Health Insurance: Friend or Foe?

Many of you in the US (and perhaps other countries as well) may face this same dilemma:  Your health insurance company is providing more barriers to care than it is providing the care that you pay for.  In my case, I have Blue Cross Blue Shield of North Carolina.  I have had an unbelievable number of claims be adjusted as “Out of Network” when the provider is in fact “In Network”.  Each explanation of benefits that I receive with the Out of Network judgement causes me to have to call them, and it’s usually a 45 minute to one hour conversation, with many transfers from one person to another.  Of course, if the care is judged to be Out of Network, this would leave me on the hook financially for most of the cost.

I am paying around $700 per month for this health insurance, and I can’t tell you how stressful it is to have to constantly be fighting Blue Cross Blue Shield of North Carolina to pay for what they are supposed to pay.  This is incredibly triggering, and without a doubt it makes my depression much worse.  I am getting to the point that I am afraid to seek the care that I need, because I am anticipating the ensuing fight with the insurance company to cover my care.

The latest issue is lab work.  I went to a lab that was on BSBCNC’s website as “In Network”, and I am now being billed for the lab work.  On a 45 minute call to Blue Cross Blue Shield of North Carolina, the person I spoke to tried to tell me that the problem was with my doctor who wrote the orders, and that I needed to contact him.  THIS MAKES NO SENSE.  If the lab work at that lab is In Network, it’s In Network!  I am to the point now that I want to hire an attorney to slap a suit on Blue Cross Blue Shield of North Carolina for all the emotional distress they are causing me.  What does it take to get the health care that the policy promises???

13 thoughts on “Health Insurance: Friend or Foe?

  1. $700? That is an outrage. The health system in our country is so screwed. The only ones who benefit? The insurance company. We’re their money trees. I’m so sorry you’re dealing with this crap.

  2. It is tragic that the United States spend 17% of its Gross National Product on healthcare, yet achieves no better health outcomes than many other developed nations like Germany, Sweden, or England. Most of these countries spend only about 8-10% of their GNP on health. But they do so much more efficiently and without overcharging patients in various ways. The US health care system is essentially a scam designed to benefit insurance companies, drug companies, hospitals, specialist doctors, and the wealthy. The healthcare systems in counties like Germany or Finland are so vastly superior to ours in terms of their efficiency that it is hard to even compare. The notion that our healthcare is better, more advanced, and so on is mainly a myth, in that average health care outcomes for many conditions are no better here than in other industrialized nations.

  3. Ohmygod. That is a crippling cost. And here I was thinking my coverage was expensive at R1300pm. But I’m in the same predicament – they tell me all chronic meds are covered. So I finally got to use them this month…. and guess what… fucking levies and co-payments in addition to my month fee. It makes no sense. They make the rules up as they go along. I had a whole tirade about big business and their conspiracies to make money off the disabled. They must have thought I was a right nutcracker. There’s already so much they DON’T cover – psych + phsychology consults, sleeping/anxiety tablets and lab blood work. It is fucking, fucking bullshit. Just because I’m poor, they think they can take advantage. Well, one day when they are reincarnated, I welcome them to experience my life. Dickheads. And we can’t even just say to hell with medical aid coverage, we’ll just go directly through the government hospitals. We can’t risk that – THEY RUN OUT OF LITHIUM, VENLOUR, VENLAFAXINE (all my meds). So what the fuck would I do?

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