Category Archives: health insurance

Is This A New Healthcare Scam Or What?

As you may recall, I recently went for my annual mammogram, which was quite an adventure. But now, dear friends, the adventure continues!

We’ve got really good insurance from BlueCross/BlueShield, so my annual exams of this type have always been covered 100%. But this time, for the first time ever, the hospital’s billing office called me prior to my appointment to “pre-check me in,” and also to let me know the cost would be “around $150.” I let them know my insurance has always paid for this in full and asked if they were sure about the charge? The woman on the phone sounded unconcerned, like this is something they routinely tell people without checking what their insurance plans call for, just a heads’ up of what they might need to expect. Or not, as the case may be.

I found that totally weird. If I hadn’t been doing this every year for a while and knew I was never charged, I might be a little freaked out. I’d especially be panicked if $150 was a make-or-break amount of money for my monthly budget, which it easily can be for a lot of folks. Especially the kinds of people not accustomed to shelling out large amounts of money on regular health services like mammograms. For example, people new to the healthcare market, thanks to Obamacare. Just sayin’.

As it happens, I get my mammogram and there’s no charge, as usual. The office said they’d file with insurance, as usual.

So imagine my surprise when about 4 days later I get a bill from the hospital! Again: this has never happened before! I assumed it was a bill I could ignore because BlueCross/BlueShield typically takes months to process claims. But the bill showed a discounted amount of around $143, and I’d had that phone call saying I should expect to pay around $150 … so I was a little confused. Again: if I hadn’t done this before and known not to be worried, I’d be in a panic.

So I called the hospital’s billing office and asked WTF is this thing I got in the mail. And get this: she says, “Oh, we just send that out in case you want to pay it. You don’t have to, but if you want to.”

Whaaaa…???

I asked her to clarify what she meant. “You mean, pay it and then have you pay me back when the insurance company pays?” Yes. That is what she meant. If I wanted to. But I didn’t have to.

People, I ask you: who the fuck would want to do that?

Now might be a good time to remind everyone that this service was performed at the for-profit HCA (now TriStar) hospital in Nashville, Centennial. And I just have to wonder again if this isn’t some kind of scam they’re running trying to get money out of people who are new to dealing with hospital billing departments and insurance, now that ObamaCare has brought thousands of newbies into the system.

It just seems a little sleazy to me. I absolutely would not be surprised to learn that staff at Centennial are given a bonus for every “early payment” they coerce out of patients.

Meanwhile, BlueCross/BlueShield has started sending me a stupid newsletter it calls “Healthy Options,” filled with recipes and coupons for Kellogg’s Frosted Mini-Wheats, Minute Maid Light Lemonade and other crap made out of toxic waste I wouldn’t touch with a ten-foot fork. I don’t know when my health insurance company got into bed with ConAgra, ADM and the rest of our Big Food Overlords but I find this an ominous sign and I’m pretty sure it can’t be good for anyone. I just really don’t want to be marketed to by these people. Seems like there might be something better to do with that money.

18 Comments

Filed under HCA, health insurance, healthcare, Nashville

“She Didn’t Ask”

Tennessee Gov. Haslam, who refuses to expand the state’s Medicaid program, preferring to let the state’s poor get sick and die (I suppose), while also claiming to have some kind of super-secret non-existent Tennessee plan that he’s supposedly “negotiating” (wink wink), and who recently was in the news asking HHS Secretary Kathleen Sebelius “to come up with a proposal that would give Tennessee more flexibility to expand Medicaid coverage,” could have asked Sebelius for an update on said plan today. Because today, Secretary Sebelius was in Nashville urging people to sign up for ObamaCare:

Sebelius was joined by Amy Speace, a 46-year-old singer-songwriter who was able to find insurance on the exchange for $30 a month with a $500 deductible, thanks to a tax credit. Speace said she did not at first think she would be eligible for insurance on the exchange because she already was covered by a high deductible plan through a musicians group. Despite that coverage, she nearly had to declare bankruptcy a few years ago when she developed laryngitis and ended up owing $5,000 in medical bills. She was only saved from bankruptcy by the help of a charity.

So, did Gov. Haslam meet with Sebelius for an update on that counterproposal? What do you think?

