Thread by @mommehK

An insurance story:

I was scheduled for an MRI yesterday. Last Friday I was told insurance had denied it because of no proof received about having done physical therapy & injections for at least 6 weeks. I've done them for 3 months. Asked the records to be sent over.
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The imaging center said they'd submit those records to the insurance to reconsider & would contact me if there were any issues.
Friday afternoon they left me a VM saying insurance was checked and my payment would be ~$650 (I have a $1k deductible).
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Around 2p yesterday, imaging center leaves a VM saying insurance was denied & I needed to either reschedule or make alternate payment plans.

30mins on the phone with them & they couldn't tell me what happened. Said they could resubmit but it'd take another week.
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I'm in enough pain (neck & arms) that I didn't want to wait a week when my appt was in 2hrs, so I asked about self pay.

Insurance: $648.74
Self pay: $585.00

Yeah, you read that correctly.
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I pay a few hundred dollars a month for insurance. (I chose a higher coverage otherwise my company pays 100% premiums).
My company also pays that much for my insurance.
I owe $1000 before insurance kicks in for the year.
I owe 20% of the bill after insurance up to $3k.
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I'm not complaining about my situation. I'm fortunate to have insurance and be able to mostly afford all my & hubs healthcare without too much credit card debt to cover it all.

The bigger picture is the problem. Our healthcare system is broken in too many ways.
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I make 6 figures and still struggle with medical costs. Now take a third of my salary & expect someone else to be able to go through the same.

Insurance costs are a racket.
Prescription costs are a racket.
Nobody deserves to go broke or consider bankruptcy for medical.
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#M4A or some version of it has to be implemented. If I have to pay more taxes for people to have good quality healthcare I'm all for it. Canada, European countries, so many others have great systems in place. We need the same.
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People are healthier when they can go to the doctor when needed & not worry about being able to afford it.
Healthier people miss less work so productivity isn't compromised.
Healthier people tend to be happier people.
Where's the issue with this?
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I have an HSA account also. Wooooo I get income tax benefit from it since it's deducted pre-tax. But it's ridiculous to need a savings account so I can afford medical care.

I'm facing surgery with this situation. I'm going to hit my $3k coinsurance this year.

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How many others would forego surgery because they simply cannot afford it?

For me, that $3k equates to 3 monthly bills:
- mortgage payment
- 1 car payment
- groceries

For those who can't afford it, what do they not pay in order to be pain free?

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Why should anyone have to choose between their health & groceries? Too many people I personally know don't have insurance at all. Everyone is set up for failure in this system. It has to be overhauled, period. ACA was a good start, but we need so much more.
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Think of all the cuts in the proposed budget from yesterday. Think of all the spend in that budget. Think of where existing budget dollars could fund the start of migration to #M4A. There has to be a better way.

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