I got health care scammed

(10:00AM EST – promoted by Nightprowlkitty)

For-Profit health care in America has become a scam.  How do I know?  Because I got scammed by a health care provider.  You read that correctly.  Provider.  

Read on if you care to hear how this scam worked…

As some of you may know from my Daily Kos days, I was diagnosed with chronic depression a few years ago.  The psychiatrist prescribed anti-depression medication, and, encouraged me to seek counseling.  As with many who still have the luxury of having health insurance, you have to find a “provider” that is within your insurance company network.  I did, and, this is where the story starts.

In January of 2008, I went to see a therapist that was within the network of the insurance company.  It was on an out-patient basis, so, all I was billed was my co-pay for each session.  However, after just the third weekly session, the therapist, who was also affiliated with a counseling center that operates out of one of the local hospitals, thought it would be a good idea if I moved to a group therapy setting at the counseling center.  Hey, what could it hurt, right?  So, as February began, I showed up to the counseling center at the hospital.

The group therapy setting was five days a week, and, lasted for an undetermined amount of time.  The staff member informed us “new people” not to worry about anything other than getting better, they were dealing with our insurance companies.  Then, they let something slip; the group therapy setting was classified as an “intermediate program” for insurance purposes.  

The second day I attended the clinic, I found out the difference between an “out-patient” and “intermediate” program was money.  As a client on an “out-patient” basis, all I had to pay was the co-pay.  As a client under an “intermediate program”, the insurance company covered 80% of the cost.  So, I asked the big question; just how much would this group therapy cost me “out-of-pocket?”  The staff told me that I had to get that figure from the insurance company.  So, I called my wife and had her call the insurance company.  She was told by the insurance company that we would have to get the exact amount I would have to pay “out-of-pocket” from the clinic.

Day 3.  I again ask the staff of the clinic what my “out-of-pocket” expense would be for the group therapy.  Amazingly, they simply didn’t have that information.  That was when the red flag went up in my head.  I was being asked to attend a counseling center that would charge me 20% of the cost “out-of-pocket”, and, they couldn’t even tell me how much that was going to cost me.  It was at that point that I told the clinic that I wouldn’t be back.  Because I had only attended three days, the staff member I was dealing with told me not to worry about anything, I wouldn’t be billed for just three days.  Famous last words.

Fast forward 16 months later.

You read that right, as well.  16 months.  I receive a bill from the hospital.

Not only did I receive a bill, but, it is a bill that was passed to their collections department that claimed I owed the hospital $225.00 for the three days I spent in the counseling clinic.  After a phone call to the clinic’s manager, I learned exactly why I was being charged $225.00; that was the deductible charged by the insurance company for an “intermediate” program.  

Now, why do I call this a scam?

1) I was funneled into the “intermediate” program and out of being an “out-patient” after only three sessions.

2) Have you ever been charged the exact amount of the deductible for three days of anything?  That would be, exactly, $75.00 per day of treatment.

3) I, like all the other people, were told not to worry about the cost because the staff was dealing with the insurance company.  However, it couldn’t have escaped them that their program was an “intermediate” program, and, as such, the client would be responsible for a portion of the expense at the time they stopped treatment.  Given that I was charged the full deductible for just three days, or $75.00 per day, do the math for those who spent months, or longer, attending the clinic.

4) After being told that I would not be billed, I was billed, but, the clinic never billed me directly.  They waited until the account was in arrears, then the collection department sent me a bill 16 months later.

No, this wasn’t an insurance company.  It was a health care provider treating clients with depression.  

As bad as this is for me, I can only imagine how bad it is for other clients that are getting swindled.  Imagine that you seek treatment for your depression.  You are told, “don’t worry about money, we’re dealing with your insurance,” so, you don’t worry about it.  Then, several months later, you’re declared better, and, you find out that you suddenly owe the clinic thousands.

As has been reported, medical bills are the leading cause of bankruptcy.

Illness and medical bills caused half of the 1,458,000 personal bankruptcies in 2001, according to a study published by the journal Health Affairs.

The study estimates that medical bankruptcies affect about 2 million Americans annually — counting debtors and their dependents, including about 700,000 children.

Surprisingly, most of those bankrupted by illness had health insurance. More than three-quarters were insured at the start of the bankrupting illness. However, 38 percent had lost coverage at least temporarily by the time they filed for bankruptcy.

And, as was just reported, the Insurance companies are going to continue canceling policies.

Executives of three of the nation’s largest health insurers told federal lawmakers in Washington on Tuesday that they would continue canceling medical coverage for some sick policyholders, despite withering criticism from Republican and Democratic members of Congress who decried the practice as unfair and abusive.

The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills despite paying insurance premiums, began a day after President Obama outlined his proposals for revamping the nation’s healthcare system.

Of course, that new bankruptcy bill made sure that the debtors get their share no matter what.

WASHINGTON – Millions of Americans could be plunged into financial ruin if a bill giving credit card companies long-sought relief from unpaid loans gets final Congressional approval, a broad array of consumer protection, economic justice, and civil rights groups warned.

Senators on Thursday passed the bankruptcy reform bill, which political observers said was largely crafted by the credit card industry more than eight years ago, sending it to the House of Representatives. Lawmakers there said they could vote on final passage next month.

Every year, some 1.6 million Americans file for personal bankruptcy protection–more than five times as many as in 1980. The process, which in many respects mirrors corporate bankruptcy, allows them to come up with a creditor-reviewed and court-approved plan to write off some of their debts, pay off others, and reorganize their personal finances so they can make a fresh start.

Opponents of the first revamp of the nation’s personal bankruptcy laws in more than a quarter-century said the legislation would deal a ruinous blow to the overwhelming majority of those forced to declare personal bankruptcy: moderate- and low-income families, many of them black or migrant or with only one parent; and individuals of modest means hit with large divorce losses or medical expenses.

The health providers get theirs, the insurance companies get theirs, the credit card companies get theirs, in fact, everyone wins but the individual now.

Reform health care?  Not this President or Congress.  President Obama was going to bring in Tom Daschle as his “health care” guru.  Guess what Daschle says?

The man once slated to head Barack Obama’s health care system overhaul is now coming out against one of the chief components of that effort.

Former Senate Majority Leader Tom Daschle said on Wednesday that the Obama White House would likely have to scrap a federal public option for health insurance coverage if it wanted to get the votes needed to pass systematic change.

Have no fear, the worst is coming.

Former Sens. Tom Daschle, Bob Dole and Howard Baker joined forces this week to put out a health care plan 15 months in the making. The three political gray beards, who co-founded the Bipartisan Policy Center, called for an approach to reform that included state-operated public insurance options as well as individual and employer mandates for coverage. Their proposal was pitched as a bi-partisan effort at solving one of the most complex legislative issue facing the nation.

Require people to have insurance and you can say that everyone is insured, until, that is, the insurance company cancels the policy because the people actually get sick.

It’s all one big scam.