1/ In addition to being morally criminal in terms of how they operate (rejecting legit claims, charging outrageous premiums, etc), private insurance companies aren't even very smart about how they do certain things. For instance...
2/ I have asthma. For a yr it's been controlled. In fact, I've gone months w/o using my preventive inhaler. Which is good bc the name brand is $400 per mo & our plan (basic bronze) doesn't cover ANY prescriptions. There is FINALLY a generic (for $120, still crazy), but..
3/ When I've used the insurers "doctor on call" service (bc its free and easier than going to the doctor on occasions when I have a virus & my asthma kicks in badly, as it is now), they give me a hard time about calling in the generic bc the brand name is "preferred." But why?...
4/ First, they aren't covering anything. It's all out of pocket, so all this does is force me to pay more, and secondly, it's not even smart for them, because the more I pay the closer I can get theoretically to my deductible, at which point they WOULD have to cover things...
5/ Now granted, that deductible isn't likely to be met w/o some catastrophic health issue (it's over $8k), but honestly, there is NO logical reason for them to encourage me to spend more UNLESS the co that makes Advair is giving kickbacks...
6/ The good news is, the pharmacist has filled the generic 2x now, after going thru hoops to get that OKd. The bad news is, when a person is having an asthma attack, stressful shit like this is dangerous. And it's all unnecessary. Oh, and of course, add to this the fact that...
7/ ...despite our plan not covering prescriptions and having that crazy deductible, we're still paying $1600 a month for the premiums. That's insurance in America, and especially states like TN where right wingers didn't expand Medicaid under ACA...
8/ ...which means poorer and sicker folks unable to get in the government pool were kept in the private pay pool, thereby causing private insurers to not enter the market or charge outrageous premiums...and here we are...This system cannot ultimately be salvaged or made to work..
