Though I have full health care coverage, I had an issue while away from home and I experienced a little glimpse of the nightmare that health care can be while traveling.
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Personal Experience
I don’t usually cover specific personal experiences, but in this instance, I will share my own account of an event that happened to me. I have some good things to say about specific brands and some bad things to say as well. I haven’t been paid to say anything, I just want to share my experience for others.
Good Health Insurance
I have carried some version of Blue Cross Blue Shield health insurance for the better part of the last decade. Due to my family, we carry close to the best coverage we can within the plans offered by an employer and have been happy with the experience and coverage. We have tested the extents of our coverage a few times and have always found the insurance to cover anything we encounter with fair prices and reasonably good customer service.
Unbearable Pain on a Trip
When I was around 16 year-old I began to develop stress ulcers in my throat while I was managing some particularly difficult challenges. A few months ago I transitioned jobs and it was a very stressful time. Contracts, lawyers, selling a house, buying a house, replacing a vehicle… it brought the ulcer back, this time in the back of my throat.
While the early signs felt like a sore throat (it had been almost two decades since I’d had an ulcer), I was away from home but in the US when I discovered it. The ulcer grew from a small pain to unbearable and nearly half an inch in length. That may seem small, but given the moisture in one’s throat, air flow from breathing drying it out – there’s just constant pain that extends beyond swallowing and it’s nearly unavoidable.
Seeking Solutions
Before I realized that it was a return of the ulcer, I sought help at an Urgent care facility which provided me with some pain relief and a solution to coat and seal the ulcer for a period of time before reapplying. My insurance covered it and the prescriptions at very little cost.
However, the ulcer was only getting larger. The medicines were simply treating the pain and symptoms but not solving the issue. My mother, who was with us at the time, is a dental hygenist and knew of a new use of laser technology to treat mouth ulcers by scoring the surface causing it to close and heal faster.
I found a handful of dental facilities in the Fort Myers area that offered the service but very few could get me in on short notice. All of them were happy to work with my insurance without incident.
The Used Car Dealership of Dental Care
I found Bonita Dental Care of Bonita Springs, FL, about 10 minutes south of Fort Myers. They had the availability on short notice, indicated they would accept my insurance and got me in within a day. I showed up delighted, filled out the paperwork and got back into the chair where a dental assistant and then a dentist examined the ulcer and agreed it could be treated.
Then something unexpected occurred. The “Business Manager” for the facility came in and began asking me where I worked which I answered assuming it related to my insurance as a new patient. Several other questions that identified I was in a tough position (am I on vacation, how bad is the pain, etc.), had the means to pay and was in a critical enough position to do so, formed the basis of our discussion.
She indicated that they could provide the service and provide a relief to the pain (nothing short of excuciating at that point) for the low, low price of $2800 in cash. Flabbergasted, I indicated I had insurance and was certain they would cover it. She didn’t want to file it with my insurance because she kept avoiding the issue and suggesting they wouldn’t cover it then circling back and discounting the offer price.
Finally, she pulled the ultimate used car move but instead of “talking to her manager” she talked to the dentist. She came back with a big red “X” through the $2800 price and dropped it $2200. I asked for my wife to come through to “help me with the decision” when in reality, I wanted her to see the railroading for herself.
When she saw what was happening and how they were taking advantage of my situation, she indicated that we wouldn’t be doing that. She stepped away for another minute and came back with a final number closer to $1500 out-of-pocket on the spot and refused to use my insurance. I left Bonita Dental and their crazy tactics behind.
When I got home to my actual dentist, they took my insurance and did the service on the spot with nothing more than a $20 co-pay. The reality was that the procedure usually costs just a couple of hundred dollars out of pocket (I shopped it), my insurance company would have paid less than that because they receive wholesale rates and the dentist and business manager knew I was in pain and would likely pay.
Conclusion
Despite having excellent health care coverage, travelling even domestically can still present challenges for treatment. It was disheartening that a business focused on care would care so little. I can only imagine how challenging and budget-busting health care needs must be for those without coverage.
Do you have a horror story from an insurance need while travelling?
Ah the joys of the American healthcare system. Never change.
