy.
15% cap on administration costs. Talked to many foreign folks, chickens in the background. Interesting talking about the Philippines though. Big Pharma? Gŕr.

 

[Xtrmwakeboarder]

BoD salaries are limited. Public companies average 125k a year. The lowest is around 75k a year, up to 500k, plus travel expenses. Currently working with a search firm for BoD potential. My landing spot is the audit committee.

Some allow RSU’s and stock options, but most organizations limit that.

Dream “job.” That’ll be my retirement deal. At my last public company they were getting $300k for 4 meetings.

 

[OldSchoolBoats]

YEP!!! There's a reason we gave up fighting blue shield for two years trying to get my wifes heart issue addressed. They kept denying a specialist, denying what she needed (surgery) we finally found a specialist in Athens and paid out of pocket. 100% success. Shown a HUGE spotlight on how broken the american medical system is. Owned by pharma, controlled by insurance companies, dr's are just shills. It's a business of fucking people out of money and business is good!!

I'm sorry to hear you're sick. Don't fuck around with Pneumonia. Real pneumonia will kill a mother fucker. Quick. I nearly died from it about 13 years ago. Pneumonia went sepsis and then pleurisy. kidneys shut down. Was not good at all.

Anyway, fuck insurance companies and the medical system. They're criminals. There's a reason people flock to various other countries for reproductive help, cancer treatment, cardio care, etc. US system is broken.

Get better.

Couldn't have said it better.

 

[Andy B.]

Take care get well quick!!!

 

[beerrun]

Go to Oklahoma on 12/02 for a work conference. 12/05 I’m not feeling well. 12/06 I can’t breathe and go to the ER in Oklahoma. Flu turned into pneumonia then respiratory failure. On bipap 3 days. Took a week to get down from 6 liters nasal cannula. Hospital will discharge when I can do 2 liters or less. Well that happened this last Friday. Insurance processing closed over the weekend. Monday they get the order for temporary home oxygen. Deny, it came from the Oklahoma hospital which is out of network. Retry today. Denied again. Appealed. Oops, algorithm made the decision, just need primary doctor’s ok. She’s closed and tomorrow is Christmas. I fly home tomorrow but have to go straight to a local hospital as all I have is a portable concentrator for the flight which I had to buy out of pocket for $3300. Blue Shield.

Are you on a PPO or HMO plan? Contact your providers office, they are required to have a backup. Contact BS and request a case manager.

 

[n2otoofast4u]

I don’t wish any of that shit (insurance or concentrator) on anyone! My mother (RIP) moved in when she was late stages with pulmonary fibrosis and we fought with trying to get oxygen what seemed like daily.

To the OP, I googled the concentrator she had and was able to buy one directly for almost half what the vendor wanted. Hope you don’t need it long term and are able to get back to normal quickly!

 

[Singleton]

Dream “job.” That’ll be my retirement deal. At my last public company they were getting $300k for 4 meetings.

Based on the last six months of working with search firms, it is a ‘who you know‘ or ‘who knows your name’ position.
I am currently going through legal approval at my current company to sit on boards. Already have approval for charity orgs, but public companies require an entirely new round of approvals. For me, that requires CEO approval after legal clears it.

 

[Sleek-Jet]

On their 990, the Blue Shield board doesn't make a whole lot, maybe $10k a year. Doesn't sound that lucrative to me. Not for profit boards usually don't get much for director compensation.

 

[TimeBandit]

People talk shit about Kaiser, but I have yet to be denied anything. Blue cross was always a battle.

Delta dental, well they suck. They have denied my wife's last two claims for no reason. Yes it's covered, No we will not cover it?

 

[BabyRay]

Blue Cross is fine if it’s a Medicare supplement plan. They don’t get to make decisions, as they have to cover anything that Medicare allows, and Medicare has never denied anything.

I had Kaiser for a few years, and I’ll agree they were very good. The only problem, which may have been a local one, was that all of their doctors were fresh out of school. That’s maybe not all bad, but sometimes their inexperience showed. I will say Kaiser didn’t shy away from ordering and allowing every test needed. I left them only because for Medicare patients, they offer only Advantage plans, not Supplements.

 

[oldman]

People talk shit about Kaiser, but I have yet to be denied anything. Blue cross was always a battle.

