The PPACA Thread Part VI: Tax Cuts Are More Important Than Your Health Care!

[Handyman]

Re: The PPACA Thread Part VI: Tax Cuts Are More Important Than Your Health Care!

<img src="https://media.giphy.com/media/U9CFWw4zEzlDO/giphy.gif" />

 

[MissThundercat]

Re: The PPACA Thread Part VI: Tax Cuts Are More Important Than Your Health Care!

I need something. I learned that my antidepressant, bipolar, and concentration medicine aren't covered by insurance (not in the formulary). Only the concentration medicine has a generic, and even then... ugh. On the Trintellix (antidepressant) alone, the copay is $200, which is 40% of my paycheck. Apps like GoodRx don't really help.

 

[ScoobyDoo]

Re: The PPACA Thread Part VI: Tax Cuts Are More Important Than Your Health Care!

You get exactly what you vote for.

The number of Americans without health insurance increased again in 2018, the second consecutive year that figure has risen after several years of declines under Obamacare, a Centers for Disease Control and Prevention survey shows.

About 30.4 million Americans did not have health insurance in 2018, up from 29.3 million in 2017, according to the CDC's National Health Interview Survey. That means about 1.1 million more Americans lost insurance coverage last year.

Efforts by the Trump administration and Congress to challenge and loosen requirements of the Affordable Care Act probably played a role in some going without coverage, analysts said.

"I don't think it's too shocking with efforts to undermine the Affordable Care Act as part of the Tax Cuts and Jobs Act," said Daniel Derksen, a University of Arizona professor and health policy expert.

https://www.usatoday.com/story/news...oMOasEqPRVj9HhjaLIbnTv1M2KRe81GzACFz6tNUBVB14

 

[ScoobyDoo]

Re: The PPACA Thread Part VI: Tax Cuts Are More Important Than Your Health Care!

Congratulations Republicans.

Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump
The administration’s moves to weaken the Affordable Care Act have taken hold, and companies are cashing in.

https://www.bloomberg.com/news/feat...verage-floods-market?utm_source=pocket-newtab

 

[Kepler]

Re: The PPACA Thread Part VI: Tax Cuts Are More Important Than Your Health Care!

I need something. I learned that my antidepressant, bipolar, and concentration medicine aren't covered by insurance (not in the formulary). Only the concentration medicine has a generic, and even then... ugh. On the Trintellix (antidepressant) alone, the copay is $200, which is 40% of my paycheck. Apps like GoodRx don't really help.

You get your doctor to tell the insurance company that the generic is insufficient. The drug manufacturer of the brand medication will write down your prescription by 90% and the insurer will cover the rest. Remember, the "cost" of your medication is ludicrously inflated to cover the drug company's R&D (and share price and executive compensation). The actual dollar cost of your medications is something like 1% of what they are charging for many reasons, a couple of them legitimate and the rest Capitalism 101.

Dr. Mrs. takes a specific cocktail to keep her MS from kicking back in. It would cost $2k a month. The drug company writes it down to $200 a month but even then our insurer tries to f-ck us. Every 12 months they kick her off it and put her on a generic that would have her in a wheelchair within 10 years. And so, every 12 months, her neurologist picks up the phone, explains to them why the generic is insufficient, and cites them the case law where insurance companies have been successfully sued for incompetence and intimidation in making the switch. And every 12 months plus 2 weeks we get a letter from the insurance company's in-house counsel saying OMG it was all a clerical error!

And then next year it happens again.

Insurance companies are crooks. The only way to keep crooks in line is constant vigilance. If we had an actual democratic government the managers would go to jail and the owners would be sued into penury, but we have a plutocracy, at least until the day The People wake up and the heads roll into the baskets, which is to say, the day they turn off their TV soma IV drip, which is to say, never.

Until then, have your doctor make that phone call. If you think patients hate the insurance racket you should talk to doctors. It is more than likely your doctor will enjoy nuking your insurer back to the stone age. They have to deal with this kind of sociopathy every day.

 

[WisconsinWildcard]

Re: The PPACA Thread Part VI: Tax Cuts Are More Important Than Your Health Care!

And so, every 12 months, her neurologist picks up the phone, explains to them why the generic is insufficient, and cites them the case law where insurance companies have been successfully sued for incompetence and intimidation in making the switch.

You forgot the part where we sit on hold for an hour. Or are told we will be called back during a specific time which is always when we are seeing patients. Or when you get to talk to a doctor at the insurance company who knows jack **** about your specialty (like an ENT doc telling a neurologist how treat MS).

It is more than likely your doctor will enjoy nuking your insurer back to the stone age.

It is helpful at times to ask their full name, where they trained, and what is their specific training is in first thing into the conversation. Tends to cut down on the ****ing around. One of my favorite attendings in residency would start most conversations by asking them if their mother knew what they did for a living.

 

[MissThundercat]

Re: The PPACA Thread Part VI: Tax Cuts Are More Important Than Your Health Care!

You get your doctor to tell the insurance company that the generic is insufficient. The drug manufacturer of the brand medication will write down your prescription by 90% and the insurer will cover the rest. Remember, the "cost" of your medication is ludicrously inflated to cover the drug company's R&D (and share price and executive compensation). The actual dollar cost of your medications is something like 1% of what they are charging for many reasons, a couple of them legitimate and the rest Capitalism 101.

Dr. Mrs. takes a specific cocktail to keep her MS from kicking back in. It would cost $2k a month. The drug company writes it down to $200 a month but even then our insurer tries to f-ck us. Every 12 months they kick her off it and put her on a generic that would have her in a wheelchair within 10 years. And so, every 12 months, her neurologist picks up the phone, explains to them why the generic is insufficient, and cites them the case law where insurance companies have been successfully sued for incompetence and intimidation in making the switch. And every 12 months plus 2 weeks we get a letter from the insurance company's in-house counsel saying OMG it was all a clerical error!

And then next year it happens again.

Insurance companies are crooks. The only way to keep crooks in line is constant vigilance. If we had an actual democratic government the managers would go to jail and the owners would be sued into penury, but we have a plutocracy, at least until the day The People wake up and the heads roll into the baskets, which is to say, the day they turn off their TV soma IV drip, which is to say, never.

Until then, have your doctor make that phone call. If you think patients hate the insurance racket you should talk to doctors. It is more than likely your doctor will enjoy nuking your insurer back to the stone age. They have to deal with this kind of sociopathy every day.

You forgot the part where we sit on hold for an hour. Or are told we will be called back during a specific time which is always when we are seeing patients. Or when you get to talk to a doctor at the insurance company who knows jack **** about your specialty (like an ENT doc telling a neurologist how treat MS).




It is helpful at times to ask their full name, where they trained, and what is their specific training is in first thing into the conversation. Tends to cut down on the ****ing around. One of my favorite attendings in residency would start most conversations by asking them if their mother knew what they did for a living.

Situation was resolved a few months ago. Basically, I learned that Walgreens was no longer "in network," and I had to switch to CVS.

I've had good luck with them so far.