reform

Mar 07, 2011

Just a rant.  I work for United Health Care, I have stated that before. .. I have been here 11 years next month.  My revision surgery wasn't even approved by my insurance, it's a direct exclusion on my plan.....I keep getting these updates on my email at work about a new EOB.  I have been ignoring them.  Why did I go look at it today and 7 months post surgery I have an additional bill from my surgeon for $32,000?  The hospital bill (which I assumed included the surgeon's bill since it never came separately) was over $84,000.  Granted, my surgery was a little out of the normal since it was a revision. (my initial surgery I paid for out of pocket). But, seriously?  $2,200 for anesthesia, $84,00 for the hospital and $32,000 for the surgeon?  Not including various labs and EKG prior to surgery, etc.  And they say INSURANCE is the problem?  No.  Insurance is NOT the problem.  Physician/Facility BILLING is the problem.  The allowable amount for that $32,000 bill was just under $5,000.  How can Usual & Customary (U&C) be $5,000 and you bill $32,000. Where is the discrepancy here?  Providers blame the insurance but the insurance is a company like everything else, and they are here to make money.  I said it before and I will say it again, your car insurance doesn't cover everything, why should your health insurance.  It's there for major catostrophe, major illnesses, it's not there to pay everything that goes wrong with your body, especially when it's self-inflicted.  Boob job is cosmetic, stop trying to get around it by saying that it's medically necessary if you want bigger, perkier boobs, pay for em.  Nose job is cosmetic, stopy saying it's a deviated septum and it affects your breathing.  If you want a prettier, cuter, smaller nose...pay for it.  LOL.  Pannulectomy after surgery is NOT cosmetic.  You lose 100 or 200 lbs and have skin hanging off your body, that is not cosmetic, that is medically necessary.  If you lose 60 lbs and have sagging skin and want it removed, that is cosmetic, pay for it yourself.  If the government would regulate what the providers could charge for services then there would be less out of pocket expense for services.  Why should the insurance companies be regulated but the providers charging these astronomical prices just continue to be able to keep over charging for their services without any type of regulation what so ever?  And, don't get mad if your insurance doesn't pay for bariatric surgery.....no one got you fat but you.  Don't say you have tried every diet and failed, because if you committed yourself to losing weight and were honest with yourself, you would lose the weight on your own.  Truth is, we just have no will power.  A lifetime of unhealthy eating habits are hard /impossible to break. If you can't diet and exercise down to your healthy weight and want bariatric surgery and your plan doesn't cover it...start saving your money.  It is my honest belief that this will be a mandatory benefit on everyone's surgery soon enough, since obesity is an epidimic in the US.  But, until then, keep trying your insurance and keep saving your money...this surgery is expensive.

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