Wednesday, May 25, 2016

I'm going to complain now, Episode 71

Where the hell is all of our money going when it comes to health care? My friend just had her appendix out (because appendicitis can, you know, kill you) and her health insurance is refusing to pay for the surgery and hospital bills because her appendix hadn't exploded yet.

As in, "Sorry, that's not covered because you weren't actively dying."

Kind of like the time I went for x-rays and the place charged me for a hospital visit ($350.00) instead of just charging me for lab work ($12.00). How is this place getting away with insurance fraud? They're Officially associated with Englewood Hospital, so they can charge me as visiting the hospital even though I didn't. The same thing happened to Bossman a few years ago. Also at a place associated with Englewood Hospital.*

I didn't pay. I let it go to collections first so at least those a-holes aren't getting the full balance because now they have to pay the collection agency a chunk of it.

Bossman pays something like $2,600.00 a month for three of us to be covered on the health insurance. That's about $866.67 per month if I had to pay it. I couldn't afford that even if I had no other bills to pay. Oh and that doesn't cover dental issues (which is why I have a wisdom tooth sticking out the side of my jaw) or eye care (which is why I will never get the new stronger glasses that I need to see things that are far away).

In other news, trying to find a moving company that doesn't charge a small fortune is proving difficult. I tried using the guys we became friends with after Mumsy's move to the condo, as they gave me an amazing deal on getting my belongings from the Pod to the condo. Now, however, they quoted me an estimate of $1,100.00 for the move to the apartment, which I definitely cannot afford. Trying a different mover, and keeping their job to moving only the large pieces of furniture. I'll deal with everything else myself one bit at a time.

Out to dinner with Big Sis#2 tonight. I think this will be the first time I've hung out with her without Niecey G and Useless-in-Law in..... .................... wow. Years. 

In all honesty that's the reason I wanted to get her alone. Something is up in that house and it's been getting gradually worse. I've been after Big Sis#2 to have dinner, just the two of us, for like a year. The few times she agreed, she ended up cancelling at the last minute. Fingers crossed she doesn't do that again.

*Pro tip: for anyone in this area of New Jersey, stay the hell away from Englewood Hospital and anyone associated with them. They will drain your wallet.


  1. Isn't our healthcare amazing. My husband had an emergency appendectomy. He was in the hospital for 3 days and it was considered outpatient surgery which medicare didn't pay.

  2. That's sort of amazing. They'd rather wait until your friend is sicker and it maybe costs more to cure.

    I could go on and on about health insurance. I could probably start a blog page just telling horror stories.

  3. This is one of the worst health care insurance stories I've heard. I think he should fight it if he has a doctor claiming the surgery was required. I've always heard that if you take the appendix out after it bursts it is often too late.

    1. Hey, Mich, I tried to write earlier but stupid blogger atr it so , surprise, I got annoyed! I cannot believe insurance! My husband works his ass off as a teacher and I don't care what people say about them having the summer off, because he doean't and he pays more than 500.00 each paychech, two tines a month for insurance and we still get f@$#ked when the med bills come in! I don't know why he pays that money in the first place! I am desperately hoping he puts in he resingation in this week, he is an excellent teacher and they don't deserve him! Plus, he is truly worn out

      Love you, Mich my Dear1

    2. I truly hope you are able to talk to Big Sis and and out what is happening...that is lovely that you Big Sis is only "talking" E-mailing husband at the you1

  4. I hope you can have a nice dinner with your sister, and that nothing all that bad is going on in the house. Sorry to hear that your health insurance is being such dicks. I don't even know how they can get away with denying people because they already have health problems. Of course they need health insurance, they have health issues. Somehow this means they can't have it though. I really wish I understood how that stuff worked sometimes and, others, I'm kind of glad I don't.

  5. seems like you've got to have peritonitis and a Gram negative infection before people care to cover you these days, aye? oh, sorry, sir. i'll tell my other organs to behave next time but if something does happen, i'll be sure to let me gallbladder burst!

    i opened the other post and i do have to say that for a pain scale, if the woman did have children, i'd say "rate the pain. from 0 to 10, with 10 being childbirth". i think for you, i'd probably have to say, "rate the pain. from 0 to 10, with 10 being one of your cats is severely injured." that should do the trick (though now, i'm shuddering at the thought of any of the cats being hurt... God protect them and give them long, healthy lives forever. even thinking about it makes my skin crawl.)

    that and if you make someone rate the pain, and they give me a rating of 9 and they're sitting about chattering like nothing's happening then... well. i mean if you're giving me a pain rating of 9, i'd expect that you'd threaten my life if i didn't give you a cure RIGHT THIS INSTANT.

    oh God (relating to your healthcare). that sounds... oh God. i don't even want to think.

    my head is whooshing. i'd rather stay here in my room where i can throw away my money on useless junk instead of setting it up for healthcare. i'm in a lucky position. healthcare is PAYING ME to study. brilliant.

    fingers crossed for Big Sis #2 and your's dinner.

    hopefully things goes by just fine...

