M is for Mama 18

[mhainlen]

1 minute ago, GreenBeans said:

It’s heart breaking. There should be mandatory insurance for children at least. If parents opt against insurance and proper treatment for themselves that’s one thing. But it should be illegal for children.

Agree so strongly.  I don't understand why we can't provide good health care and education to all children.  This should be a no-brainer, non-partisan priority.  

[Bluebirdbluebell]

2 hours ago, JermajestyDuggar said:

Braggie should just be honest. They can afford to pay out of pocket if they scameritan wont pay. If you can afford a 6 week long vacation to Europe for 13 people, you can afford a few hospital bills. 

They aren't the same company. Abbie is advertising Christian Health Ministries (CHM).  Whereas, Samaritan Ministries is a similar, but different company. They both provide the same type of  Christian "health share" plan, but not the same. There are a few other companies besides them. 

[klein_roeschen]

4 hours ago, Bluebirdbluebell said:

They aren't the same company. Abbie is advertising Christian Health Ministries (CHM).  Whereas, Samaritan Ministries is a similar, but different company. They both provide the same type of  Christian "health share" plan, but not the same. There are a few other companies besides them. 

Wasn't that the same company that Jessa and I think Joy Duggar advertised last year? Jessa included some footage of a family emergency involving I think Spurgeon?

[JermajestyDuggar]

30 minutes ago, klein_roeschen said:

Wasn't that the same company that Jessa and I think Joy Duggar advertised last year? Jessa included some footage of a family emergency involving I think Spurgeon?

Now I can’t remember which one Jessa pushes because I get them mixed up. In my brain they are the same because they have the same model and they are both scams. I just can’t imagine having to deal with this shit “insurance.” It’s probably why most fundies never take their kids to the doctor and don’t vaccinate. 

[Bluebirdbluebell]

43 minutes ago, klein_roeschen said:

Wasn't that the same company that Jessa and I think Joy Duggar advertised last year? Jessa included some footage of a family emergency involving I think Spurgeon?

According to Google, yes for Jessa. Not sure about Joy, but probably? 🤷‍♀️

[MariaariaM]

8 hours ago, mhainlen said:

Agree so strongly.  I don't understand why we can't provide good health care and education to all children.  This should be a no-brainer, non-partisan priority.  

It should. But when you believe that the country is full of "wellfare queens" who basically only have kids to cost you money...

[MomKB]

11 hours ago, mhainlen said:

As a healthcare provider I hate nothing more than seeing kids in clinic on these "plans."  Their parents try to negotiate the workup and treatment with you.  I'm left saying "Well, your child had a seizure and standard of care and recommendations from all concerned societies agree that they need an MRI brain and an EEG so that's what I recommend. But you are their parent, so you can certainly decide not to proceed with that recommendation." 

I think they require their members to negotiate the cost with providers. Then the patients pay out of pocket and supposed get reimbursed (not guaranteed.) IIRC

[hoipolloi]

46 minutes ago, MomKB said:

I think they require their members to negotiate the cost with providers.

Yes, this is an integral part of their business model along with just not paying for many things, like care associated with special needs (e.g., therapies) or most pre-existing conditions. I wonder how Shaun & Braggie would react if someone who hired Shaun refused to pay his invoice unless Shaun agreed to "negotiate" a lower price. 

Mind you, healthcare in the US is a criminal enterprise so no justifications from me for outrageous costs. Still, the hypocrisy of these people is never-ending. 

[FilleMondaine]

Fellow medical provider, these are heartbreaking. I do mental health, now, but I was the medical social worker at a skilled nursing facility (step down from hospital)

My god, I hate crappy health insurance. I use that word sparingly, and also there is no other word for entities that cynically let people die. And sometimes to die in utter pain.

[Ozlsn]

I keep being shocked by posts about insurance companies refusing to pay for treatment. You would think by now I'd be used to it, but it feels like it's either gotten worse or more blatant.

[JDuggs]

I believe CHM was the one Jinger was pushing when Hilary Spivey said it wasn’t great for her child’s cancer.

[SassyPants]

Aside from The Dillards, all the Duggar et al families likely have the CHM coverage. None of them have jobs where they work for a company other than their own business, or a company large enough to mandate employer provided coverage. I am sure they are all anti the ACA, and since health insurance is mandatory for everyone to have, I’m betting that CHM is what they all use.

[Bluebirdbluebell]

1 hour ago, JDuggs said:

I believe CHM was the one Jinger was pushing when Hilary Spivey said it wasn’t great for her child’s cancer.

Yes, Jinger was shilling this one as well. I didn't remember, but I looked it up.

Edited August 29 by Bluebirdbluebell

[3splenty]

This is kind of off-topic, but kind of not, since we're discussing scam insurances.

Another thing Americans don't understand is the pitfalls of Medicare Advantage. It is NOT MEDICARE (a form of health coverage for elderly and/or individuals with disabilities), they will tell you it is.  It sounds great, until you need it. It doesn't pay out. Here's a case I worked with:

Patient had to have a knee replacement. After it was done, there were issues with the implant and they had to go in again to fix it several times. She remained in a facility for seven months.  The insurance company's payment didn't even cover room and board for the patient. The facility had to absorb the costs for nursing staff, treatment and wound care supplies, medications, therapies and food. They wouldn't pay for a new leg stabilizer because she had gotten one in the past 5 years.

The insurance companies also encourage doctors to put patients on medications that aren't in the patient's best interest. For instance: Patient does not respond well to Drug A, so the doctor switches them to Drug B. Patient responds well to Drug B. Insurance is in cahoots with the manufacturer of Drug A and tells the doctor to discontinue Drug B and restart Drug A at a lower dose. If they do this, the doctor can get more money from the insurance company.