The governor told a reporter that he had no plans to meet with Sebelius when she came through Nashville on Thursday.

“She didn’t ask,” Haslam said.

I guess he just doesn’t give a shit.

Every day thousands of Tennesseans who lack health insurance face bankruptcy and worse. Gov. Haslam certainly doesn’t seem unduly concerned about those folks.

Good to know.

8 Comments

Filed under Gov. Bill Haslam, health insurance, healthcare, Nashville, Obamacare

Yet Another Anti-Obamacare Story Falls Apart

The Tennessean committed an act of journalism and actually looked into the claims of Emilie Lamb, a Tennessee woman who has become the “national posterchild” for the anti-Obamacare crowd, appearing in Americans For Prosperity ads and mentioned in an op-ed by that harpy Marsha Blackburn.

Like every other one of these stories, it doesn’t add up:

Her beef? The health coverage she had received for years — and liked — under a state program known as CoverTN ended last year because it was deemed substandard under the health care law. Now she pays seven times more for a plan she says is more than she needs.

Supporters of the law who have examined CoverTN say the coverage Lamb had under the state plan was the very kind of junk policy the health care law was meant to replace.

There were restrictions on the number of times she could see a doctor or specialist. Emergency room visits were limited. Financial help for prescriptions was capped. But the real danger of CoverTN, they said, was that it covered a maximum $25,000 in medical bills a year— an amount a moderate hospital stay could easily eat up.

Even BlueCross BlueShield of Tennessee, which administered the program for the state, warned consumers on its website that CoverTN benefits “are very limited compared to traditional insurance.”

[…]

Advocates for the health care law say Lamb was lucky to avoid financial ruin under her old plan, especially because of the long-term expenses associated with lupus.

And they said she could have opted for a much less expensive option that covers hospitalization — including a plan costing $159 per month — among the 37 plans offered on the federal HealthCare.gov health exchange serving Tennessee residents.

Basically, Lamb is an idiot. As I wrote last November,

If you liked insurance that is basically ripping you off then you’re a moron. You’re probably one of those people who thinks a Nigerian prince wants to send you a million bucks. Guess what, that’s a scam, too.

Okay, it’s not fair to say CoverTN was ripping people off but let’s remember who and what it was designed for: it was a program Gov. Bredesen created to cover all of those people who were uninsured because of pre-existing conditions and those who got kicked off TennCare, our state Medicaid program. It was,

[…] designed to offer stripped-down medical coverage to the uninsured at a steep discount.

Denying coverage because of pre-existing conditions is now against the law — remember, this is the part of the Affordable Care Act everybody likes — so you can see how an insurance program designed to cover a group of people who no longer exist might be a tad superfluous.

CoverTN was also created for the unemployed and self-employed — it was designed for portability. Again, this is a key part of the Affordable Care Act (and the part that the media completely missed when it erroneously reported the “Obamacare kills 2.5 million jobs” lie): with health insurance tied to your employment, people didn’t have the freedom to leave jobs, retire, stay home with the kids for a while, start a new enterprise, be self-employed, etc. etc. If you, your spouse or child had a health condition, you were trapped in your job by your need for health insurance. Under Obamacare this is no longer the case. As a self-employed person let me say: this is wonderful.

Also, CoverTN was created for low-income people who made too much money to be eligible for TennCare but not enough money to be able to afford traditional insurance. Emilie Lamb paid $52 a month, but that was just one-third of the actual premium’s cost: the rest was paid by employers ($50) and the state ($50). Seems like if Gov. Haslam would get off his ass and accept the federal help to expand Medicaid here, people like Lamb wouldn’t be complaining.

And finally,

The entire Cover Tennessee plan will “sunset” in 2010, at which time it will be re-evaluated by the legislature.

It was going to go away anyway.

CoverTN was created as a stop-gap measure for a marketplace which no longer exists. People are no longer denied insurance for pre-existing conditions. The unemployed and self-employed no longer have limited options for obtaining health insurance. Low-income people — at least, those in states which don’t have recalcitrant Republican governors who’d rather hurt the poor than defy the Tea Party — have expanded state Medicaid programs to turn to.

I just can’t take Emilie Lamb’s complaints seriously.

