I work for a startup company trying to sell early disease detection for colon cancer, and we’re having a hard time making sales in the market. Our product takes in a list of patients who are overdue for colonoscopies and spits out a smaller list of patients that should get screened. The hospital administrators that we talk to think our idea is really cool, start the sales process, but end up bailing. We’re using a usage-based pricing model because we pay for the model that we use to do the predictions. We thought the improvements of patient outcomes and high ROI would convince hospitals to adopt. What’s wrong with our approach?

Edit: I understand that hospitals are motivated by money. It’s more about what am I not understanding about the ROI

Basically- My father was laid off and his last day was December 29th, 2023. My birthday was in March 2024, where I turned 26. He says he signed me up for Cobra that would last from December 30th 2023 to June 30th 2024. Then he even said that he would be able to get me on his new job’s plan (Horizon) from July 1st to December 31st, 2024.

However, when I called his/my insurance a couple days ago (Aetna) they said my coverage ended on March 31st, 2024. My job gives a period of 30 days after the date of loss of coverage to hop onto their insurance via Life Event Enrollment, and it is now May 4th. The period is over, and it appears I have absolutely zero health insurance until my company’s open enrollment opens up again in November.

My options seem to be to try and somehow get on my company’s plan (probably not happening), see if there is a way I can get Cobra to extend to June 30th like I was originally told it would (not counting on this either) or get a short term health insurance plan myself that lasts from now to November. I don’t know what that looks like or where to start.

I’m really not sure what my options are right now, and I don’t know who to go to right now, so I’m asking Reddit. Honestly I’m very scared, I don’t have health insurance right now all because I trusted my father telling me I would have it until December 31st, when in reality it looks like I haven’t had health insurance for a month.

Please help me. Thank you

My doctor retired in 2018. I requested my records in 2020 shortly after he passed away. I never received them. I contacted the group he was a partner with asking them for my records again in 2022. I never got a reply. This morning I contacted them again asking what it takes to get my records. What should I do if I don't hear back from them again?

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As soon as Collin Davis found out his ex-partner was planning to travel to Colorado to have an abortion in late February, the Texas man retained a high-powered antiabortion attorney — who court records show immediately issued a legal threat.

If the woman proceeded with the abortion, even in a state where the procedure remains legal, Davis would seek a full investigation into the circumstances surrounding the abortion and “pursue wrongful-death claims against anyone involved in the killing of his unborn child,” the lawyer wrote in a letter, according to records.

Awhile back I posted about trying to get health insurance to cover a dental procedure (previous oral surgeries were covered by health insurance but ultimately failed due to additional medical conditions, this is a procedure that is only coded dental and only done by dentists)

Took months before the dentist (mayo) agreed to request pre-auth, they don't normally do that for health insurance (and no dental insurance) and it was promptly denied, but gathered the entire history and related medical info and got approval!

Recently displaced (new euphemism for RIF) and need to make a decision regarding health insurance. I can continue what I currently have via COBRA till I am 65 in 11 months, OR I can take advantage of South Consumers Alliance offering of coverage through Freedom Life Insurance which is part of USHealth Group. They use the United Healthcare Choice Plus Network and it's a fixed indemnity plan. It is about $146 dollar cheaper per month than COBRA through Aetna for medical and vision/ MetLife for Dental.

Not eligible for ACA as astronomical due to not eligible for any subsidies. Retiree medical is about $400 more than COBRA.

I want to make a very measured decision and not simply pick the cheapest. I am rather healthy.

Anyone here have any feedback on this company and the Premier Advantage Fixed Indemnity Plan? Their materials clearly say not ACA Compliant which kinda scares me.

Thanks and need to make a decision soon since my work coverage ends on 5/30/24.

...what the cost of the appointment is before services are rendered. Doctors need to stick to it, and should be required to disclose that discussing something can cause an appointment to go from X code to Y code. Insurance companies need to clarify what codes are covered, not what services. There is a huge disconnect and its costing folks a ton of money when their intentions are to go be seen for items covered by insurance.

If folks knew code XYZ is the preventative code covered, they should be able to go into the docs office and ask for that. But codes aren't on EOBs, and doctors pick whatever code fancies them. They need to be transparent and let people accept or deny the services.

I'm going in for a surgery that I pretty much just barely can't afford, and of course my insurance won't cover it because it's an elective cosmetic surgery. The only option they're giving me for payment plans is CommerceCare, which I'd be interested in if it weren't offered by Commerce Bank... That part makes me really, really nervous.