As an American who for the past 12 years has lived in Canada and France (two countries with excellent universal health care systems), I can only shake my head at America’s inability to offer its citizens a similar benefit. It’s common here in Nova Scotia for people to take-out a million dollar insurance policy if they’re only going to the States for a weekend – because everyone knows an illness or accident in the States can wipe you out financially.
You should take out at least 2 million.
Welcome to health-care for profit in the ! Shame on Bonita for caring more about profits than a patient in pain and in need of care. Nothing will change until we all get sick enough of the greed and lack of compassion. Currently healthcare is run bt insurance companies, vig pharma and their lobbyists.
You should add to their Yelp reviews. They can’t have enough of bad ones, that’s for sure.
Predatory blood-sucking bastards.
Many years ago my family has a similar horrible experience in a Florida strip mall clinic referred to us by our 4.5 star hotel. The short story is our 6 yo daughter got strep throat while we were at disney world. The md gave her such an old anti biotic that it did not even treat the infection. We flew home a few days later and our pediatrician was horrified to learn the med that was prescribed.
Florida in particular is notorious for things like this. There are few consumer protections there and, unfortunately, a lot of good people get duped just as you are.
There is a big difference between “happy to work with” and “contracted” with your carrier. When they are contracted they are breaching a contract in this situation, if they are not they can do whatever the heck they want.
Always look up and ask if they are contracted and in network, never ask “do you take X”.
The big problem might be dentists. They are other part of many health insurance plans. Unlike doctors, dentistry is the Wild West because many dental problems have poor solutions, which create many treatments, some expensive. With illnesses, if there are many different treatments that means either the disease is really several diseases with the same name (cancer, for example) or a disease with not really good existing treatment.
I also advised you to see a MD (real doctor). Your throat ulcer may someday develop into cancer. Anything raw for a long time can turn into cancer. Also cells that divide a lot, like intestines (colon) and breast ducts have more chance of cancer. See ENT, ear nose throat, otolaryngology head and neck surgery. All are the same specialty, ENT is the informal name, otolaryngology head and neck surgery is the formal name.
Typo: dentist are not part of insurance (not in-network). I typed “other” by mistake (2nd sentence )
The problem with dentists and optometrists (fake eye doctors) is they don’t go to medical school. They knowledge of medical treatment is horrible. Many people die on the dentist chair from being put to sleep and many eye problems, like glaucoma, get worse because people don’t see a real doctor, which is someone with a MD degree (ophthalmologist). It’s only the going to get worse because nurse practitioners are starting to call themselves “doctor”.
Anyone with a doctorate may call themselves “doctor.” There is nothing unique about an MD that gives awardees the special authority to stick “Dr.” in front of their name. Non-physician medical professionals are trained through accredited programs and are required to take licensing exams that ensure their ability to competently exercise their professions within their scopes of practice.
The rate of death from anesthesia during dental procedures is less than in a hospital operating theater. See, for example, doi: 10.7860/JCDR/2017/24813.10009. This likely has more to do with the overall health of the patient population than the practitioner administrating anesthesia, but rather contradicts your statement. Perhaps you could share your sources?
While I know it’s easiest to ask a medical provider if they accept your particular insurance, it’s much better to ask your insurance carrier if a particular provider is in-network (i.e., contracted). As you discovered, a provider without a contract can and will charge you whatever they’d like. They may “work with your insurance” but still bill you thousands of dollars.
I’ve found that BCBS in particular has excellent support for clients that are travelling outside their “home” blue’s territory. Always remember that health care is primarily regulated by the states: protections you enjoy in your home state will not apply. However, contracts are enforced everywhere so stay in-network.
Why would you go to a dentist for a throat ulcer? My first call would have been to BCBS to recommend a couple of ENT’s in the area, No matter how they try to spin it, dentists are not real doctors.
“In my country, dentists are not real doctors” – Stu’s future father in law – Hangover II
The ulcer was diagnosed – it was just an ulcer and consistent with my medical history (as stated). The dentist wouldn’t have been my first go-to health care professional (and wasn’t). However, only dentists had both availability and the laser technology needed (as stated).
@ALbert
Great point! Thanks for clarifying this distinction. I’ll try to remember that next time.