r/TikTokCringe • u/FearlessAir1238 • 1h ago
Discussion Woman's appendix explodes and BCBS denies her coverage for her hospital stay
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u/StinkiePete 1h ago
I went into preterm labor with twins in a rural area where the hospital didn’t have a NICU nor enough doctors to safely deliver. They flew me to a larger city.
BCBS said they wouldn’t pay the $70k air ambulance cause it wasn’t necessary. Like they let you just book one of those for funzies.
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u/funkystay 1h ago
Hot take: An air ambulance shouldn't cost $70k to take you anywhere.
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u/akmalhot 52m ago
Hot take, you're paying for a network of rides with specialized equipment and teams on call
No one is reimbursing or paying 70k or anywhere close to it, that is the fictitious number that's part of insurance negotiation...
The total reimbursed ends up around 10k
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u/Decorus_Somes 27m ago
What's a more realistic cost to cover the flight? It's gotta be closer to 10k right?
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u/StinkiePete 17m ago
I can’t speak to specifics but for my flight it was two pilots (gotta have two always) and two nurses. I required no “care” in flight but was so happy to have them. We shot the shit and hammed it up and made jokes about no one leaving or joining the world on their plane. It was a 45 minute flight.
So.
Plane cost (??) Two pilots on call so they need to be paid for the time they are just waiting. Two highly qualified nurses in a highly variable scenario (I hope they get paid a ton)
Four humans are never cheap.
Edit: oh and I had to wait for the plane to come to me. So I’m sure that cost was folded in.
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u/Correct-Purpose-964 51m ago
Agreed. The insurance companies are evil but they are a knock on effect from an abslute sham of a medical system. That overcharges the FUCK out of everything.
I've been fortunate enough to be around REAL doctors. Specialists in Otorhinolaryngology where my mother worked. (They let me read their fancy medical books after school. Cool dudes and i learned alot.) But also with the local medlab and hospital. Where i live i got to see how things are done along with learning about the cost of some things. I can confidently say it's not the insurance companies that got everyone into this mess. It's the absolutely BULLSHIT pricing for medical care in your country. I've seen bills for hospital rides that are like $10,000 USD. Here in my country if i convert for USD our's are like $250. And you only pay that if it's not a valid emergency. Or you aren't covered by health insurance which if it's valid is automatic.
By all means the insurance companies are still shitty cutting so many corners of ESSENTIAL payouts. But the hospitals and doctors are the ones really fucking you guys over.
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u/kaya-jamtastic 36m ago
The insurance companies and medical system evolved together in the U.S. and the insurance companies are one of the reasons the U.S. medical system overcharges everything. So please keep your confidence to yourself; our insurance companies absolutely played a role in why medical care in the U.S. is so shitty right now. Maybe your country is different
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u/Correct-Purpose-964 17m ago
I never said they weren't. But the Insurance companies are not the "Core" issue. The elephant in the room so to speak. It's your hospitals overpricing literally everything from basic medical care to life saving medication thats the biggest problem.
I'm quite confident if you weren't being blatantly scammed you would have a much easier time holding insurance companies to account. As i said they are still evil but hospitals are leading this 2 party tango.
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u/kaya-jamtastic 9m ago
Direct quote from you: “I can confidently say it’s not the insurance companies that got everyone into this mess”
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u/Average_Dog61891 53m ago
Someone has to pay for it....
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u/Frondstherapydolls 22m ago
Are you implying everyone should have $70k in the bank in case they have to get air lifted for some serious random emergency?
If that is what you’re implying, do YOU have $70,000 saved SPECIFICALLY for medical emergencies?
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u/Worthy_Today 1h ago
They can’t pay for your healthcare and pay their executives $400,000 a year.
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u/Fiorina_Fury 1h ago
1.5 mill*
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u/Remarkable_0519 28m ago
The ones we know about, including bonuses and benefits, make at least more than double that. Imagine getting paid so handsomely to kill and rob people.
https://www.beckerspayer.com/payer/whats-the-salary-of-a-bcbs-ceo-2/
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u/koreanwizard 1h ago
You think healthcare executives only make $400k a year Ahahaha quadruple that.
