United Healthcare Is Staffed by Incompetents

[billroper]

So it's like this.

I have sleep apnea. So does Gretchen. I have been using a CPAP for 25 years now; Gretchen for a bit over a decade. Our current CPAP machines are over 10 years old and are due for replacement. Overdue, in fact.

Our primary care physician thinks that it would be a good idea for us to get a fresh sleep study done to check our pressure since it's been 10 years in Gretchen's case and 25 years in my case since we've had one. This requires us to have it done in a lab so they can get an accurate reading.

United Healthcare, who we are insured by, has approved Gretchen's sleep study in the lab.

They have denied mine.

Why? Nobody seems to know, although when I spoke with United Healthcare on the phone today, they said that they normally want to have a home sleep study done first to determine that I have sleep apnea. As should be evident to a blind, syphilitic camel, since I have been diagnosed with sleep apnea previously and have been sleeping with a CPAP every night for 25 years and have not done anything that might improve the situation -- such as, for instance, lose a metric ton of weight -- a home sleep study is a waste of time, money, and effort.

But here we are.

The doctor at the sleep clinic must now call them and ask them kindly to review this denial in a peer-to-peer discussion, as opposed to what seems to be the "let's throw darts at the board and see where they land" system that they have used previously.

This is not an argument in favor of Medicare-For-All. Government is nothing if not as good or better at setting up unnecessary bureaucratic procedures than the private sector.

In any case, I am righteously annoyed.

Comments

[madfilkentist]

As for "Medicare for All": I've been paying all my working life for Medicare. I'm paying the government a premium for what I already paid for. I'm paying two insurance companies for the stuff which Medicare doesn't cover. The "Medicare for All" people are real sadists.

[patoadam]

I, too, have been paying all my working life for Medicare. I, too, am paying the government a premium (for Medicare parts A and B). I, too, am paying two insurance companies for the stuff Medicare doesn't cover (Medicare Part D and a Medicare Supplement plan). And I am thrilled with Medicare. I expect to save a bunch of money through being on Medicare, for two reasons:

* Medicare has much lower overhead than private insurance. Last time I looked, it was 7% vs. 15% to 20%. (And the only reason overhead for private insurance is down to 20% is that the Affordable Care Act made anything higher illegal. Medicare could do better; the overhead for the Japanese version of Medicare is around 1%.)

* Medicare parts A and B save patients money by paying medical providers at a lower rate than private insurers do. As of a few years ago, private insurance was about 40% more expensive than Medicare for a given basket of medical services.