I can't find any information about it online that isn't directly from Commerce Bank, which is just making me more nervous somehow. Couple that with my typical USAmerican lack of financial literacy and I'm stumped. Does anyone know anything about it or have experience with it? Is it any good, or should I just hold off for a few more years until I can actually afford the surgery?

For background, I’m a 25 year old female in the US on my parents insurance plan which is state insurance.

I visited a chiropractor this week who does the first intake session free. The next day, we had our second session where we reviewed my x rays and he suggested an ongoing treatment plan with 3 visits a week in the first month then 1-2 visits a week after.

He says the deductible for my insurance is supposed to be $300, and that my insurance covers 70% of each visit. He offered to waive the deductible and said he would accept a $20 copay per visit as opposed to the 30% (apparently, the cost of the 30% and the $20 are about the same)

He told me when the insurance mails the check for the visits, I have to bring it to the office. This will be about twice a month and I signed a paper saying I am aware that my insurance mails checks, and that I will bring him the checks. This seems normal.

My concern is that he says I’m going to continue seeing the $300 balance for the deductible on my insurance bill, and that I should just ignore it because he’s waiving it. I asked the front desk person what happens to that balance if I decide to stop treatment, since it will always be on the “expected contribution”. I didn’t really understand their answer.

My question is: is it normal for a doctor to waive a deductible? If so, what steps can I take to make sure I’m not charged in the future?*

PS I also signed a estimate that says my expected cop pay is $20. The estimate paper says if I’m charged more than the good faith estimate, I have the right to dispute the bill. This makes me feel slightly safer but I want to be 100% before I move forward.

Honestly, today just broke me. I don’t have a solution or proposal to fix anything and this post may get ranty but I need somewhere to vent my frustration with the utter insanity the US healthcare system has become.

In the late fall of 2023, I got a letter from my insurance company that the manufacturer of my 3 year old son’s asthma medication was going to stop producing his daily inhaler and that we would need to switch to an alternative. The alternative that was provided for children under 6 years old was not an inhaler but a nebulizer solution (I.e. we would need to buy a several hundred dollar nebulizer machine and he would have to do a daily course of a 15-20 minute nebulized medication compared to the 30 second 2 puff inhaler he had in the past). Obviously this solution was bonkers as getting a 3 year old to sit holding a nebulizer to his face for 1/3 of an hour every night would have been akin to giving a lion a pedicure.

We filled his inhaler earlier this year just before the cutoff deadline of when our insurance said they would stop covering it and this week was the first time we had to refill it since. I asked our doctor to submit an override authorization, which our insurance promptly denied and referenced the nebulizer alternative. I called my insurer and said what am I supposed to do? I can’t get a toddler to take a daily nebulized medication that he needs to prevent having a potentially devastating asthma attack. They told me “sorry it’s not covered, but if you decide to pay out of pocket for it then the cost will count against your deductible for your high deductible plan at least”. This medication is $320 for a 60 day supply so I went on GoodRX to find a coupon and saw that Walgreens had one for $90. $50 less than any other pharmacy. I called my son’s pediatrician and had them call in the prescription to a Walgreens pharmacy as we gave him the last doses of his previous inhaler today.

I stopped at the Walgreens after work (and after my son’s doctors office had closed for the day) to pick up the inhaler. I get to the pickup window and the tech informs me that Walgreens does not accept my insurance so the cost of the medication will not count against my deductible. I had no other choice so I silently seethed while I paid for the inhaler that my sons needs.

I don’t understand how, in the year 2024 in the wealthiest country on earth, we can have a situation where an insurer can just decide that they are no longer covering a medication that is the 23rd most commonly prescribed medication in the United States. It helps keep my son alive for God’s sake. How have we let things slip to such a ridiculous extreme that nobody is standing on their goddamn desk in congress and screaming about this bullshit? I don’t know if I’ve ever been angrier with this fucking hellhole than I am at this point. I apologize for this block of text but I just needed to scream into the void for a few minutes.

Good rx?

I just called to make an apt with a new primary care because my insurance changed. I cant meet with any providers until October at the very earliest and it’s at a hospital an hour away.

When I asked how I’m supposed to get my maintenance medications in the mean time, the phone operator told me to go to urgent care to get a prescription for it ?

How is this advice that’s supposed to be given out by hospital telephone operators ?!

As a nurse, people using urgent care or emergency rooms for non-emergent matters are one of the most annoying/wasteful use of time and resources we encounter. It’s a huge waste of resources and takes time away from patients who actually need our care and beds in emergency and urgent care clinics.

