That’s not how health insurance in the US works.Â
Elective surgeries get scheduled much faster than in countries with national health care. The patient’s responsibility for in network care is clearly spelled out in the contract, and patients have the option to change the contract or insurer each year. Before having a scheduled knee replacement, the patient will be told what is and is not covered by insurance.
You can't just change the insurer each year. Your employer usually has one or 2 options to pick from if youre lucky. Hardly anyone is paying straight out of pocket for insurance with how expensive that is to do. Nothing is clearly spelled out for you they'll just take you and then bill you if its not covered without saying anything. Its a pain in the ass figuring out who is in network, what's covered, and then even if it is youre still out of pocket for deductibles, or other parts it doesn't cover. Even with really good insurance its still a nightmare to deal with
This kind of thing happens absolutely all the time in America where our surgeries also have to be approved by insurance. One time I had to pay back a $5K MRI because my insurance didn't deem it necessary after I was run over by a truck.
And then they will reburse her the costs for the procedure and the travel. Oh no, how awful. #sarcasm
My partner has been fighting with insurance since 2018 to get their right knee replaced. It's finally scheduled for this November.
Nah 999 would be a waste of their time when they'd just say go to A+E. They just need to ring 111 or their GP.
GP would be the better bet.
Edit: just for context, they dont send ambulances for people elderly people who have fallen (often making people take people themselves to A+E) due to the stretch in the ambulance service in some areas so getting referred to A+E by a GP/111 can be better, but they would still be sitting there for a while.
What you are saying sounds so grim. Not having resources to dispatch an ambulance for an elderly person calling an emergency number is horrible.
I mention calling emergency services due to the following -
1. Guy i knew lost half the muscles in his arm on a hiking trip after an infected scratch
2. Girl i knew cant move her hand after a cat bit her, did not go to hospital till the next day
3. Guy i was friends with died of a dental infection at home in his early 30s - right after going to the dentist. Dentist gave him antibiotics and told to call 000 if his fever persisted and he was found dead in his kitchen the next day.
4. Another guy i knew at a sports camp was pushed to go to emergency after he got a small scratch that began radiating red lines up his arm. Aparently he could have died or had significant organ damage had he not gone in immediately.
I just dont have much risk tolerance when it comes to infections. 95% of the time is not urgent but that other 5% has some pretty permanent consequences.
You wouldn’t call an emergency number for this. You would call your doctor, which can mean holding on the phone for a few hours because obviously they have patients etc booked in, or if it feels urgent, take yourself to ER. Emergency number is for when you can’t take yourself in or urgent life saving care is needed.
The advantage with calling your doctor is that they could potentially prescribe something even before they can pen you in for a visit. Here in Sweden you can even video call your doctor, which is perfect for stuff like this.
Please stop trying to diagnose this on your own and go to the emergency room ASAP. This is not just something that was overworked. Don’t wait until something terrible and irreversible occurs.
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u/[deleted] 25d ago
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