Every doctor and specialist I work with has told me (with varying degrees of profanity) to tell the insurance rep where to go, and they know I side with them, as does our administration. It's against our ethics and code of conduct.

[Hane]

Once my daughter had a bad reaction to a prescription (Paxil) and flipped out so badly I took her to the ER. My insurance denied the claim, so I called the company ready to go to war: “Where else *shouid* I have taken her but the ER?” The rep quietly said, “I’m not supposed to tell you this, but it’s our official policy to deny all first claims. Just resubmit it and you should be fine.” I did, and it was. It was stupid.

This was over 30 years ago, and I fear it’s worse now.

[hoipolloi]

Pro Publica has a lot of articles on various health insurance problems, particularly denying care or coverage. If your blood pressure isnʻt high now, it will be elevated after reading a few of them.

Between private health insurance and the hedge funds/private equity companies taking over medical practices, weʻre going to be in a world of hurt, illness, and death.

 

[SassyPants]

1 hour ago, Hane said:

Once my daughter had a bad reaction to a prescription (Paxil) and flipped out so badly I took her to the ER. My insurance denied the claim, so I called the company ready to go to war: “Where else *shouid* I have taken her but the ER?” The rep quietly said, “I’m not supposed to tell you this, but it’s our official policy to deny all first claims. Just resubmit it and you should be fine.” I did, and it was. It was stupid.

This was over 30 years ago, and I fear it’s worse now.

Years ago we had an HMO as our primary coverage and an open BC plan as secondary(this was in the 90s). Anyhow, our toddler was stung by a wasp around his eye and the swelling was severe and immediate, so I took him to the HMO covered ER as it was after dinner hours. Well, he was seen by an out of network MD in the ER, so the insurance company (#1) initially denied the claim. When I called to enquire, I asked if was my responsibility to “screen all potential HC providers for their network status in an EMERGENCY?” They did end up covering it. They also wouldn’t pass it on to the secondary insurance either-

[3splenty]

Just now, SassyPants said:

Years ago we had an HMO as our primary coverage and an open BC plan as secondary(this was in the 90s). Anyhow, our toddler was stung by a wasp around his eye and the swelling was severe and immediate, so I took him to the HMO covered ER as it was after dinner hours. Well, he was seen by an out of network MD in the ER, so the insurance company (#1) initially denied the claim. When I called to enquire, I asked if was my responsibility to “screen all potential HC providers for their network status in an EMERGENCY?” They did end up covering it. They also wouldn’t pass it on to the secondary insurance either-

In my mind, if a practitioner is affiliated with a hospital and has practicing rights there, they should have to accept every insurance the hospital does, as they're working our of that facility. You shouldn't have to check your anesthesiologist, surgeon, specialist, etc. to verify their network eligibility.

I have a few cartoons hanging on my bulletin board in my office:

The first one isn't true, but it feels like it. The second one sums up my thoughts on the insurance meetings...

[Expectopatronus]

More and more families will end up being forced to pull a Gil Bates and just not pay their medical bills. 
I just found out my dental insurance plan won’t cover my nightguard that wore out. They consider it to be « unnecessary ». Grrr. Dental care needs to be free and considered no different than medical care. 

[JermajestyDuggar]

Braggie picked up their new puppy. Probably from a puppy mill. And they had to stop at outlet stores on the way home. It looks like a doodle. She really needed some new content so a doodle puppy gets the job. 

[MariaariaM]

1 hour ago, JermajestyDuggar said:

Braggie picked up their new puppy. Probably from a puppy mill. And they had to stop at outlet stores on the way home. It looks like a doodle. She really needed some new content so a doodle puppy gets the job. 

Are doodles still the fashionable thing? I thought influencers would've come up with something new by now - and that Abby would want to have the latest and most expensive.

[JermajestyDuggar]

3 minutes ago, MariaariaM said:

Are doodles still the fashionable thing? I thought influencers would've come up with something new by now - and that Abby would want to have the latest and most expensive.

They are still fashionable. What’s more fashionable are newer poodle mixes. It used to be just labroadoodles. Now they are making lots of mixes with poodles to look best on social media. 

[3splenty]

On 8/28/2024 at 9:59 PM, Expectopatronus said:

More and more families will end up being forced to pull a Gil Bates and just not pay their medical bills. 
I just found out my dental insurance plan won’t cover my nightguard that wore out. They consider it to be « unnecessary ». Grrr. Dental care needs to be free and considered no different than medical care. 

Especially because good dental/oral care has a direct impact on the rest of your health.

[JermajestyDuggar]

Braggie has said the new puppy is a cavie-poo. I told you guys it was a poodle cross because that’s what’s trendy. I personally love King Charles Cavalier Spaniels. I have no idea why you would cross one with a poodle. Oh yes I do. It’s because they look good on social media and all the puppy mills are doing it. She probably tried to get a good deal by going to a bottom of the barrel puppy mill. 

[Maggie Mae]

On 8/31/2024 at 9:10 AM, MariaariaM said:

Are doodles still the fashionable thing? I thought influencers would've come up with something new by now - and that Abby would want to have the latest and most expensive.

I think a lot of people like the poodle cross because they shed less and are supposedly hypoallergenic.  Cavapoos and cockapoos are adorable dogs and I think the King Charles Spaniels are more laid back/less energenic overall than the cocker spaniel. IDK though. I don't like to think there are that many people buying dogs specifically to look good on social media, more like "i like how that one look, and i had a good time interacting with it" Obviously there are exceptions like Jake Paul.