Has anyone encountered this and how did you get a prescription for medications while you don’t have a primary care provider?

For reference, the two medications are birth control and an SSRI.

I was recently laid off & so I’m getting new insurance from the NYSOH marketplace.

I do not qualify for Medicaid bc I earned some income in 2024 before I was laid off.

But I will qualify for the Essentials plan.

There may be some confusion bc I vaguely remember hearing that the “essentials plan” is actually an umbrella term and there are an array of specific plans within that that you choose to use as your health insurance , with some Medicaid options and some non-Medicaid options that you can choose from.

(either way, I’d be signing up for a NON Medicaid version of the essentials plan if they offer both)

The “Medicaid” distinction is extremely important for me, bc if you have ANY medicaid plan in NY then ALL of your Rx’s need to be written by a Medicaid doctor or else your prescriptions won’t be covered by their pharmacy benefits (NYRX)…. And I have one Rx that I need every month from a doctor who is NOT a Medicaid Doctor. I cannot go without this medication and it will take months for me to switch to a Medicaid doctor for my issue (long story).

On the surface, it seems clear that it’s not Medicaid & everyone at the NYSOH exchange keeps telling me that the Essentials plan is NOT considered Medicaid,

but my pharmacist told me that if you have the essentials plan then your Rx’s nevertheless must be written by a Medicaid doctor bc they have to “run it through the system as Medicaid”. And it will automatically be rejected by the system if the prescribing doctor is not Medicaid covered.

So I don’t know who to believe and I’m really nervous bc if my pharmacist is correct, then I’m gonna be screwed when I go to fill my Rx since it will have been written by a non Medicaid doctor.

The one thing I would REALLY TRUST is If anyone here actually is ON the essential plan and IS able to get their Rx’s filled by a non/medicaid doctor. Does anyone here have any experience with this 🙏? ANY help would be greatly appreciated!!!

I (23M) just went to the Doctor for my first checkup since being 18 and seeing a pediatrician. When filling out the medical history and information forms I was 100% honest about my drinking/smoking habits (I drink a lot and smoke occasionally, but I still checked the smoking box). I was always under the impression you were supposed to be fully transparent with your doctor and that this would be confidential information, otherwise no one would be honest with their Doctor. Someone told me yesterday this information will be available to insurance companies when I get my own health insurance in a few years (on my parents now). Is this true? How big did I screw up? Guess I should lie to my Doctor the rest of my life? Help me understand. Thanks!

Hi all,

I live in the EU but am planning on moving to the US, so forgive my ignorance on the US health system at this point in time.

When it comes to buying my medication via a retail payment, would my prescription forward the cost to my insurance company and therefore contribute to my deductible?

Thanks in advance, u/iwishiwasthemoon_8

Ever heard of HealthBot?

It's a messaging tool that keeps your health info safe and gives personalized advice. It even reminds you about check-ups and can find local doctors if you need one.

Worth checking out!

https://preview.redd.it/idmyb3k3acxc1.png?width=1500&format=png&auto=webp&s=0ffd9b9f706d8cb4bd94b6d54a89c51663433b4c

Let’s propose a scenario.

I am about to die, someone stabbed me 4 times and I am bleeding out fast. I get to the hospital because someone decided to call an ambulance for me. I get the standard treatment in the ambulance, I get to the hospital and they do whatever it takes to save me. And thank goodness they save me, hooray I’m alive. I stay in the hospital an extra week until I recover a bit more. I get home and I get a $100,000+ medical bill in the mail. I almost have a mini heart attack just looking at the number, because I cannot afford it, nor will I ever be able to afford it on my $22,000 annual salary. I think back and wondered if I should’ve refused treatment and just die. Of course I’m grateful to be alive, I’m grateful to the doctors and nurses that saved my life. But now it feels like I’m trapped with this medical bill that I’m unable to pay. Obviously the hospital staff needs to be paid, they don’t work for free. But how am I supposed to deal with this.

Now a different scenario, well at least the second half. (I don’t have health insurance for both scenarios)

This time it’s the same scenario up until I get the medical bill. I look down at the $100,000 medical bill, but I just shrug it off and place it back down. Weeks and months go by and I ignore the medical bill, I don’t make any efforts to pay it nor do I intend to because I can’t afford it.

Should I have just let myself die and refused the treatment, so that I can avoid the medical bill? Me dying could’ve saved the hospital some money, because they wouldn’t have had to send out an ambulance and use all these medical supplies to save my life.