Delta dental, well they suck. They have denied my wife's last two claims for no reason. Yes it's covered, No we will not cover it?

I've have Kaiser most of my life, and when my son was born at 1 lb 9 oz, they put him on a ventilator, My Dad was working for bird Medical, (at the time they were cutting edge with infant ventilators) He assured me Kaiser was buying some of the most state of the art equipment available, I was able to confirm that with the NICO at the time, We joke the kid was a million dollar baby that cost us a $5 copay at the time.

But if you don't have some kind of a supplement, and are just on Medicare your getting the last course of action care, In our case that's where mom is, I've never dealt with Blue Shield, I hope OP has sorted it out, not getting proper care because of paperwork is not right.

 

[BTR]

Update to the ongoing saga. It appears the oxygen concentrator I bought to fly home is not suitable despite FAA approval shit all over it. Flights are too long for the standard battery in the oxygen concentrator and the big battery I purchased that would last the duration is too powerful for air travel. They count flight time from gate to gate including layover where I can charge the small battery back up. Both Southwest and American said no go. Looks like I will be renting a car and driving for 3 days once I buy something with constant flow for sleeping.

 

[4Waters]

People talk shit about Kaiser, but I have yet to be denied anything. Blue cross was always a battle.

Delta dental, well they suck. They have denied my wife's last two claims for no reason. Yes it's covered, No we will not cover it?

Blue cross PPO was great until obama fucked up the healthcare system. I never thought killer kaiser would end up being the best healthcare you could get.

My biggest gripe with kaiser is they just want to put you on meds instead of running labs to find an issue.
I work construction, go to the gym and am pretty active in general but yet I can't lose weight until I'm under 800 calories a day, they want to put me on ozempic and I want them to run labs to check testosterone, thyroid, cortisol...... levels and they just say ozempic is easier. I'm not on ozempic and I'm not going to either, I'm just going to starve the rest of my life I guess.

 

[DarkJuJu]

Sorry to hear, what a shitty way to deal with the holidays. I had something very similar, same conditions for hospital release ect, was on o2 for 3 months ~. Just a warning try to avoid as much altitude as you can, I recall trying to go from Phoenix to Flagstaff (8k elevation I think) and I was on a portable o2 tank, once I got to Camp Verde, about half way and 4k elevation I had a real hard time needed to take a good long break before I could make the rest of the trip. Of course I was hauling a 5th wheel and not going that fast to begin with. I am guessing your going to be coming through Albuquerque and Flagstaff if your in So Cal, just plan to take it easy or take breaks as you climb if your starting to feel wonky.

 

[monkeyswrench]

Sorry to hear, what a shitty way to deal with the holidays. I had something very similar, same conditions for hospital release ect, was on o2 for 3 months ~. Just a warning try to avoid as much altitude as you can, I recall trying to go from Phoenix to Flagstaff (8k elevation I think) and I was on a portable o2 tank, once I got to Camp Verde, about half way and 4k elevation I had a real hard time needed to take a good long break before I could make the rest of the trip. Of course I was hauling a 5th wheel and not going that fast to begin with. I am guessing your going to be coming through Albuquerque and Flagstaff if your in So Cal, just plan to take it easy or take breaks as you climb if your starting to feel wonky.

Yes, be careful! From Winslow to Flag, then down to Seligman. 5k to just shy of 8k, then back down to 5 again. A year ago my buddy was hospitalized in Kingman for some lung infection. After 3 weeks, was released and drove home to Missouri. He said in Flag he felt like he'd just smoked a carton of cigarettes.

 

[Bobby V]

People talk shit about Kaiser, but I have yet to be denied anything. Blue cross was always a battle.

Delta dental, well they suck. They have denied my wife's last two claims for no reason. Yes it's covered, No we will not cover it?

I have had great experiences with Delta Dental and BCBS PPO. Knee surgeries, cataract surgeries, plenty of dental work and cleanings with no issues. Same primary doctor and dentist for over 25 years. $400 deductible and $4K out of pocket. Hopefully Medicare will be this good when I turn 65 in July.

 

[propcheck]

Did somebody say they are having trouble with healthcare claims?