2 Comments

Filed under health insurance, healthcare, Tennessee

Rand Paul Is Lying

Stop the presses: Rand Paul claims when his son signed up for Obamacare, he was “forced” onto the Kentucky Medicaid rolls:

The senator briefly flashed a blue-and-white insurance card before launching into a diatribe about his son’s travails: “We didn’t try to get him Medicaid…They automatically enrolled him in Medicaid,” Paul said. “For a month they wouldn’t talk to us because they said they weren’t sure he existed. He had to go down to the welfare office, prove his existence, then, next thing we know, we get a Medicaid card.”

Paul then extrapolated from his son’s experience to make a general point about Kentucky’s health exchange: “Most of the people in Kentucky are getting automatically enrolled in Medicaid.”

Paul is lying.

The Affordable Care Act allowed states to automatically add residents who already receive other social services, such as food stamps and other health programs, to the Medicaid rolls. But Kentucky chose not to take advantage of that provision of the law. The state is notifying some residents of their eligibility for Medicaid, but Paul’s son would have needed to actually apply for Medicaid in order to receive a Medicaid card.

Midkiff couldn’t discuss the Paul family’s specific troubles due to confidentiality laws. But her general description of the state’s exchange clearly contradicts Paul’s story. When a Kentuckian visits Kynect, the state’s health insurance website, she’s asked to provide basic information about herself—age, location, income, number of dependents, etc.—to determine whether she qualifies for the Medicaid expansion or other insurance subsidies. The website is designed to encourage people who are eligible for Medicaid to apply, but it doesn’t force anyone onto the Medicaid rolls. The applicant would still have to actively choose to enroll in a specific Medicaid plan.

Rand Paul is lying.

Of course, it wouldn’t be the first time.

17 Comments

Filed under health insurance, healthcare, Rand Paul

Identity Theft Memory Hole

It’s very amusing that people have suddenly discovered the identity theft issue, but it’s really annoying that they only seem to care about it in relation to Healthcare.gov. It’s not like your private insurance company doesn’t have all of this same information, folks, and it’s not like they are any less vulnerable to theft than Obamacare.

Let’s take a trip into the memory hole and go waay back to 2009. Oh lookie here: BlueCross BlueShield of Tennessee had 57 hard drives containing unencrypted client identity information stolen from a closet at its Chattanooga office.

Or how about back in 2007, when thieves stole laptops containing the Davidson County voter rolls — which include everyone’s social security numbers?

We’re always hearing about data breaches at places like Amazon.com and PayPal. I need look no further back than October 2013 when the State of Tennessee, which processes my paychecks, lost all of my information — not just social security number and passport number but also my freaking bank account number, because I signed up for direct deposit. All of it … gone. Not only did I not get paid for an entire month but now I have to worry about what the hell happened to this sensitive information. Probably nothing, but should I take this risk?

Wingers are going nuts about the Obamacare website exposing people to identity theft, but it’s not like everyone’s information isn’t available to thieves in a thousand other ways, too. Identity theft isn’t new, and it isn’t something Obamacare has brought on.

I find this incredibly annoying.

6 Comments

Filed under Blue Cross, health insurance, healthcare, Obamacare

Things That You Can’t Buy Anymore

John Cole nailed it last night:

I find this whole “Obama lied” about keeping your plan nonsense to be quite distressing. The only reason people are not able to keep their plans is that insurance companies no longer offer them. This may because the companies have decided they needed to alter the plans to be more competitive with other plans, or if the plan was so shitty that it covered nothing and the ACA requires the plan to actually do something. That’s it. Obama isn’t running around kicking people off their insurance for shits and giggles, it’s that people can’t keep their insurance plan because the companies ARE NO LONGER OFFERING IT.

There are a ton of things that used to exist that I would love to have back. The original Boomslang Razer, for example. But it doesn’t exist, because the company NO LONGER MAKES IT, so I can’t have what I believe was the best feeling mouse ever. I’m not blaming Obama for that, either.

This is exactly right, and it’s annoying the shit out of me that the news media is picking up the whole “people were kicked off their plans” language. This is what we call technically true but collectively bullshit. If your health insurance was so crappy it doesn’t pass the minimal standard, then you will need to get another one. Cry me a fucking river. Because Congress decided it’s not in the national interest for you to saddle the rest of us with your medical debt because your “insurance” is really just a scam and doesn’t cover jack when you actually need it. That’s the fucking point, people.