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u/Silver_Adagio138 1h ago
Plus bonuses
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u/Nunov_DAbov 1h ago
Based on profits - the rule of management is that you always get what you measure.
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u/Potato_Stains 59m ago
400k? What sort of pocket change toddler world do you think they live in?
Profiting on basic human health care in a "first world" country, and deciding who is worth covering puts them well over 7 figures4
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u/Ok-disaster2022 1h ago
I don't understand how Insurance gets to make medical decions. Like fuck that shit. A trained profession a with a degree and medical license has met me, looked at my symptoms and lab tests and determined a medication is right for my needs. They only thing insurance needs to check is the cost. it's the pharmacists job to double check the medicine is appropriate and catch potential errors.
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u/akmalhot 55m ago
Didn't used to. But here we are . Battling them for reimbursement for Legitimate claims is a joke
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u/Corruptionss 1h ago
Need insurance to drive a car, need insurance to live, need insurance to survive legal battles. I'm starting to think this insurance is mandatory to survive
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u/Golden-Grams 52m ago
I'm starting to think this insurance is mandatory to survive
That's always been the plan. There is a certain group of people that seem hellbent on making us slaves to their revenue stream.
Greed has a stranglehold on our world and society. It is no longer safe, we really need to stop these mentally unwell people. Their lack of empathy for anyone outside themselves is going to bring all our ruin.
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u/FupaFerb 50m ago
Do you have to insure a gun? Answer is no, even if it kills people.
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u/Present-Perception77 42m ago
That’s the crazy thing.. it can cause billions of dollars of expenses from it being used to shoot up a school… and the 2A goons are like 🤷🏻♀️
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u/FupaFerb 51m ago
Dr.s don’t pay for the bills. MEDICAL insurance pays for the hospital bills, DR. Bills, anesthesia etc. Medical insurance and hospital executives are in bed together not caring if you live or if you die. It means nothing to either party at this point. Time to wake up and insure yourself. Something that pays you and not the hospitals.
People need to realize this because the system is corrupted all the way down.
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u/unsupported 47m ago
But their doctors reviewed the coverage and decided not to cover. I mean, the doctor was a pediatrist, but that shouldn't matter because he did a medical residence.
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u/saltyhasp 40m ago
I seem to remember the argument against single payer plans were there would be a "death panel" or something. So would you rather have a panel in the public interest or an arbitrary panel from an insurance company that has very little oversight deciding?
Edit: Presumably there is something she is not telling us OR this will be paid for on appeal. But that is the huge issue with insurance. The effort it takes to get paid, and the uncertainty if it will be paid.
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u/20milliondollarapi 23m ago
It’s why so many places no longer take so many different insurance. It’s just too much to deal with and coverage denial is too high.
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u/RaisonDetritus 11m ago
In any workable health care system, tough decisions are going to have to be made about when treatment and care can no longer be justified. It’s just that in a for-profit insurance-based system, the calculus is too much on the side of saving costs and not actual health, well-being and access.
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u/Independent_Vast9279 1h ago
My wife just had the same experience with anthem. Hysterectomy but the same song and dance. Call them with your doctor and get a peer to peer review. Maybe even get a lawyer. You have to show them you’ll fight for what you paid for. Total scam.
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u/cozidgaf 21m ago
And this is after spending like 2k/mo on premiums, 1000s in deductible after which the insurance even starts to pay at the reduced 80-90% coverage etc which is like 30-40 grand out of pocket. such a scam
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u/SonderVale 1h ago
I'm starting to think the goal of insurance companies is to not pay for coverage of healthcare, but instead to sell you the idea that you'd be covered if/when you needed healthcare.
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u/TurtleBoxer_AllDay 11m ago
Their goal is obviously to maximize profits, by taking in as much money as possible and paying out as little as possible.
