Health Insurance

[Heracles 417]

My wife had a preventative mammogram carried out. Because she is under 35, insurance won't cover it. So we received a nice bill of $735 for it.

We have the top insurances coverage / policies through Anthem. What cracks me up is that you get screwed when you try to be preventative, then if your not and are diagnosed with something, they screw you again and refuse to pay the bills because then the treatment is too expensive.

Second thing is how the heck does a mammogram cost $735. I just wrote a check to the labs and everyone else asking for a fee but what the heck am I paying insurance for?

Cost in Australia Z E R O.

Edited May 7, 2009 by Constellation

[Mr. Big Dog 10,747]

Welcome to America!

[childress_london 3]

That's why it's important to read the fine lines of your insurance policy. If it's not covered, I'm not having it done unless there is an overwhelming reason for it. Why did your wife get the mammogram? Does she have a genetic predisposition towards breast cancer? If she can prove that, then there might be a loophole that would allow the insurance to cover some of the mammogram fees. Preventive tests are covered only under certain conditions, such as age. Insurance only pays for what it absolutely has to and nothing more. I didn't have my first mammogram until I was 44.

[Heracles 417]

Welcome to America!

What the heck to the sick and poor do in this country? They are basically fu-ked. There is no other way to put it.

For us is is no big deal but how the hell does someone on minimum wage, out of a job or food stamps pay for it?

That one test would cost more than their monthly pay check.

[Trompe le Monde 1,107]

My wife had a preventative mammogram carried out. Because she is under 35, insurance won't cover it. So we received a nice bill of $735 for it.

We have the top insurances coverage / policies through Anthem. What cracks me up is that you get screwed when you try to be preventative, then if your not and are diagnosed with something, they screw you again and refuse to pay the bills because then the treatment is too expensive.

Second thing is how the heck does a mammogram cost $735. I just wrote a check to the labs and everyone else asking for a fee but what the heck am I paying insurance for?

Cost in Australia Z E R O.

They should pay for it if your wife's doctor thought there was something to be concerned about, like a lump or irregularity. Was there?

I know my doctor will always create a "reason" for mammograms even if her patients are too young to have insurance cover it, if they want the piece of mind.

[DeadPoolX 9]

Welcome to America!

What the heck to the sick and poor do in this country? They are basically fu-ked. There is no other way to put it.

For us is is no big deal but how the hell does someone on minimum wage, out of a job or food stamps pay for it?

That one test would cost more than their monthly pay check.

Medicaid exists for those below the poverty line. However, there are many individuals who make above the poverty line, but not enough to afford health insurance of their own. These people are called the "working poor" and get the worst of it.

[Empress of Groovy 373]

My wife had a preventative mammogram carried out. Because she is under 35, insurance won't cover it. So we received a nice bill of $735 for it.

We have the top insurances coverage / policies through Anthem. What cracks me up is that you get screwed when you try to be preventative, then if your not and are diagnosed with something, they screw you again and refuse to pay the bills because then the treatment is too expensive.

Second thing is how the heck does a mammogram cost $735. I just wrote a check to the labs and everyone else asking for a fee but what the heck am I paying insurance for?

Cost in Australia Z E R O.

Definitely follow up w/ the insurance company. Get details. Keep documentation.

Getting health insurance companies to pay for stuff they should cover can be a full-time job in itself.

Insurance companies also screw up a lot--it could be a mistake.

I wouldn't take it lying down--get on the phone.

Edited May 7, 2009 by Big Agnes!

[Heracles 417]

That's why it's important to read the fine lines of your insurance policy. If it's not covered, I'm not having it done unless there is an overwhelming reason for it. Why did your wife get the mammogram? Does she have a genetic predisposition towards breast cancer? If she can prove that, then there might be a loophole that would allow the insurance to cover some of the mammogram fees. Preventive tests are covered only under certain conditions, such as age. Insurance only pays for what it absolutely has to and nothing more. I didn't have my first mammogram until I was 44.

Her mother had breast cancer so she just wanted to make sure there are no signs. Actually, her doctor advised her to have the test.

When it comes to health insurance in AUS, they basically swipe a card and tell you then and there whether or not your are covered and what you will pay. No surprises. Keep in mind we have a NHS there, so most procedures and tests are free anyway.