If you liked insurance that is basically ripping you off then you’re a moron. You’re probably one of those people who thinks a Nigerian prince wants to send you a million bucks. Guess what, that’s a scam, too.

And can I tell you how annoying I find this national pearl-clutching over what Obama said about people who like getting ripped off by their health insurance company? Jesus effin’ Christmas Tree, people, where the hell was this national pearl-clutching and word-parsing when Bush-Cheney-Rummy et. al. told us Saddam Hussein had weapons of mass destruction and we invaded and occupied Iraq and then it turned out he didn’t have them after all? My God, this “but he said it!” bullshit is gonna give me an aneurism.

The discourse in this country is so fucking annoying. Why is it Democratic presidents are always held to a higher standard than Republican ones? So President Obama said if you like your health insurance you can keep it, and then the insurance companies no longer offer these plans, and Obama is a liar and impeeeeach??! Grow the fuck up, people.

Okay, end rant.

There are a lot of things that have gone the way of the dinosaur which I miss. For example:

1- Free matchbooks at restaurants. I loved those things. I loved them as souvenirs of places I visited, restaurants I liked. I used them, too, because I love matches (not lighter wands) for things like candles and incense. I love that smell of sulfur as you light a matchstick. But no one offers them anymore because people don’t smoke anymore.

2- Public laundromats. I don’t know about where you live, but pretty much every public laundromat in Nashville has closed its doors. I use public laundromats for washing dog beds and large quilts. I don’t know what I’m going to do when the last one near me closes (which is going to be soon, I hear).

3- Liner notes. It was bad enough when liner notes shrunk down to microscopic levels to fit in CD jewel boxes. You needed a magnifying glass to read them, but they at least existed. But now with digital music, you just don’t see them at all. I miss that.

4- Neighborhood speed humps. Metro Nashville Public Works used to put them on residential streets to keep the damn speeders from roaring through our neighborhoods but now that we really really need them on my street I’m told they aren’t building them anymore. Not only that, they’re actually ripping out ones they’d already built. That kinda pisses me off.

These are things I liked and, dangit, I can’t keep ‘em. Whaah. What are yours?

30 Comments

Filed under health insurance, healthcare

Julia Hurley Lost Her Insurance

That’s pretty much all you need to know about the former Republican state rep/dog surfer, who has written an Obamacare op-ed (excerpted here).

In it, Hurley states that since she lost her job and got dumped by her insurance company, she is rethinking Obamacare. As so often happens with Republicans, all bets are off once the plight of the plebes lands on their doorstep. Suddenly the social safety net isn’t the “hammock” they thought it was.

Hurley makes one good point:

I am a conservative Republican who believes in providing a future for myself without government involvement. I have been unemployed for nearly 14 months. Unable to collect unemployment and unwilling to take government assistance, I have spent nearly all my savings and, unless an employment option arrives, soon will be spending my retirement savings as well.

[…] If the Republican Party continues to fight Obamacare without offering an alternative, I fear the failure of my party is inevitable. The expectation of personal responsibility is being outweighed by the overwhelming number of unemployed voters, uninsured voters and, to be honest, voters without hope who are tired of being told to just hang in there a little longer because things will get better.

Well, join the club, honey. Yes, we’ve all been dying to know what the Republican healthcare plan is. Cue the *crickets*, right?

Then she says this:

If the Democratic Party continues to provide everything for a voter without encouraging some personal responsibility, I fear a gap between taxpayers and beneficiaries will open so wide that our government will not be able to repair the financial damages.

While I do not support the premise of Obamacare, I can fully understand the frustration of the unemployed, uninsured American. I cannot judge those who choose to use the program, for I know exactly what it is like to need it.

Gosh, I’m so old, I remember when Republicans sold the individual mandate as a “personal responsibility provision.” I mean seriously, Julia?

I still think Julia Hurley is an idiot, but she’s the kind of idiot who’s slowly starting to realize that Obamacare sure beats “I don’t care.”

9 Comments

Filed under health insurance, healthcare, Tennessee, Tennessee politics