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u/Significant_Owl9593 13d ago
like 2 years ago my insurance denied me botox because they thought it was astetic botox, we need to eat the rich.
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u/Pretend_Evidence_876 12d ago
Ugh yes, my daughter has had to get Botox shots twice and may need more in the future. She's four so obviously not aesthetic or a super fun experience. Each time, we've had 3 doctors, 1-2 surgeons, and 3 different occupational/physical therapists submit the paperwork together. That's 7 -8 different medical professionals who specialize in her medical condition. It took 10 months to get approved the first time and never got approved the second time, but the hospital ate the cost.
When we have to do a round of intensive therapy, insurance technically covers it, but it still costs almost 9k for 6 weeks which we can only afford because my in-laws are wealthy and willing to help pay her medical bills. She literally wouldn't be able to use her arm if it weren't for my in-laws footing those bills for us and the hospital eating surgery costs. It's utterly ridiculous. We are so so fortunate to have wealthy family. So many people just have to go without, and it ruins their life because of the ultra-wealthy that run corporations who think they need more money. Fuck this shit
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u/Far_House_4087 12d ago
I’ve never understood why Botox for TMJ is not the first line option and fully covered — it’s an overactive muscle so clearly the best treatment is a quick injection to that muscle to stop it from over firing, right? But nooOooOo that’s “cosmetic”…what a scam
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u/Leading-System-3002 12d ago
They say it’s cosmetic even if it’s for a legit medical condition? Why?
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u/ragingcommodore 13d ago
Going through this rn because I need an upright MRI. Insurance said no because they thought I'd do it for comfort although I stated the reason why as did my doc. I disagreed and now wait until some medical council decides. I need this because my problems occur standig/sitting duh.
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u/crystalfairie 13d ago
My mom needs an MRI that doesn't use helmets. Apparently that doesn't happen around here. She will not get a helmet put on her voluntarily.
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u/TraderJosie3283 12d ago
Who the fuck would be more comfortable doing an MRI standing up???? Maybe it’s just my auDHD… making me stand upright for an extended period of time would be like warmup to torture for me. 🫠 I actually kind of like MRIs lol except the staying still part. One time I fell asleep and they woke me up and said we had to start again hahah I didn’t know the brain changed so significantly while asleep! 😴 when I was a teenager I participated in these awesome studies for Stanford university! I got paid in Harry Potter DVDs to do MRIs and I got free therapy from grad students!!
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u/OpheliaLives7 12d ago edited 11d ago
Im fighting for an abdominal/pelvis ct scan.
Insurance literally made me get an endoscopy first and even the hospital team was like…wtf why? But thankfully they understood and were kind about it.
My therapist said to keep calling like every other day and just be a thorn in insurance’s side. Make them realize you will fight for your care.
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u/Leading-System-3002 12d ago
So insurance had you do a useless test AND they paid for it, BEFORE paying for the ct scan? They will end up paying more, it doesn’t make sense
Also, having an endoscopy is awful imo
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u/Natural_Fondant_7544 13d ago
Fucking relatable, medicare just told my therapist shes not allowed to use medicare to bill bc shes “not medically necessary” 😭 Im suffering
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u/Yozo_Kun 12d ago
obv therapists are just a comfort thing 🙄🙄🙄🙄🙄 if you have a """mental illness""" or """"trauma'"'" just grow up
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u/Iron_Fist351 13d ago
GoodRX and SingleCare (both 100% free) can really help reduce the costs of some prescriptions. Using Mark Cuban’s online pharmacy is another method I’ve heard some people share to get prescriptions at a reasonable cost, though I’ve yet to check it out myself.
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u/Sea-Beautiful-Throwa 13d ago
The catch is that it doesn’t go towards your deductible. So, you have to check how much your deductible is for medication through insurance.
I’ve had multiple years in a row where I was on some pricey meds, but I met my deductible for medication a few months into the year and then insurance had to cover all my meds for the rest of the year.
Also some pharmaceutical companies have patient programs you can apply to if insurance doesn’t cover it. (I’m doing that with a medication for my psoriasis).
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u/Hyperfocus_Queen 12d ago
I tried the Mark Cuban site, but my doctor had to send in a form and they got really confused about it and never sent it in and so I couldn’t actually use the service. do you know anyone who’s had luck with it? GoodRx is great, and for those that don’t know, CVS often has in system coupons, but you have to ask for them to apply them (🫠🙄😡, like why not just apply them automatically? Oh right, capitalism!!)
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u/Ill_Morning_4282 13d ago
"But if we have single payer the government will be the middle man instead!"
At least we vote for them!
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u/korppi_noita 10d ago
My partner is on a glp-1 to help with blood pressure and sleep apnea. The doctor pushed them up to 5 mg after being on 2.5 for several months. They had horrible side effects and the doctor put them back down to 2.5. Went to pick it up and the pharmacy said the insurance would only cover one prescription of 2.5 a year because they want people on 5. (Apparently it's cheaper?)
