{"id":3170,"date":"2021-09-11T09:00:38","date_gmt":"2021-09-11T09:00:38","guid":{"rendered":"https:\/\/healthdrum.com\/?p=3170"},"modified":"2021-10-12T15:58:41","modified_gmt":"2021-10-12T15:58:41","slug":"how-health-insurance-plans-screw-patients","status":"publish","type":"post","link":"https:\/\/healthdrum.com\/blog\/how-health-insurance-plans-screw-patients\/","title":{"rendered":"How Health Insurance Plans Screw Patients"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">The health insurance industry is in the business of making money at your expense. They are not there to make you feel better and there\u2019s no evidence that they improve overall health. Stop letting health insurance plans play doctor. Take control away from them with cash price, customer-directed care.<\/span><\/p>\n<p><b>Tricks used by health plans to deny care.<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Here\u2019s a short list of the tricks used by health plans to deny care and payments in order to maximize profits. The word benefits in health plan benefits is an oxymoron.<\/span><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Using catchy labels like \u201cadvantage plans\u201d to have you believe their plan comes with special advantages when these plans are actually a disadvantage<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Unnecessarily complex in design and difficult to understand<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Virtually impossible to compare health benefits plans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Use endless scare-tactics to encourage purchase of health plans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Beware the junk insurance plan &#8211; there are a lot of them &#8211; overpromise, under deliver<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Beware of capitation plans where doctors have already been paid by the insurance plan to cover patients and subsequent payments for services have to\u00a0 come from the doctor. This is a major conflict of interest and could result in delayed or denied care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Commonly loaded with cheap freebies to make you think you are getting extra benefits and \u201cadvantages\u201d<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Set up numerous barriers to access with the need for referrals and authorizations &#8211; typically determined by a non-medical intermediary working for the health plan &#8211; many of these referrals require correct codes for services attached &#8211; this also is self-serving and only provides another opportunity for delaying or denying care by claiming code was incorrect &#8211; also, these referrals often come with time limits so if a patient can\u2019t get an appointment within the time frame, the appointment is denied and the patient has to start the request again<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Routinely call some tests and treatments experimental, wasteful or unnecessary so coverage denied and they don\u2019t have to pay<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Difficult to appeal denials and difficult to reach health plan decision-makers<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Numerous cost-shifting games &#8211; keep premiums low to have you believe you have \u201caffordable\u201d coverage when in fact costs (in addition to plan costs) are simply passed on to patients with deductibles, copays and non-covered services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Narrow provider networks &#8211; usually with providers who accept one-sided contracts and severely discounted health plan fees<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Opaque costs for tests and treatments so you can be hit with surprise bills<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Artificially tiered drug lists and so-called preferred lists &#8211; another excuse to pass costs on to patients &#8211; a form of discrimination<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Finally, it\u2019s not a matter of IF your health plan will screw you BUT, how often.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Visit <\/span><a href=\"https:\/\/healthdrum.com\/\"><span style=\"font-weight: 400;\">www.HEALTHdrum.com<\/span><\/a><span style=\"font-weight: 400;\"> Come join our healthcare community and discover how consumer-directed care and paying for as-needed routine care yourself can save you money.<\/span><\/p>\n<p><strong>Read more.<\/strong><br \/>\n<a href=\"https:\/\/theconversation.com\/why-insurance-companies-control-your-medical-care-62540#:~:text=In%20order%20to%20build%20up,permitted%20to%20offer%20medical%20coverage\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">https:\/\/theconversation.com\/why-insurance-companies-control-your-medical-care-62540<\/span><span style=\"font-weight: 400;\">.<\/span><\/a><\/p>\n<p style=\"text-align: center;\">Written by HEALTHdrum<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The health insurance industry is in the business of making money at your expense. They are not there to make you feel better and there\u2019s no evidence that they improve overall health. Stop letting health insurance plans play doctor. Take control away from them with cash price, customer-directed care. Tricks used by health plans to [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":3171,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[21],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How Health Insurance Plans Screw Patients | HEALTHdrum<\/title>\n<meta name=\"description\" content=\"The health insurance industry is in the business of making money at your expense.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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Subsequently, he completed fellowship training in Pediatric and Adult Reconstructive Urology at the Eastern Virginia Medical School in Norfolk, Virginia. During his time there he also undertook NIH sponsored, pioneering research on \u201cUrinary Bladder Reinnervation\u201d earning him the honor of a Masters of Surgery Diploma through the University of Otago, New Zealand. Dr Vorstman returned to Miami to become a board-certified faculty member in the department of urology, Jackson Memorial Hospital, University of Miami. Eventually, he left academic practice, moved north to Coral Springs and established Florida Urological Associates pa (www.urologyweb.com) in 1987. Dr. Vorstman is passionate about consumer-directed healthcare and helping men diagnosed with prostate cancer navigate the minefield of prostate cancer misinformation. After retiring and leaving colleagues to continue the urology practice, he became founder and CEO of a healthcare platform that connects buyers and sellers of routine, cash pay healthcare services - www.HEALTHdrum.com\/ Through this platform he also enables colleagues to reclaim their profession from health industry exploitation. Partial bibliography https:\/\/ascopost.com\/issues\/june-10-2016\/prostate-cancer-opinions-vary-on-gleason-scores-and-surgery\/ https:\/\/ascopost.com\/issues\/november-25-2020\/a-urologic-surgeon-assesses-the-current-state-of-prostate-cancer\/ https:\/\/www.medscape.com\/viewarticle\/945928 https:\/\/urologyweb.com\/robotic-deception-prostate-cancer-hoax-p-5\/ https:\/\/bvorstman.medium.com\/prostate-cancer-treatment-deception-and-lies-30e23f17b749 https:\/\/healthdrum.com\/blog\/the-gleason-6-prostate-cancer\/"}]}},"_links":{"self":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3170"}],"collection":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/comments?post=3170"}],"version-history":[{"count":10,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3170\/revisions"}],"predecessor-version":[{"id":3903,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3170\/revisions\/3903"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/media\/3171"}],"wp:attachment":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/media?parent=3170"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/categories?post=3170"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/tags?post=3170"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}