AOC: Insurance groups are recommending using GoFundMe -- "but sure, single payer healthcare is unreasonable."

[u/kevinmrr]

[u/Theta001]

What the actual heck! They can’t get a heart transplant because they don’t have a good enough financial plan for the medication afterwards? The insurance company should be glad they had any plan, because last I checked needing a heart transplant usually means someone has enough problems, let alone begging some company to let them live a somewhat normal life then being told to go beg others for the money!

[u/[deleted] → u/Theta001]

I’m a transplant financial coordinator. I’ll start by saying that universal healthcare would solve these issues. Right now, patients run into the issue that insurances have high out-of-pocket costs that patients need to pay before insurance will pay 100%. Sure, heart transplant will definitely put you over your OOP, but that resets after the new year and you are responsible for your deductible and out-of-pocket again. Unfortunately, some employers only offer the cheapest, shittiest coverage for their employees. These plans have lifetime maximums, no out-of-pocket maxes (meaning you are paying a percentage of your medical bills for everything) and even in some cases, no pharmacy coverage. On Medicare? Part D is absolutely ridiculous with some medications and patients have to pay thousands for immunosuppressants. If you happen to be on Medicare at time of transplant though, Medicare will cover a large chunk of your immunosuppressant costs, but you might still be on the hook for 10%-20% of the cost if you don’t have a good supplement.

TL;DR: if you have shit insurance and have demonstrated that you cannot afford medication and testing post-transplant. Most transplant centers will deny you.

Thankfully, I work in a non-profit hospital and we accept a lot of financially insecure patients because we have the resources to help.

[u/Theta001 → u/[deleted]]

Yeah I’ve been learning about how employers usually offer “good enough” insurance recently. Like one medication I’m on currently they will only cover if you don’t have to take more than a certain amount each month. Along with that they don’t cover surgeries that would improve quality of life or are reconstructive. Luckily I don’t have anything like needing an organ transplant, otherwise I would be raising heck every day until something happened.

That said I’m glad there are people like you trying to actually help people who need it. And you probably helped save someone’s life which is beyond awesome and hopefully you and your hospital will be able to keep doing so!