this post was submitted on 25 Jun 2023
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Mildly Infuriating

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She literally called me at the time of the appointment to tell me she can't see me. She was so apologetic, but was like "I absolutely can treat you, but I'm not allowed by your insurance". Fuck this country.

Update: I went to urgent care. Before leaving home, I called to be sure they would accept my insurance (Aetna). They said yes.. After arriving for my appointment, they told me they do not accept my insurance. I will simply leave without paying.

Final Update: I can understand that that differences in physical biology demand different attention. That's not what I'm complaining about. It's the way it's set up. I was told that at my appointment. Why not just refer me to a specialist? The website could've even just referred me to urgent care (yes, my insurance requires a primary care physician's referral for urgent care, according to the urgent care facility). But, no, their goal is to obfuscate and irritate until the patient gives you and pays out-of-pocket.

I was able to receive care at a cost I could not afford. I won't discuss what I had to do to "find" the money to pay for care and prescriptions. That being said, the condition I was diagnosed with was more serious than a simple infection, and I'm glad that I saw a doctor. I need further treatment and just hope I can get insurance to cover any of it.

If you're an American reading this, please consider ways to get involved in organizing in support of Medicare For All in your community. Here is one resource I have found. We don't need to live like this. We deserve better. Stay safe and healthy, friends.

(page 3) 46 comments
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[–] 4am@lemmy.world 1 points 2 years ago

There is no fucking shot she is correct. If your insurance won’t cover it then man just cancel it, they’d probably not even cover an ER visit, it should be cheaper to not have it.

Also, report them to your state’s DOI.

Is it because CVS is out of network? Have them bill, get denied, and then appeal it. Put that it would be cheaper than an ER visit for them.

[–] racer983@mander.xyz 1 points 2 years ago* (last edited 2 years ago) (1 children)

This is mildly infuriating, I can give you a little more context though if you're interested. I don't know exactly about contracts between insurance companies and CVS so I can't speak to that definitely. Probably something related to how much insurance is willing to pay minute clinic for such a short visit, and what things are feasible to address in such a short visit (hence CVS only allowing certain complaints).

I think this is something to do with the concept of "uncomplicated" vs "complicated" uti. Complicated utis are when there's an increased danger of serious complications from a uti or increased likelihood of failing a typical antibiotic therapy. Utis in men are much much rarer than women, and are considered to be an automatic "complicated" uti by many. The greater length of the urethra in men helps prevent bacteria from being able to travel up to the bladder, whereas in women the short distance allows for this to happen much more frequently. So when a male has a UTI there is a much greater chance there will be complicating factors like prostate issues, structural problems, kidney stones, kidney infection, catheter use, atypical bacteria, etc. If you look more into their info on utis, they also state if they suspect any of those things, even in women, they won't treat it and will just refer you to someone else, probably the Ed or a real urgent care clinic. Since the odds of that are much greater in men, they probably aren't allowed to have longer appointments in minute clinic based on what insurance will pay for what they're providing, they just decided to not see that at all in minute clinic. Looks like they do see men for sexually transmitted infections though, which are actually the most common cause of utis in young men, so if that's a concern looks like they would be able to see people for that.

But I totally agree with you, fuck insurance companies in general.

[–] throwaway38575061@lemmy.world 0 points 2 years ago (4 children)

That's very interesting, and I appreciate you taking the time to explain this in so much detail. I looked at urgent care near me, but my insurance requires a referral from a primary care physician first. I will continue to explore my options.

[–] racer983@mander.xyz 1 points 2 years ago

I've never heard of urgent care requiring referral from a pcp, that wouldn't make any sense as the whole point of urgent care is being seen more urgently than your primary physician can accommodate. And seeing people who don't have a primary physician and keeping them out of the ed if not necessary. I would ask your insurance for that policy in writing, that can't be right. And if it is it should be reported to that state insurance commission because that's totally asinine. I mean never underestimate the dumbness of insurance companies but I think something might be being lost in translation here.

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[–] fne8w2ah@lemmy.world 1 points 2 years ago (1 children)

Aww man you poor sods. In any other civilised country that wouldn't be so much of a worry. 😭

[–] utopianfiat@lemmy.world 1 points 2 years ago

The fuck did you just call us?

[–] haxguru@lemmy.world 1 points 2 years ago (4 children)

Are the people in the comments bots or real people? It's too good to be true that so many people have switched to Lemmy!!

