"please keep me updated about oximeters "
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Insurance problems
I am wondering if we need or could use an insurance problems link here. I'm battling the insurance cartel trying to find insurance as my COBRA is running out. I thought I had DME coverage, yet it was not paid(rejected) on Anthem/Blue Cross. My $1600 HRA balance apparently can't be used for CPAP, so I am awaiting a bill for my new mask,etc. They won't tell me what the doc costs, so I cancelled a followup. At 60 yrs old here in California, I just got rejected from Aetna for a $5,000 deductable policy costing $258/month. I take only one med, 10mg lisinopril for elevated bp. Basically, these monopolistic companies don't want to insure anyone over 30. I've applied to Kaiser, it's about $276/month. If denied, it's $600/month with the California plan. They are ripping-off individuals needing insurance. Forget CPAP, this isn't covered, all you get is a physical exam.
Any cheap plans are 20-30% " CO-INSURANCE", meaning you pay the annual deductable of $5K-$7500, then you pay 20 or 30% out of pocket for anything else, so if you get an ailment, let's say that costs $100K (major), you pay $7500 PLUS $ $33K or about forty thousand dollar$$$.
I bet there are 5-10 million more without health insurance (if it is indeed that) in the last 2 yrs,( a travesty).
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Replies to This Discussion
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Permalink Reply by Chris H on
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Insurance , copays, deductables vs heat, gas, groceries ....throw in preixisting and age ooooh what a frusterating mess it all is.
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I'm happy to report they paid for my new FX mask and chinstrap out of my HRA (after I demanded it, ). They would not approve an upgrade to my machine, even though I have over $1,000 still in there, they must know my COBRA ends on 3-31, so the HRA goes in their pocket, so to speak, it's gone.
Pretty amazed at costs. FX headgear sold as 2 pieces"frame and headgear" ($200+), those nasal pillows are $60 ea(don't rip them), and they make sure you have a medium size too ($120), chinstrap ($35) $355.00 or so in total. Insurance accepted about 10% less than billed.
chris h said:Insurance , copays, deductables vs heat, gas, groceries ....throw in preixisting and age ooooh what a frusterating mess it all is.
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Permalink Reply by Mary Z on
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Insurance amazes me. They charged $200 for my new mask plus $60 for the headgear. But you can't order it without the headgear! The one good thing is doctors in my network accept what is "allowed" instead of the ridiculous fees they charge. My sleep doc charges over $300 for 10- 15 minutes. He's not worth it.
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The insurance paid for the sleep doc and my oximetry test, that was one visit to pick up the oximetry machine (no doc) then I saw the doc to go over it. TOTAL billed : $351.00 Total paid: $273.00. Then add the DME I posted about $355.00, so there's $725.00 WITH insurance to see a doc and get a new mask and talk for 15 minutes and he calls a tech in to raise the pressure on my machine 2 pts. What a system! Or is it "racket" ?
Mary Z said:
Insurance amazes me. They charged $200 for my new mask plus $60 for the headgear. But you can't order it without the headgear! The one good thing is doctors in my network accept what is "allowed" instead of the ridiculous fees they charge. My sleep doc charges over $300 for 10- 15 minutes. He's not worth it.
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