
Telehealth will be free, no copays, they said. But patients are getting billed - hhs
https://khn.org/news/telehealth-will-be-free-no-copays-they-said-but-angry-patients-are-getting-billed/
======
whoisjuan
If you're wondering what's happening here, this is a shady tactic used by
health providers to squeeze out of pocket money from patients. It happens also
when your health plan clearly states that things like preventive care are
covered with no-copay and outside of the deductible.

The loophole they exploit is claiming ignorance about coverage that's not
under the umbrella of your deductible.

They can do this because when they check with the plan provider they don't
have to, or want to do a lengthy inquiry in relation to the patient's
situation and their plan. That check is usually a 2 minutes call. So they go
with a blanket scenario which is:

“A patient is here for a consultation. Based on their coverage how much can I
get out of their pocket?”

That's literally the only validation they are interested in doing.

Of course, you can try to fight this, but the process for this is probably so
long that it's not worth your time. So they get away with it all the time.
Most people don't even want to deal with this. Going to the doctor is already
stressing enough, so 75 USD less is not worth it more stress. And they do this
because nobody says anything and patients don’t understand well enough their
coverage. The average person hardly understands the concept of a deductible.

If people were actually fighting back this it would be harder for healthcare
providers to charge fees they are not entitled to.

Healthcare in the US is one of the most exploitative and unethical industries.
They don't care about the patients, they only care about their money. And I'm
not talking about the nurses and doctors. Most of them are simply cogs of that
system. They may have knowledge of these shady things but rarely can control
them (except the ones that have private practices)

I'm talking about the organizations that insure patients and the organizations
that provide healthcare. Patients are always in the middle of a constant tug
between insurers and providers.

In a situation where someone has to lose something, you better believe it
would be the patient.

~~~
sudders
The more I learn about the US healthcare system, the more i'm sad for everyone
living there.

All these loads and loads of information you need to know to go to the doctor.
How can regular people ever get the healthcare they need, and we're not even
talking about the vulnerable, low income, low schooled.

This. Is. Ridiculous.

I'll take socialism over this nonsense any day of the week.

~~~
ab_testing
The most interesting thing is that most of this healthcare is tied to
employment. So now in the past few weeks when 25 million people have been laid
off, they have also effectively lost their health insurance. Now they cannot
afford to go to the doctor and cannot afford their prescriptions.

As of December 2019, 26 million people in the US were inunsured. Since then,
around 26 million more have lost their jobs - effectively losing their
healthcare. So now as of today, around 52 million people in a country of 320
million have no access to primary healthcare.

[https://www.kff.org/uninsured/issue-brief/key-facts-about-
th...](https://www.kff.org/uninsured/issue-brief/key-facts-about-the-
uninsured-population/)

~~~
blackrock
The more I think of it, the more it seems like..

COVID-19 is the symptom.

Capitalism is the disease.

This comment will of course, get heavily downvoted, and likely flagged.

But, it appears we are reaching a reckoning. This virus does not give a damn
if you’re rich or poor. Insured or not. It’s going to take out anyone that it
can. And the poor, and those on the fringe, are going to get hit the hardest.

------
rayhendricks
This is 100% political but imo this industry really just needs to be
nationalized ASAP. You literally have people who are working as essential
workers worried about paying for healthcare coverage or how much an
appointment will cost. There will be many US citizens who will die due to
this. This will also include the wealthy...

Also my health insurance still says my premium was not paid but when I called
them up in TX they said everything was paid up. Then they said I’d need a bill
audit at their other location in GA and I haven’t heard anything since. This
is after paying all bills and calling their customer service. Most likely
their backend billing systems are not talking but no one cares to fix it. It’s
a fucking disgrace.

~~~
epmaybe
The crazy thing is that most people, on both sides of the aisle, are unhappy
with the current system. Unfortunately, nobody seems to agree on how to fix
it.

~~~
rayhendricks
Single payer is a possibility but not the only possibly. DE/NL have private
insurance + universal coverage and it works just fine. But the shenanigans
insurance companies get up to are not allowed there.

I’d prefer single payer but either one works and but regulated insurance will
be more politically palatable in the USA.

------
erentz
Pre COVID I tripped over something related. In some states insurance is
required to cover telehealth (including mine). So I had a feel visit with my
specialist but then after it turned out it wasn’t covered. I debated it with
them and after much back and forth eventually discovered no, because I’m on an
employer self funded plan (the majority of plans) state insurance laws don’t
apply.

Another good one is, go to most oncologists these days and you’ll expect to
pay your co pay. What they won’t often tell you is that you’ll also be
separately billed for what they call a “facility fee”. This can be anywhere
from $180 to $450 and can obviously be quite a surprise. So your $20 copay can
become anything up to $470 depending on your plan. Their justification for
this is that they are “hospital based” even if they aren’t. And even if you
might attend a cardiologist or neurologist in the same speciality building and
they don’t charge facility fees. It’s just another way to extract more money
from the system.