 

[lbhsbz]

Update to the ongoing saga. It appears the oxygen concentrator I bought to fly home is not suitable despite FAA approval shit all over it. Flights are too long for the standard battery in the oxygen concentrator and the big battery I purchased that would last the duration is too powerful for air travel. They count flight time from gate to gate including layover where I can charge the small battery back up. Both Southwest and American said no go. Looks like I will be renting a car and driving for 3 days once I buy something with constant flow for sleeping.

Can you just get a couple oxygen cylinders to get you home on the plane?

 

[BTR]

Can you just get a couple oxygen cylinders to get you home on the plane?

Cylinders not allowed at all. If that was the case; I’d be home already.

 

[BTR]

Ok, I’m man enough to admit it. I was seriously afraid of flying on battery powered oxygen. Was really cutting it close flight time vs battery life on a low dose not to mention the low air pressure inside the cabin that may have required an increased dose.


Although long and boring, I feel great relief and optimism about driving home. I think things work out for a reason. Maybe not flying is my little Christmas miracle. Not a religious man as far as institutions go but I do believe in a guiding force that we will never understand. Something steered me to this way home. Wife is flying out tonight. We hit the road tomorrow.

Merry Christmas

 

[BabyRay]

Update to the ongoing saga. It appears the oxygen concentrator I bought to fly home is not suitable despite FAA approval shit all over it. Flights are too long for the standard battery in the oxygen concentrator and the big battery I purchased that would last the duration is too powerful for air travel. They count flight time from gate to gate including layover where I can charge the small battery back up. Both Southwest and American said no go. Looks like I will be renting a car and driving for 3 days once I buy something with constant flow for sleeping.

Man, I’d consider just staying where you are for a while. I was hospitalized in Ohio for blood clots, and after getting out of the hospital, I stayed in a hotel for a week, until I was released to fly. No way did I want to drive all the way to western Washington when I felt like crap. Adding concerns about the reliability of an oxygen device and its batteries would definitely be a deal breaker.

 

[yz450mm]

Blue cross PPO was great until obama fucked up the healthcare system. I never thought killer kaiser would end up being the best healthcare you could get.

My biggest gripe with kaiser is they just want to put you on meds instead of running labs to find an issue.
I work construction, go to the gym and am pretty active in general but yet I can't lose weight until I'm under 800 calories a day, they want to put me on ozempic and I want them to run labs to check testosterone, thyroid, cortisol...... levels and they just say ozempic is easier. I'm not on ozempic and I'm not going to either, I'm just going to starve the rest of my life I guess.

Schedule your annual physical that includes all the blood work, and make sure that you ask the doctor at the time to include testosterone and anything else that can be checked. Then use that as your baseline, I bet your testosterone is low.

If you're in the two or 300s, don't bother going back to Kaiser cuz they won't approve testosterone replacement therapy. Just go with one of the independent places, it costs a little money but it's easier than fighting with your primary Dr because you don't meet the 200 threshold.

 

[LazyLavey]

Insurance CEO's and board of directors salaries should be capped and no bonuses allowed. If you want that shit then get out of Insurance.

or how bout require congress and other politicians to use the same health ins options as their constituents ... might see some changes

 

[DarkJuJu]

Cylinders not allowed at all. If that was the case; I’d be home already.

Correct, that is actually what took down the flight over the everglades like 20 years ago (empty o2 generators) . Some mechanic at a airframe repair facility I might have worked at in the 90s left some in the aircraft after a C or D check.

 

[monkeyswrench]

Some of the concentrators have 12v power options to run and recharge in the car. I'm 1.5hrs from Flag, and 45min from Ashfork. Holler if you need something coming through!

 

[LazyLavey]

Blue cross PPO was great until obama fucked up the healthcare system. I never thought killer kaiser would end up being the best healthcare you could get.

My biggest gripe with kaiser is they just want to put you on meds instead of running labs to find an issue.
I work construction, go to the gym and am pretty active in general but yet I can't lose weight until I'm under 800 calories a day, they want to put me on ozempic and I want them to run labs to check testosterone, thyroid, cortisol...... levels and they just say ozempic is easier. I'm not on ozempic and I'm not going to either, I'm just going to starve the rest of my life I guess.

Had physical last year.. Dr didn't check T. I'm nearly 70, typical loss of energy and typical symptoms of "getting older".. I guess it's very common for GPs to not run T levels for a typical physical check up.

If you're interested, Simi Valley Gameday will run your T and PSA levels and chat with their physician.

No charge for initial consultation, No pressure ..