It’s also pretty shocking to find out what y’all have to deal with. German healthcare can be mildly annoying at times (the bureaucracy of finding the right form to fill out to get something like psychotherapy approved can be tedious), but I’ve never heard of anyone here getting their request dismissed without a good, legally predefined, reason. Apparently American Healthcare companies can just say no just because they feel like it?? whack.
I’ll never forget when I was prescribed a medication for a heart condition, literally crucial for me to continue living, and the insurance company denied the claim. Without insurance it was $600/mo at a time when I was making $5.25/hr.
I really don’t get how your insurance company can be like “you need this treatment to live” (Or anaesthesia is vital for an operation, and an insurance company just be like “nah…”.
I remember the phone call with the insurance clearly. I asked the lady on the phone, “I don’t understand - my doctor says this is crucial but you’re saying I can’t have it?” And she said, verbatim, “I’m not saying you don’t need it or can’t have it. I’m saying we’re not going to pay for it.” And when I told her “Then you’re giving me a death sentence.” she went silent. I ended up stretching my one month doses over 3 months so it was “only” $200/mo.
That’s inhumane. I wonder if the person on the other end of the phone just didn’t give a shit or what…
She probably had no authority to do anything about it. Delay, deny, defend…she’s part of deny/defend. She’s there to tell you that you were rejected, not to explain why or appeal. If a doctor calls, they’ll go into “you didn’t submit X step of paperwork declaring the patient has Y, and so even though you noted it elsewhere we’re denying”
Going off script risks her job, and for what? By design, she can do nothing to actually help
Two issues:
~ The problem persist despite the incident. Maybe this is the beginning of a sea change for healthcare in the US, but so far, it’s a single ring wave in the pond.
~ Europe is no stranger to problems being solved, including each other, via violence.