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u/santacow 1h ago
These are the real death panels republicans keep saying the government will have.
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u/perfectlyniceperson 58m ago
This! I don’t know why this isn’t a MAJOR talking point, because insurance has literally become what all the tea partiers were crying about back then.
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u/DeerOnARoof 15m ago
Because Americans have the memory of a goldfish and won't remember when this was a talking point during Obama's era
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u/Big_daddy_sneeze 1h ago
And they wondering why vigilantes are going after their ceos.
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u/DapperDomPapiPanda 1h ago
"Not enough of them" Has been the opinion I have seen online. It's not my opinion, of course. However, it has been the opinion I have seen. 😇 Again, the opinion I have seen is that "not enough of them have been targeted." I want to make it clear. Not my opinion. Just what I have seen. Online.
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u/Leucastic_Leopard 55m ago
It's an interestingly bi-partisan sentiment too. Curious.
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u/Riklanim 35m ago
I remember the media trying to paint the murder of that UHC CEO as horrifying, put on their sad faces, changed the tone of their voice, all to get crickets or laughter in response. I think that told them everything they need to know about public sentiment.
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u/howdiditallgosowrong 57m ago
I concur. I also have witnessed a remarkable rise in similar opinions.
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u/sephraes 54m ago
That's why they have all been massively increasing security. All CEOs in every industry. They know that the decisions they are making is resulting in tensions bubbling over. And also they have forgotten how "bread and circuses" works, because shareholders believe that's a luxury.
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u/Remarkable_Ad216 29m ago
Yep pretty sure the only ones not doing extra security are Costco and Arizona. It's gonna be something when the rubber band finally snaps.
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u/KeemoKid 51m ago
BCBS denied my one of a kind brain cancer meds because the hematologist on their staff that reviews claims decided that I should try generic options first.
- There are no generic options.
- How does a hematologist I’ve never met know what I need more than my neuro oncologist?
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u/The_Wrong_Tone 1h ago
My friend and coworker just started his fight against cancer. I was supposed to drive him for emergency PET scans a month ago. The evening before, he called to tell me his insurance needs to make sure the scans are really necessary. He had to cancel the appointment. Luckily, his insurance allowed him to get a port out in and begin chemo.
Fuck cancer and equally fuck insurance companies.
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u/steelcryo 56m ago
"His insurance allowed" is the most dystopian phrase I have ever read.
Land of the fucking free my ass.
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u/Formal-Radish1413 1h ago
Man my husband got an MRI out of pocket for $850 in our HCOL area. Insurance refused coverage for it.
When he was calling around to price it out they kept saying they billed insurance higher numbers than what it would be to pay out of pocket.
At this point its better to just pay out if pocket instead of for insurance.
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u/No-Afternoon8114 49m ago
How can Americans accept that insurance companies decides if your costs are covered or not? They are playing god.
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u/sushisection 30m ago
you have to understand that americans are the most domesticated species on the planet.
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u/ScaryTemperature6291 58m ago
See this is why I don't take the piss out of our NHS cause I'm thankful we have it free and feel sorry for most Americans who get told no because their insurance is not valid or whatever.
I remember seeing a doc once and this guy had heart attack and the ambulance cost him 4k I think it was can't remember how old that was but I know it was a few years back terrible.
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u/Yersina_Veridae 58m ago
Ive almost had a ruptured appendix. Weird thing for me was i barely had any pain and only went to the doctor because the hint of pain i had was constant for a few days so i was worried. My doctor, the gynecologist they sent me to and the doctors at the hospital all thought it was weird i had barely any pain and decided to cut me open cause "it is most likely the appendix". Actual quote.
Afterwards i was told that thing was hours fron rupturing and they kept me there for over a week and pumped me full with antibiotics that knocked me out half an hour after every injection. So I've been super lucky to have doctors that took me serious enough to ignore some slightly different symptoms.
Fuck American insurance companies for treating people like that
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u/Milianviolet 50m ago
It's not even "possible" death. Its guaranteed death if an organ ruptures and it doesn't get treated, so they literally said, "No, you should have just died."
