Telehealth will be free, no copays, they said. But patients are getting billed | Hacker News Reader

Telehealth will be free, no copays, they said. But patients are getting billed

khn.org

61 pointshhs12 comments

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.

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.

The low income / low schooled people I've worked with are actually the most knowledgeable about these scenarios for exactly this reason.

While the knowledgeable and rich can afford to post on HN, discuss which stocks or investments are going up/down, the poor are stuck playing games avoiding illegal charges.

Still sounds like a rigged game.

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...

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.

Social media shaming of individual doctors who permit this at their clinics could be effective. People are pissed about pandemic profiteers already, but the perception is that most of them are distant mega corps. If they find out it's happening in their immediate community and know the parties responsible, it probably has a good chance of being shared.

This is just a drop on a hot plate. The entire system is rotten, and it needs to go.

But by all means, everyone is stuck playing the blame game, the red ties point to the blue ties and the other way round.

In the mean time, nothing changes and regular people loose.

Fuck Republicans, fuck Democrats, fuck Libertarians, fuck them all. The whole system needs to start over.

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.

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.

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.

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.

Reply on news.ycombinator.com