Recently, I’ve witnessed the games played by the health care system. They aren’t pretty.

I filled a prescription for medicine with a co-pay of $485 for 90 pills, but, oops, they billed the wrong insurance. In the end, my co-pay was only $20. So did the insurance company really pay the other $465-plus for those pills? I doubt it. But other customers with no insurance would pay that or more.

I received an unexpected refund check from an oral surgeon where I’d had work done. I like unexpected checks. But since I don’t have dental insurance, why was I getting a refund?

The answer: My health insurance paid for the work in full, $300. But, oops, I needed to mail back the check because I was supposed to get back only the $125 I’d paid, not the $300 that the insurance company had paid.

So did the work really cost $125 or $300? Guess it depends who’s paying for it and who’s pocketing the difference.

I show the hospital and doctor’s offices my insurance card at each visit, but they keep billing my old insurance, and coverage is denied. Oops, yes, they have the photocopy of my new insurance card but didn’t enter it. I have had to make 10 phone calls to try to get the correct information into the system.

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I’m just one person, and these examples happened over only a few months. Imagine what the results would be if we magnify these health care games, inconsistencies, errors by thousands, by millions.

We need a system that is streamlined, accurate and honest. It’s time to stop the games.

Lynn Plourde

Winthrop


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