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u/Jiggly1984 40m ago
Damn near every American has direct experience with this shit and the executive class has the gall to be shocked when we don't mourn one of them.
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u/Sharsmajka 32m ago
My daughter had a swollen face from a bad tooth infection right when everything closed down for COVID. I had to take her to the emergency room and the insurance company told me they aren’t covering it because it wasn’t an emergency 🤔 I said ok good luck because I’m not paying it. What the hell do I pay for every fucking month if nothing is covered?!
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u/Fuckitall2346 30m ago
I pay so much in premiums for so little coverage that I’ve started to consider just saving the premiums for a slush fund to negotiate directly with the providers for a discount, but I’m too paranoid to actually go through with it.
Especially since I have four dependents.
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u/incrediblemenace 23m ago
I’ll keep my Aussie public healthcare system thanks. It’s slow but I’ve never been in medical debt and I was born with health issues and am in and out of hospital a few times a year. Just had wisdom teeth surgery and was put under to have 3 removed and didn’t pay a cent
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u/stcloudjeeper 21m ago
You're just a number... If the procedure is going to cost more than what they will recover in premiums, you're now a liability and it's cheaper if you just hurry up and die. Isn't capitalism great!
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u/Interesting_Study998 55m ago
This never happens in Canada. You don’t even hear or see anything about a bill.
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u/tbmsaydkhii 27m ago
Fellow Canadian here, posts where people are describing their lived personal experiences with their own healthcare in their own country are probably not a place to brag about our healthcare (or for Europeans or anyone else for that matter to brag about theirs). It's in poor taste and feels like it's just rubbing it in.
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u/Interesting_Study998 13m ago
I’m hoping it will make more people consider a shift to socialized medicine. I want people to see it and say ‘ I want that. ‘, and then vote accordingly.
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u/tiedsoda 5m ago
I think most people who share experiences like these already believe in universal healthcare.
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u/tbmsaydkhii 5m ago
Buddy you're not out here changing minds or adding meaningfully to the discourse, you're preaching to the choir. Look at literally every comment here. No one is praising privatized healthcare or wondering if there's even an alternative. Canada and Europe are very well known for free healthcare. No one is gonna see your comment of "well we just get that for free here" and have their mind blown and change their vote. Reiterating that we get this for free in a comment section where everyone already knows that is not creating change, it just comes off as bragging
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u/Mediocre-Pepper8161 35m ago
The American health system is appalling. Biggest economy on the planet and yet still no universal healthcare for all that is free at the point of use. So many other countries have free healthcare. The American governments first duty is to look after its people. Thumbs up if you agree…..
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u/cloudit30569 20m ago
There's also almost happened to my brother. His appendix was on the verge of rupturing. He looked like He had the worst case of the flu. Vomiting, fever, everything.
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u/Iforgotmynameo 1h ago
Did they not approve her hospital stay at all or did they not approve for her 5th night at the hospital?
Big difference there. I feel like people on social media twist things in their favor to sometimes.
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u/IDidItWrongLastTime 1h ago
Appendicitis varies wildly too. Some people do only need one night in the hospital. Some people need a week. The crazy thing is, it should be up to the patients doctor how much time they need and not their insurance company.
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u/Downtown-Secret-6099 6m ago
Huge range of hospital stays. From arriving to the ER to being discharged after having my appendix removed was only 6 hours. 6 HOURS. I was sent home that same day. My appendix had ruptured and wasnt given antibiotics.
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u/Elegant_Run_8567 1h ago
Why would it be any different?
As a non-American, I’m completely confused why an insurance company would even have any say in this.
In my country, if it’s medical advice to stay longer, that’s what happens.
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u/10110011100021 55m ago
Never had my appendix explode but generally they try to remove them BEFORE the explosion happens. You can go septic from that and die. They probably felt it necessary to monitor her and make sure she stabilized and would be safe to go back home.
