She literally called me at the time of the appointment to tell me she can’t see me. She was so apologetic, but was like “I absolutely can treat you, but I’m not allowed by your insurance”. Fuck this country.
Update: I went to urgent care. Before leaving home, I called to be sure they would accept my insurance (Aetna). They said yes… After arriving for my appointment, they told me they do not accept my insurance. I will simply leave without paying.
Final Update: I can understand that that differences in physical biology demand different attention. That’s not what I’m complaining about. It’s the way it’s set up. I was told that at my appointment. Why not just refer me to a specialist? The website could’ve even just referred me to urgent care (yes, my insurance requires a primary care physician’s referral for urgent care, according to the urgent care facility). But, no, their goal is to obfuscate and irritate until the patient gives you and pays out-of-pocket.
I was able to receive care at a cost I could not afford. I won’t discuss what I had to do to “find” the money to pay for care and prescriptions. That being said, the condition I was diagnosed with was more serious than a simple infection, and I’m glad that I saw a doctor. I need further treatment and just hope I can get insurance to cover any of it.
If you’re an American reading this, please consider ways to get involved in organizing in support of Medicare For All in your community. Here is one resource I have found. We don’t need to live like this. We deserve better. Stay safe and healthy, friends.
That’s more than mildly infuriating…
Sounds like discrimination based on sex. A clear violation of the Civil Rights act of 1964.
Car insurance companies are literally allowed to discriminate by sex and will openly tell you that they do so, why would health insurance be different?
Civil Rights Act of 1964 prohibits different treatment of insured persons on the basis of their sex in connection with pension funds. This was a supreme court ruling, so kind of linked but not quite.
https://www.jstor.org/stable/253100
Interestingly, in UK and EU it became illegal to discriminate by sex for car insurance from about 2012, without very careful use of data - which doesn’t happen. It is allowed to be linked on things like jobs though.
newsflash: US never cared about civil rights and despite it being “law” it gets regularly ignored on an institutional scale
I will look into that. Thank you for brining it to my attention ❤️
It might be, but some health related coverage is legitimately divided along sex lines. I don’t know what the answer is, but it might not be so simple.
Stupid either way though.
Different genitals. But all genders have bladders so why the hell wouldn’t the insurance just cover it for everyone
So a few things. This is a CVS minute-clinic visit, not a visit to a general provider. The minute clinics have contracts with insurance companies that look a bit different in terms of what and who they are permitted by the insurance companies to treat. There are some really odd variations in these contracts by insurance companies for reasons that are not always grounded in science.
This, as you’ve noted, is an unfortunate reality of a for-profit health care system that is dictated by private companies, insurance companies, and mind-bogglingly complex contracts that sit between providers and patients. The most annoying part IMO is that insurance companies provide zero transparency into these contracts and the justification behind decisions. It’s all “business decisions” at the end of the day, not decisions that are medically sound and in the best interest of the patient.
And for those wondering why OP maybe just didn’t go to a “regular doctor” - the U.S. has a horrible shortage of general practitioners (primary care) physicians. This shortage is worse in some areas than others. And even if you’re lucky to live in an area that has general practitioners, the waiting list to get into their practices might be long. This leaves many people relying on a “doc in the box” aka CVS Minute Clinic or some similar outfit. These doc in the box clinics often only have a nurse or nurse practitioner on site, with a supervising physician off side. They are for-profit entities and they work with the insurance companies to design their contracts to maximize profit.
If you ever find yourself in OP’s physician, one easy way to get around this is to indicate that the visit is for something more general, like abdominal pain or unexplained fever. While the staff still might refer you off to another provider, it might be a good way to at least “get in” with someone.
Another option is to visit a local urgent care clinic if one is available and covered by insurance. These are often staffed by actual physicians so they can treat a wider range of conditions. Many often even have testing facilities right on site for a number of issues.
Finally, another option is to call your insurance company and see if they have an over-the-phone nurse consultant available. They can usually help direct you to the right location for treatment based on your symptoms and insurance coverage.