    -Sam Lupin

    PS. i absolutely adore you.

  6. My hospital has created this "Employer contribution" tally to health coverage on each paystub, and created a whole "see how much you REALLY make!" website for tracking such numbers. It's nauseating. No, I don't "really make" that money, it just means it's costing even more than we used to know to get crummy health insurance.

    It's an only partially related issue, but I think something would have to rupture before the worker's comp folks would give me medical care, too. I'm a terrified mess right now.

    Big Sis #2's state sounds very, very worrying. Socially isolating a partner is red flag, sirens blaring level concern. I hope she follows through with dinner and you find out there isn't really anything bad happening :/

  7. We are so lucky to have military health insurance. Our dental insurance is a little different tho. It goes through Met Life and they don't pay for or cover everything which sucks!

    1. Hi Mich, me again, with "Family Intrigue" talked to cousin's son last night, he has always been a, a rhyme, the he said something like "I am having a big problem with my mom and grandma(I get along well with both of them!)...but I can't talk about it right now......" What is that all about???? I told him he could call any time when he decided he wanted to talk, but.....I dunnno....strange....and he was really attached to my mum, and we don't have to go in to that..........hummmmmmmmm families...................

  8. Jesus your system sucks! I'm really grateful for our NHS. Yeah, they're a little rubbish with the whole mental health area, but physical health they're excellent. Everyone contributes through their taxes and everything's free from the point of access. I can see my GP whenever I want, I can go into hospital whenever I want (well obviously if I'm ill, not just for the lolz), and no one has to take out insurance because everything's covered. People bitch and moan about the NHS all the time, but they really don't know how lucky they are to have it. Have loads of friends in the US who have loads of debts that are just medical care...

    Re the breaking bad meme, there are loads related to the fact that if it was set in England, it would be a very short series because he'd just get treatment on the NHS and that would be the end of it! Haha!

    Hope your sister doesn't cancel and you manage to get the the bottom of the family intrigue...


  9. That's messed up :(

    It's little in comparison, but on top of out-of-pocket admission fees (because it's a private A&E) from my last admission, I was surprised to get $240 of pathology bills in the mail - and that's after my insurance have paid their bit. Apparently they've changed their agreement with my insurance, because in the past it's been 100% covered. I only got two blood tests the whole time I was in!

    $866 per person is bloody nuts! That actually disgusts me a little. I never thought about the price of insurance over there, especially considering how often I hear of them refusing to pay out. I have top level insurance with all the extras (dental and optical included), and I only pay ~AUD250 a month (about USD180).


  10. Private insurance in this country is actually the worst option for most people (except it's also the only option for most people). I mean I would have had better maternity coverage under Medicaid than I do under my current plan which I pay thousands of dollars for each year but I would never qualify for Medicaid. It's crazy! That's really awful for your friend. Hopefully she has access to patient advocates who can at least make sure the hospital still charges her the contracted insurance rate rather than the charge sheet rate? Just as an example - my hospital charged $3000 for my ultrasound plus $600ish for the radiologist to look over the ultrasound and say everything was ok, like he wasn't even in the room, the tech took the images to his office! Even though I hadn't met the deductible and was responsible for the full amount, my insurance did not allow the hospital to make me pay the full amount. I paid $298 for the ultrasound and $72 for the radiologist because that was their contracted rate. Patient advocates are really awesome and they will work with the hospital and the insurance companies to try and make sure you don't go into medical debt. Usually the hospital has social workers on site who can put you in touch with patient advocates.

    Also - I know you've already sorted out the movers but for next time - uHaul has movers listed on their website and I used one of them - it cost $600 for them to pack up the stuff, move it 200 miles from Mass to New Hampshire and unpack it and bring it into the new apartment. They were awesome. Treated my crappy ikea stuff like it was high end furniture - it was all packed so well and nothing was damaged. I did have to pay for renting the uHaul itself (probably $50 for the day plus gas), but they packed and drove it over, and returned it when done. Just make sure to read the reviews and pick a company with good ratings!


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