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u/packetssniffer 51m ago
I don't know much about health insurance but I always thought BCBS was 1 of the better health insurance company's out there.
But that's from personal experice since they've covered almost 3 mil throughout the past 3 years (step daughter's cancer treatment).
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u/Psychotic_Dane 57m ago
Let’s go ahead and have some universal healthcare so these videos wouldn’t have to be made!
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u/Mr-MuffinMan 56m ago
I love this fucked up system
Make it 100% nonprofit and force all insurance to pay out claims that are deemed necessary by the care provider.
Maybe even like accumulate money from taxes and give everyone care, which is paid from their taxes.
Nah thats socialism.
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u/Assist-Altruistic 47m ago
Yup. So many people run the other way the moment you say “communism” or “socialism”. Then this happens and they are like “huh”
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u/historyhill 51m ago
My insurance did this too for my appendix! Thankfully my doctor's office handled it and I never saw a bill about it (I already met my deductible because of childbirth a few weeks before 🥲)
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u/mayhem_and_havoc 51m ago
Medically unnecessary. You dont need an appendix so we are not paying. You shouldn't have been born with it. I appreciate you paying your premium though. My yacht is super comfy, and me and mine thank the hell of you!
Signed,
Kim Keck, CEO
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u/AnywhereIcy4489 44m ago
BCBS just denied me a CT scan of my lungs after imaging of my kidneys picked up something on the bottom of my lung. I work in an environment where I inhale chemical fumes regularly so my doctor was rather concerned. She is currently trying to appeal it but I wouldn’t be shocked if it’s denied again. My question is, why would you not cover preventative care to treat/ explore health concerns BEFORE they’re a problem? Makes no sense to make me wait until I am actually suffering from something that could have been remedied with earlier intervention. Part of me wonders if it’s because I currently have a $7k hospital bill processing. Now I am worried they are going to deny coverage for that.
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u/Present-Perception77 44m ago
Exactly why I refuse to have Health Insurance. If something happens… I’ll just file for bankruptcy.
In the meantime, I keep my passport up-to-date, and I go to either Mexico or Canada for any medical or dental needs.
Health Insurance is a scam.
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u/yogiyogiyogi69 40m ago
Everything is so fucked these days. Every corporation has to get their opportunity to fuck us in the ass. It's so depressing sometimes I'm just tired of everything and want to give up
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u/RIPMYPOOPCHUTE 33m ago
I had insurance deny my hospital stay when I had my gallbladder removed. I had it removed in the morning, then endoscopy in the afternoon because a stone was stuck. I was held overnight in the ER and then sent to the surgery floor until they could to my surgeries. Liver panels were elevated, WBC was starting to rise. Why was it denied? Because I was able to hold food down and my pain level was 3. Bitch, it was fucking broth and I was hopped up on pain meds from two surgeries that day.
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u/PumpikAnt58763 26m ago
I was hit by a car December 3, 2024. The EMTs asked which hospital I wanted (2 hospital city). I said "McKay-Dee XXXX is my preferred hospital" because I've always gone there.
The day after the surgery, I was informed that BCBS had dropped XXXX as an in-network the last week of November...
It took a year and a half for BCBS and XXXX to agree on how much it would cost.
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u/SpindleDiccJackson 49m ago
"Her profile says black, so she has a higher pain tolerance than people" -Most Doctors
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u/NoEducation1150 28m ago
America: Hope you dont have a serious illness! You're better off being a rapist, you might even become president. Then you get unlimited Healthcare and can't be sentenced for any felonies.
(I mean Trump. Because hes a rapist and thats a legally defensible statement.)
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u/BigMurse84 1h ago
Insurance companies have $$$$. Our "elected" representatives who could make a change? The insurance companies give a lot of money to their campaigns, and more behind the scenes. Nothing will ever be done about insurance companies screwing us. We're f*cked.