But yes, OP, I agree with you that we need something better. Medicaid and Medicare have slowly been expanding and my hope is that they will eventually expand enough to cover all Americans. it has been proven that they can still operate without completely decimating the insurance industry (see Medicare and Medicaid managed care). While I don’t agree with for-profit health insurance, the reality is that they are a lobbying force that has to be worked with if we are going to get everyone universal coverage.
Source: Health policy professional by trade, extensive experience within the health care industry
This is great. Thank you for providing such great info to lemmy. A lot of people in the US suffer from a lack of information, and this more than certainly helps.
What the hell? Was someone drunk when they drew up that policy?
deleted by creator
Too much cocaine
My friend, you need to do two things –
One, get treated. It seems you’ve visited urgent care. They are “real” doctors and, assuming the hospital or clinic the urgent care is associated with is well-staffed and stocked, should be able to get your sorted today. Be sure to get any prescriptions you need filled on-site, if possible, before you leave.
Two, review your healthcare plan. While the Affordable Care Act mandated certain minimum coverages several things happened since that allow people to purchase plans that do not conform to the ACA mandates. On those so-called “catastrophic” plans, insurers can deny or decline to cover all sorts of things. Patients often simply shop by monthly premium cost and don’t check coverages. Make sure your health plan is ACA-compliant, and, if not, look into a way to get covered by a compliant plan.
If it IS ACA-compliant, then treating a UTI, even in a male, is covered. You may be selecting providers that are not in-network, or do not have the proper staffing to treat this fairly rare condition, though. It may be worth a visit to your primary care provider if you can’t get something like CVS or another “Doc in a Box” to treat it.
I think you’re just supposed to die now…
I don’t believe I can afford to, though. 😓
You are presuming that it is a UTI and and coding it wrong for insurance purposes. Do a visit for something more generalized that is covered like abdominal pain and doctor will know how to code it properly for insurance.
I’m living in Turkey. All health care is free.
but if you live in turkey you get hate for being gay
You get that in the US too, so what’s the difference?
true that
Unless you are unemployed. Then you have to pay the unemployed tax (GSS) whether you use the healthcare services or not.
That sounds so fucking stupid
You’re unemployed so pay us money you can’t recoup until we make you homeless
That sounds expensive. So when you don’t have an income source they charge you a tax for it?
It makes sense if you think about it (assuming my thoughts are correct, I’m in the US). If you’re employed, you are contributing through your taxes. Just because you’re unemployed, it doesn’t mean your contributions pause. Now, should they? That’s a good question, but the current implementation makes sense. I imagine it does incentivize people to look for employment.
In germany, the state is paying for your health insurance when you’re unemployed(along with other social insurances). More precisely the job centers are paying it, but they are ultimately paid by the state so…
there is so much money in the world, and food/water, and housing that literally everyone - theoretically - could be fed and healthy without needing to pick on the unemployed first.
No. No, it does not. A poor tax makes no sense.
We can discuss where the money comes from, but the idea isn’t pie-in-the-sky wild. I don’t disagree with you.
Are the people in the comments bots or real people? It’s too good to be true that so many people have switched to Lemmy!!
Everyone on Lemmy is a bot except you.
I checked and am definitely a robot.
We are the robots https://youtu.be/VxF0aja7rLU
We are bots😃
The entirely of modern America could be summarized with “Mildly Infiruating”, tbh.
It is utterly baffling to me how the US has not figured out nationalized healthcare. Literally every other developped nation in the western hemisphere has at this point.
Its crazy that a politician could come out and say “my number one priority is to ensure that every American has access to healthcare, paid for by the state”, and would instantly be villified by like half the country.
Because the healthcare industry makes money. A shitload of money. Why would they “fix” that? The problem is the fact that it is an industry.
