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Thread: insurance a joke

  1. #1
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    insurance a joke

    i have used shephard in atl for 10 yrs on supllies neve an issue till now was told my plan no longer ang good united hooked me uo to 1 identiall wrong

    i called carol a month ago asking why supllies had dam near double don/t know you check plan called you have no network use who u want ok another sky high bill only this time i get the envople for united health

    telling me shepard is not in network

    now i called the 3 they gave me 1 does not do my supplies 1 apria no answer closed even at noon another 1 the get faxed script but i want to know cost and my cost

    why is it such a big secret why can u not go on ine annd get price

    i know i am going to talk to shephard and get my cost reduce to 20% i

  2. #2
    You're not alone.
    Of the biggest healthcare insurers in the USA, United Healthcare is #1.
    The sheer numbers of people insured by UHC give them the power to go to a hospital system and negotiate a lower payment rate in exchange for an increased volume of patients. Likely, Shepard's financial people ran the numbers and turned down their "offer"
    UHC had been denying payment for urinary catheters a few years ago. I thought it had been resolved but, I guess not.
    Some of the CareCure members were affected by the prior changes. They may be able to offer you advice on how and where to get your supplies.
    As far as the Rehab Hospital, sometimes the financial administrators are able to re-negotiate and eventually get back into network.
    Sorry. I've had to change my go -to hospital and Primary Care doctor twice because they were getting paid too little by Blue Cross and determined that caring for us was losing them money.
    Do you need some catheters? We are fortunate to have extra and can send them to you. We have Bard 14 Fr closed system. PM me. No charge.

  3. #3
    I have started buying mine on eBay. I just Put in my search info and when something comes in as a match I get notified. I also reuse mine I am able to just wipe down the catheter with a baby wipe after use and then again before use. I use essential oils a lot which helps with my own body . My catheters were about 250. A month. Instead I bought almost 8 months for a bit less than that. The only way I was going to make it to my deductible was to have something serious happen. Even though I have great prescription coverage and I had a prescription for the catheters. They were durable medical and so not covered the same way. So for now it is just ebay, still delivered to my home very quickly. Saving me lots of money.

  4. #4
    Senior Member Oddity's Avatar
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    Provider networks have been collapsing for the past many years. Our 'in network' provider options recently went from 1000s across 50 states to less than 50 in our immediate region (handful of zipcodes).
    A Buddhist monk walked up to the guy working behind a hot dog cart and said, "Make me one with everything."

    "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus

  5. #5
    Senior Member Andy's Avatar
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    I have something called a "PPO Waiver" with BCBS so I can use an out of state non-network vender for caths. Need to renew it every year or two. I would surmise that UHC may have a similar function in their systems. Just tell them that there are no other appropriate venders in-network and you need to use whomever to get what you need. This should get that vendor on a higher payment tier.

    The EOB's that I get from BCBS seem rather scary, but with the vendor overcharging and getting sufficient money out of BCBS, everything works out perfectly for the last 5 years or so. The best part is that this vendor eats whatever co-pay I have and my yearly medical deductible, making caths at zero cost to me. PM if you want more info on the place I'm using...service is totally awesome as well.

  6. #6
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    i called last night about a blood test dr order but they denied and i was talking she gave me 4 mored but i want to know cost how much mark up no way in hell does does a ducette cathe cost 25.98 1 5 colorplast concave wafers 5 for 34.90 or colorplast ostompy pouch 90 149.00

    that why we are payting thru the nose they charge 3 time to much cr bard they are made in mexici i know we pu the trailers there bring back to covington

  7. #7
    Senior Member soonerborn's Avatar
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    I have 12 boxes of 100 14fr caths rush mmg h2o kits for sale $1 per if your interested let me know. I also have speedicath compacts that are the same size but only like ten left of those and there 20 to a box.

  8. #8
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    Quote Originally Posted by soonerborn View Post
    I have 12 boxes of 100 14fr caths rush mmg h2o kits for sale $1 per if your interested let me know. I also have speedicath compacts that are the same size but only like ten left of those and there 20 to a box.

    thank you but i use 18 fr how you get so many

  9. #9
    Senior Member Tim C.'s Avatar
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    Is this AHA collapsing?

  10. #10
    Quote Originally Posted by Tim C. View Post
    Is this AHA collapsing?
    Yes, but it won't collapse before it's repealed and replaced with something even worse.

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