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We all know the insurance companies are horrible. It does not matter where we are in this great country. Back in the Fall of 2022 I was having some issues that I needed to see a specialist about. He was also a surgeon. At our first appointment when he walked in I saw him and FALSELY made a snap judgment. We talked a bit and he did the exam. I was having some issues I had ignored and would possibly need surgery down the road. He prescribed a medication to help reduce the issues I was having. He was up front and told me that insurance will probably not cover this and only one pharmacy in the area can make it. It is a compound that has to be prepared on site. He said the cost was around $60. Now of course $60 for medication is not bad at all in today's world but I am a man of principle and I planned to fight the insurance company.

As we talked I saw how wrong I was with my snap judgement. The doctor was about the most personable doctor I had every met. We talked for what seemed like a very long time. He was from Jordan and his family was still there with no plans to come to the USA. I know a lot of folks think (rightfully so) that folks come here from the Middle East came here to suck off the American teat and get their medical education. That does happen but this his man was the opposite. Dr Z was educated in Jordan and came here because of his wife. He said he loved America but our health care system is horribly broken. He went on to say that if he needed the same sort of surgeries he performs here that he could fly to Jordan first class, get the procedure(s) done, pay for them in cash, and fly back first class for less money than what his out of pocket cost would be based on the insurance that he has through the hospital he is employed at. This man is a surgeon in a hospital and the insurance for him is still CHIIT! There is someone really wrong here!!

Now back to the medication he prescribed. He said the insurance will not cover it but I am a persistent grouchy arse. I do not take no lightly and fight on principle. Many incorrectly call me a grouchy ole bastard. I smile and mention that I am definitely not a bastard, I was both conceived and born in wedlock therefore not a bastard, I am indeed an arse. Now of course the insurance denied it as he said they would. I fought back and forth with them. Yes I should have just paid the $60 but as I mentioned earlier I am a man of principle and dammit they need to cover the medication. This went on for a couple weeks. They asked if the doctor could prescribe a different medication. I said no this what he prescribed. After awhile I called his office and he wrote a script for a different medication. The insurance company accepted that but guess what, it was $750. They thought that was fine and accepted it. I think I went through 5 rounds of it and it was not doing much. The insurance had paid out $3750 for a medication taht did not work but had denied a $60 medication. I ended paying the $60 and it worked along with about $60 in OTC. Yes I should have paid the $60 upfront and not argued with insurance but dammit why have insurance that denies everything. The original doctor I saw got so fed up with American medicine he moved his wife and young kids back to Jordan. The guy I see now is OK but just not the same.
My wife is a nurse and has my insurance because its better than she can get us through the University of Michigan hospital. I have a friend that work for TACOM and has his wife’s insurance who is a school teacher.

Federal Govt insurance is also garbage.
 

Jusgunn3

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Bill G

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We all fit together like peas and carrots.

Peas and carrots....that's veggie food! I am a meat and taters guy. :)

When I go see my very attractive, mature doc she always says.....Bill, you need to lay off the meat and potatoes.
I say yes ma'am, would you like to go out Friday night? It is prime rib night at the Enchanted Inn.
 
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