Employer provided Insurance

Is it just me, or is insurance MUCH harder to navigate than 10 years ago?

I am trying to schedule some minor surgery and a few tests prior to it, and WOW, the amount of phone calls, website research, and emails back and forth is crazy. I have to do the things/communication that the Dr office or insurance company used to do. Does my insurance just suck, or is it all like this?

I work for a small not-for- profit agency. But I have always worked in non-profit, so that’s not new. ?

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Insurance is harder to navigate. Pre-approval is required for many things. Hospitals have no clue of what insurance covers, so they want to cover their butts to make sure they get paid. There is a sign in my doctor’s office that says in plain English that insurance is a contract between you and your insurance company. It is up to you to find out what your insurance covers and what your out of pocket costs will be. You will be held responsible for any service that they do not cover.

This, of course, is covered in the paperwork you sign for treatment, as well.

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Yes, at this point I am feeling like I should either get paid for all these hours on the phone, or get a discount!
I’m dreaming, I know.

KellyfromKeene i so agree with you

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Navigating insurance is challenging. There are many things that require pre-approval. Hospitals want to cover their butts in order to ensure that they are paid because they have no idea what insurance covers. My doctor’s office has a sign that explains in plain language that insurance is a contract between you and your insurance provider. You are responsible for learning what services your insurance covers and how much you will have to pay out of pocket. If they do not cover a service, you will be liable for it. basketball stars

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Not only is it difficult to navigate, but for a lot of people the cost keeps going up too. My wife had a great plan that her and my son were on and her work was grandfathered into but they finally got rid of that plan entirely which doubled the cost of the insurance!

Medical insurance has always been something I have just not had because I am relatively healthy and don’t visit the doctor unless something serious is wrong, but I just had to sign up for insurance so I could get my son insurance as well.

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i have to agree with you i have Medicare and the prices keep going up and the co-pays are high for special doctors wish we could all get better coverage

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@kellyfromkeene Definitely not you! Last month, I spent nearly a day on the phone over five different phone calls just trying to navigate whether my insurer would pay for a name-brand medication because the generic was back-ordered. I almost cried when they asked me for the fifth time in a day whether there had been any changes to my health status since we last spoke. Nope, not in the last hour to my knowledge…

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I’m struggling with this now. I don’t want to get into the details since I’m still appealing and will likely need to get a lawyer involved but it’s been awful. Insurance should be there for you when you need it. I’m not used to the insurance trying to interact with me like I’m a medical student and it’s infuriating how much they are interfering with my doctor/specialist course of treatment. I hope everything worked out for you @kellyfromkeene.

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I am still dealing with this! Unbelievable. I have to work at it for awhile then step away. I am grateful for the coverage I do have, and just plugging along to take of of what I need to. It will get done. My Dr and I now commiserate on how the insurance companies have taken over medical care.