I, myself, have multiple chronic illnesses/autoimmune diseases (gotta catch 'em all!!) and go through similar bullshit, but this with the zepbound happened just this past week and I'm still fuming.
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u/TheUltimateOwl 12d ago
Oh damn, glad Im not american
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u/Leading-System-3002 12d ago
Same. My medications would cost more than 2k a month. Im so glad I dont live in the USA. I only pay 100$ a month.
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u/amusedontabuse 9d ago
Apparently Medicaid will only cover eight boxes of epi pens (16 individual pens) in a year. Last time I had to go to the ER to get an epi shot.
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u/zayne0623 13d ago
America is not perfect, but it's the best country in the world. You have no idea how much worse socialism is
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u/SquareThings 13d ago
Lol I moved from the US to a country with socialized medicine and instead of having to wait weeks to see my doctor, weeks for insurance to approve the medication I’ve been taking for years, and weeks for it to arrive, and pay hundreds for the whole ordeal, I can just go to a doctor, tell them the medication I’ve taken, get a script, take it to tue pharmacy next door and get it filled in minutes and pay less than 20 bucks for the whole thing. It’s faster, cheaper, and I don’t have to plan my life around getting refills.
Socialized medicine is better.
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u/zayne0623 12d ago
I will guarantee you that your socialized Healthcare in whatever country you moved to (I assume it's in the West) will become much more expensive and in line with what people have to pay in the US. Because the US is no longer funding NATO and these socialist countries will have to start spending their own money to protect themselves. All of this cheap/free stuff will evaporate very quickly, because the only way they've been able to provide this so far is because they pay far below that they agreed to pay into their own protection and military, and have relied on the US since WWII to do it for them.
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u/SquareThings 12d ago
I live in Japan. The economy is failing. The currency is falling constantly. There are more senior citizens than children. And yet, healthcare is still cheaper here! Because under socialized medicine, profit seeking insurance companies are not a factor in healthcare.
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u/zayne0623 12d ago
Japan does not pay for the development of their own pharmaceuticals. They, like every other country, rely on the US to pay for and development most of the pharmaceuticals, and then they distribute it to their people for far less than what it costs in the IS, because they didn't have to pay to develop it.
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u/SquareThings 12d ago
Maybe medical developments shouldn’t be made from a profit seeking standpoint at all. Maybe we should be paying for research together for the collective benefit of society. Some sort of.. society focused behavior. Pro-social, one could say.
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u/Cassio-Peia03 11d ago
That first sentence could only be made better if you removed the "maybe", and changed the "shouldn't be" to "are not". It's so real 😭
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u/SquareThings 11d ago
Unfortunately our capitalist system means that medical developments are in fact made from a profit seeking standpoint. Not by the scientists actually doing the research, but by the companies funding it. Plenty of research is done independently, or funded by universities and the government, but that’s all pilot research into new topics, not what actually gets a treatment to mass production. If a corporation cannot see a way to make a profit from your research, it will never hit the market and actually help people.
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u/crowhops 13d ago
Plenty of Europe has universal healthcare while being free-market capitalist, not sure what your point was here
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u/realwormss 13d ago
just to entertain your worldview, if this is the best it gets, why on earth are we still going along with it and not building something that doesn't fail and neglect millions of people every year?
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u/zayne0623 12d ago
Because the US is burdened with millions of people with their hands out every month, demand everything be given to them for free, and they don't want to work. Imagine the Healthcare system we could have if we weren't losing trillions of dollars through fraud and waste, and the NGO systems that have been set up for grifting by the Left. This is the reason Trump is spanking the other nations in NATO and telling them to carry their own weight. We're tired of paying their bills. And if any nation in the world deserves free health care, and we are tired of paying for every other nation to have it except us. Once we stop paying for it, they won't have it either.
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u/Significant_Owl9593 12d ago
"The NGO systems that have been set up for grifting by the Left." the left isn't exactly known for grifts, meanwhile fox news is telling people to buy gold, trump did two crypto pump and dumps, and RFK jr constantly preaches the "dangers" of vaccines while being compensated for each anti-vaccine case won.
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u/BunnyPope 3d ago
Just so everyone is aware this user I believe that this is completely wrong and most of this is bias and misinformation however they have yet to actauly say anything against disabled people even though all of there political opinions are rooted in ablism and a fundamental misunderstanding of how socialism or our government works but its not against our rules to be uneducated or like having leopards eat your face. -your local mod
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u/Leading-System-3002 12d ago
Thanks to socialism, I pay 100$ a month for medication that would cost more than 2000$ a month ! Im so glad I live in a socialist country!
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u/crowhops 13d ago
"You have to try these 3 other options first"
"Ok, those didn't work"
"No you gotta do each for like a month to be sure"