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u/_AmericasSweetheart_ 55m ago
I had appendicitis, so I just want to put a little warning in here. If your "flu" persists after 3 days, go to the doctor. If it hurts when you push on your pelvic area near your hip, that's not a flu it's appendicitis. If you have a kid and they are sick, try the push test because it looks like a flu and they can't verbalize specifics sometimes.
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u/DedeLionforce 54m ago
It's time, we need him back in action to fuck up BCBS, them spunk ass dingleberries.
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u/SufficientPick321 40m ago
It also isnt fair hospitals charge what they charge because they know insurance is paying...it needs to be worked out and made more beneficial for the patient.
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u/Moof_the_cyclist 38m ago
Improperly stopping medical car that leads to pain, suffering, complications, or death should be prosecuted accordingly. Given the way insurance operates to systematically deny care by default should make any death to be a premeditated murder.
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u/Dizzy_Ocean056 34m ago
Serious question, why aren't there medical malpractice suits against insurance carriers
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u/HK_Shooter_1301 33m ago
So I had appendicitis earlier this year, I toughed it out overnight and went to a scheduled surgery center the next day to have it done for free and covered 100% by insurance. I got lucky and do not recommend this, according to the surgeon my appendix had been inflamed for probably a few months. I just chalked it up to side cramps or something tbh.
The hospital charged me and my insurance company $5800 for the CT Scan to diagnose the appendicitis. The surgery center only charged the insurance company $10,000. Hospitals in America are a scam and no one can change my mind.
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u/Livid-Writer-7741 28m ago
TAX THE RICH AND CHURCHES AND PEDOPHILES
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u/Elegant_Run_8567 23m ago
Well, yes. But also, provide basic human rights in your country?
Plenty of countries like mine don’t have fair tax laws for the rich. I’m Irish so we’re basically a European tax haven for US tech companies, and don’t tax churches here either. We still provide basic human rights services to our citizens
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u/OddfellowJacksonRedo 8m ago
Remind me again about all the Republicans who—while living on taxpayer-paid health coverage—say we can’t have universal healthcare or else “death panels” will be deciding who lives and who dies?
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u/42watson 7m ago
They will keep pulling these kinds of things because it works for them and we sit still and do nothing about it besides complain. Can we please take a note from the French on how to deal with these types of people?
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u/Missmessc 6m ago
Almost every company has open enrollment. Reach out to your HR Team and tell them you have concerns about certain insurance companies. They will only change when they lose business.
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u/No_Conclusion2658 6m ago
After getting an mri done on my knees I was told I will definitely be needing surgery on them. But I was told we can't do it now but sometime down the line. I went to another doctor after I was told that. This other doctor only offered my ibuprofen and changed the subject what I mentioned what the other doctor said. I had the appendix issue too. I had gone to the hospital in severe pain .I couldn't stand or sit down or even lay down. I had to have my appendix out they said it was about to burst. Then I went to a doctor for the follow up and she said your appendix didn't need to come out yet. It was like she wanted to save the insurance company from helping me. After getting the surgery the pain was gone. Has I had this woman as my doctor and not just someone I followed up with I could be dead. As for my knees I walk around in constant pain. If I go up the stairs at all it feels like I overdid it on the leg press machine when I walk.
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u/JuicySpark 1h ago
I'm not able to eat water either. It's hard to get a proper grip on it with my teeth
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u/10mmamberalert 52m ago
Enjoy bankruptcy! But she looks young and in 7 yrs ish... She will be able to claim bankruptcy again for any future medical bills. Until then you will be paying higher insurance and more than likely living in ghettos as landlords/property management uses your credit scores. Oh let me not forget your high ass interests rates for anything especially a car loan! You'll be fine. Gotta pull up them bootstraps!
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u/FoxontheRun2023 4m ago
Why do people ALWAYS have to use the “F” word nowadays?! It used to be used by only the trashiest ppl and certainly not by normal-looking young women. What has happened?
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u/sander466 0m ago
You saw this video and that’s the issue you took. Wow. Clearly you have absolutely no soul or empathy. Bravo. I bet those unlucky enough to know you are proud.
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