The covid national emergency is declared over. Potentially up to 15 million people will lose Medicaid expansion. Florida already kicked off 600,000 people. An 87 year old who had a daily care taker lost access even though they were qualified after the cut. A 7 year old boy will now die because they took access to his leukemia treatment. About half the people still qualify but they are making everyone reapply.
My dad some how affords stupidly expensive healthcare. Premiums are $4,000 a month. ER copay is $1000. ER deductible is $18,400 per family. My mom is now on a medication that costs $1400 a day. With other meds her medication is $15,800 a month for the rest of her life (she is 59). With insurance it goes down to $28 She has had $100,000 in medical bills. She has some super rare condition. Our insurance said one of the out of network doctors was covered. My mom verified multiple times. Now they don’t want to cover that doctor so we are stuck with a $25,000 medical bill. My mom says she will put it on the lowest amount a month for the rest of her life.
In other words if my dad couldn’t afford this insurance she probably would be dead now or in a few months.
Crazy is that we are all Canadian and if we lived there we could go on OHIP plus extra insurance for a few hundred bucks a month. For those who say Canadian’s have wait times, so do we. The difference is you will be seen and will not go medically bankrupt or denied care because you are too poor.
The excuse is that Canadians come to America for better doctors with lower wait times. They do. But when you realize they come to the States they don’t have long term insurance. Meaning they pay out of pocket. So it’s wealthy Canadians that can afford insanely high prices.
All my family in Canada says my father is pissing away money. He is.
God Bless American Healthcare! /s
TLDR Doug Ford can sod off and go to hell.
That moment when it’s better to live in Russia than in US…
There are 0 objectively good reasons to live in Russia.
I’m pretty sure this is one of them…
Free healthcare in this instance.
For non citizens?
No one in A&E checks your passport. I mean I’m not in Russia, but in the UK and the only reason some medical professional might check your ID here is when you’re signing up for GP services - these are territorial in the UK. Otherwise you just go to the clinic or hospital and get a treatment. I’m migrant from an xUSSR country, so healthcare there should be close in structure to Russian I believe. And again - no one checks your IDs, except for when you sign up for GP.
And even when you need a GP, there is usually a framework for non-citizens. Usually when you sign up for GP they check your tax paying status. You pay taxes? Free healthcare for you! And in the UK if you don’t work and don’t pay taxes you can pay NHS contributions separately and then you will get all the treatment you want.
So I believe Russia should be somewhere along these lines as well.
Someone, ie insurance, has to pay for that medical coverage. I’m Czech and when I go to my doctor I give them my insurance card before I get treated. However, medical insurance isn’t “free” (well, government funded) for non citizens here either.
That’s wild. When I go to any NHS services I don’t provide anything unless I want my visit be recorded in my patient card for future references.
Are you sure this isn’t just a CVS thing? It says the same thing for me and I know my insurance covers UTIs for everyone. Maybe try an urgent care?
This is correct… there is 2 things to remember here
- CVS only has nurse practitioners, nurses, or pharmacists that are doing the screening, and must refer for certain cases
- There are 2 types of UTIs….
- complicated and uncomplicated
- Men ALWAYS have a complicated uti due to the anatomy of where the uti is located
- women can have either, these NPs are only allowed to treat UNCOMPLICATED UTIS and must refer all complicated cases to a physician.
FYI it has nothing to do with insurance
thats what you get for having a penis.
Or being born American.
smh should have known better
The grass is the same color everywhere.
There’s grass where you at? I wouldn’t know. Ain’t no grass around here.
Should have just said that you identify as a woman, probably solved. /S
But in all seriousness that’s just terrible. Everyone no matter if your a man or woman should be treated equally.
I think most everyone knows this would have to be in the USA.
Sorry OP, I really hope those greedy assholes just made some shitty mistake.
![[Final Update] My insurance won't cover UTIs for males. Yes, I'm in the US.](https://lemmy.world/pictrs/image/3f7f2fe9-6596-4427-a750-ca0a16636fcc.png){kind=link}