[Heracles 417]

I spoke to the insurance company and they said since it was preventative, that is, they didn't find anything; They will not pay for it because she is under 35.

We actually have two policies, which overlap one another, and they still don't cover it. Dirty bastards hey.

Though I have a insurance policy from AUS, which is still active too, that ironically may cover it.

[Niels Bohr 72]

Because they have such tight restrictions and standards of coverage which is very negative towards you. If there's an error on their part, then, hit them with a heavy lawsuit that will drain their profits level on attorney fees.

[DeadPoolX 9]

That's why it's important to read the fine lines of your insurance policy. If it's not covered, I'm not having it done unless there is an overwhelming reason for it. Why did your wife get the mammogram? Does she have a genetic predisposition towards breast cancer? If she can prove that, then there might be a loophole that would allow the insurance to cover some of the mammogram fees. Preventive tests are covered only under certain conditions, such as age. Insurance only pays for what it absolutely has to and nothing more. I didn't have my first mammogram until I was 44.

Her mother had breast cancer so she just wanted to make sure there are no signs. Actually, her doctor advised her to have the test.

When it comes to health insurance in AUS, they basically swipe a card and tell you then and there whether or not your are covered and what you will pay. No surprises. Keep in mind we have a NHS there, so most procedures and tests are free anyway.

It's not free. You pay for it through taxation. One way or another, you end up paying.

As for health insurance, you need to read over the details of your plan. You've said that in Australia they swipe a card and tell you if you're covered or not, right? Same basic principle here, only no card. In fact, health insurance gives you a much better idea of what's covered and what you'll need to pay since it's written out for you. Whether or not you choose to read it is your deal.

[Donna A 4]

oh that happened to me once. my first one i wasnt 40 yet but i was having alot of pains in my right one so i went for a mamo and ultrasound and they paid for it. then i was one month from turning 40 and didnt think anymore about it and went for my next one and yep u got it...they didnt pay for it. i think it only cost me $120 or something close to that if i remember right. sounds like they are really overcharging u cuz that was only 3 years ago when i had it and i dont think prices have increased that much have they?

[Heracles 417]

It's not free. You pay for it through taxation. One way or another, you end up paying.

As for health insurance, you need to read over the details of your plan. You've said that in Australia they swipe a card and tell you if you're covered or not, right? Same basic principle here, only no card. In fact, health insurance gives you a much better idea of what's covered and what you'll need to pay since it's written out for you. Whether or not you choose to read it is your deal.

Who is going to read 500 pages of policy to see what is or is not covered? It's the same ####### with auto insurance here. You have 100 different options to choose from. Whereas my auto insurance in AUS has one option which provides $20 million worth of liability for anything auto related issue.

So basically health insurance is scam here. I paid 1.5% of my salary to the government and I was covered for everything in Aus, period. Plus my fellow citizens received quite a decent quality of care rather than be left to die on the streets. I haven't had to use a doctor or anything like that here but can now see why people are complaining. It's not the doctors fault. The insurance companies can get away with anything. They get to make their own rules.

The health insurance there is just an add-on to receive even better and faster coverage. We are paying close to $5.5K a year here and still have about 1,001 clauses, policy limits, conditions bla bla bla. That is on top of what the employers are paying.

Edited May 7, 2009 by Constellation

[Heracles 417]

oh that happened to me once. my first one i wasnt 40 yet but i was having alot of pains in my right one so i went for a mamo and ultrasound and they paid for it. then i was one month from turning 40 and didnt think anymore about it and went for my next one and yep u got it...they didnt pay for it. i think it only cost me $120 or something close to that if i remember right. sounds like they are really overcharging u cuz that was only 3 years ago when i had it and i dont think prices have increased that much have they?

I believe the hospital / place is private so they charge a hefty fee for their services.

Edited May 7, 2009 by Constellation

[Mags 112]

It's not free. You pay for it through taxation. One way or another, you end up paying.

It's still WAY cheaper than paying for insurance over here. The monthly equivalent is only a fraction compared to what you pay over here, even with employer health coverage.

I know. I've done the math out of curiosity and because I was fed up with people yelling "but it's not free, you pay for it through taxation!"