[–] Alpagu@lemmy.world 1 points 2 years ago

We are bots😃

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[–] UnstuckinTime@lemmy.world 1 points 2 years ago

This country is f****** crazy. I remember like 8 years ago I was trying to get into rehab to kick opiates which I eventually did in 2015. When I got into a free bed for a detox, they wouldn't let me in because it said my insurance wasn't accepted. The irony was I didn't have insurance anymore, they still had me listed as being insured with some s***** Blue Cross program at my old job.

I actually had to get proof that I wasn't insured so the state would cover my bed.

Any other OECD Nation pretty much and you get treated like anyone else. And the sick part is both political parties are okay with this, and militantly fight any serious ever for a public health care system with one single risk pool where everybody is automatically opted in.

[–] UnicornKitty@lemmy.world 0 points 2 years ago* (last edited 2 years ago) (2 children)

Since nobody addressed this, if you (anyone reading this) have a bladder infection, go to the women's section of any pharmacy. Usually somewhere near pads/tampons, and find a box of this blessed relief. It has cleared up all but the most stubborn infections I've had.

Azo

[–] we_were_never_here@lemmy.world 1 points 2 years ago

just FYI to anyone reading this, this stuff is indeed magic pain relief, BUT it's not an antibiotic and you still need to see a doctor. UTI's can spread and it doesn't feel very good. I would up in the ER getting IV antibiotics over Thanksgiving one year. it sucked.

[–] throwaway38575061@lemmy.world 1 points 2 years ago

You're a lifesaver!

[–] Froyn@kbin.social 0 points 2 years ago

This shouldn't be infuriating at all. As others have said a Nurse Practitioner is not a Medical Doctor. Go to the "clinic", whether its a hole in the wall $25 place or a local hospital with a clinic attached. A Medical Doctor can help and can even write prescriptions that include the words "medically necessary" which trumps most insurance denials.

[–] FuzzyDoublePumper@kbin.social 0 points 2 years ago (2 children)

Hypothetically, in an emergency situation, you could get fish antibiotics from your local pet store. Not the best idea but an untreated infection isn't good either.

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[–] Liontigerwings@kbin.social 0 points 2 years ago (1 children)

What kind of facility ask for a diagnosis before care. You tell me if I have a UTI.

[–] pizza_rolls@kbin.social 1 points 2 years ago

Because UTIs are common in women, like I'm pretty sure it's extremely rare to never even have 1. Because of that we are VERY familiar with the symptoms and can immediately tell it's a UTI. I don't even go anywhere, I just go to an online doctor and say it's a UTI and I can immediately get antibiotics instead of waiting for an appointment. Studies have shown this is an effective way to treat women with UTIs, it's not less effective than making them wait and running tests.

There are some situations where you NEED to go in and get tests done when there are symptoms of a bladder or kidney infection, like pain in your lower back or fever. These are screener questions when you complete any request for UTI medication.

As someone who has had several UTIs, I am happy I don't need to wait around at a urgent care for my turn or wait for an appointment. UTIs are HELL

[–] emc@kbin.social 0 points 2 years ago (1 children)

I’m not going to defend health insurance companies, but this is not because of your insurance. CVS will only see patients with simple medical problems because they 1) are not equipped for more in-depth diagnosis and treatment and 2) don’t want the liability associated with such. UTIs in males are medically complicated, by definition which has a very specific meaning. Males don’t just get UTIs like females do, because the male urethra is significantly longer, providing significantly more protection from bacterial retrogression to the bladder. The long story short is that if you are a male with a UTI you need to go to an actual healthcare facility and see a qualified professional, not an NP/PA at your local CVS.

Source: am a pharmacist

[–] sadreality@kbin.social 1 points 2 years ago* (last edited 2 years ago)

The issue here is the clown medical delivery system that enables these scenarios. At this point, people have better chances of diagnosis and treating themselves than rely on a chain of clowns, if only medical devices and pharmaceuticals were easily available.

[–] Texas_Hangover@lemmy.world -1 points 2 years ago (2 children)

Just tell them you identify as female. They won't be able to say shit unless they start throwing religion at you.

[–] TskUghPfftUhh@lemmy.world 1 points 2 years ago (1 children)

He shouldn't have to pretend to be part of a minority group in order to be treated for something.

[–] Texas_Hangover@lemmy.world -1 points 2 years ago

It works for getting jobs too!

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[–] mirror_slap@lemmy.world -1 points 2 years ago

Get D.Mannose and take like 2 grams a day till it's gone. Mileage may vary, but it cured my wife of recurrent UTIs after more than 20 infections.

[–] doink@lemmy.world -1 points 2 years ago (1 children)

Have you since received treatment? Bad news, men don't really get UTIs.

When I had it, it was because of kidney stones.

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[–] Raphael@lemmy.world -2 points 2 years ago

Health care is communism!

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