Our healthcare system is a mess

by Peter Weinberger | pweinberger@claremont-courier.com

I thought when I turned 65 my healthcare options would be more plentiful, with insurance rates costing far less. As an employer who provides and contributes to healthcare coverage for Courier staff members, I know how expensive coverage can be, especially as one gets older.

Now I was going on Medicare and only had supplemental coverage to worry about. Based on my parents’ experiences, I wouldn’t have to worry about coverage. I mean, everyone takes Medicare, right? So I was ready to make the jump. Unfortunately, reality hit pretty quickly.

Just several months after getting set up with my new Medicare coverage, Inland Valley Health Plan announced in late in 2022 it was going out of business after 43 years. I had three months to start over with a new plan and new doctors. Being one of the largest healthcare providers in the country, I chose United Healthcare for my supplemental coverage. Everyone takes them, right?

The first thing I noticed after the change was my regular prescriptions were more expensive. It seems two of them were on another tier. The higher the tier, the more expensive. Within my first week of new coverage, I was paying $250 more per month for the same meds. So much for lowering costs.

I was happy to find the dentist I wanted was on the list of accepted providers with Delta Dental PPO. I scheduled an appointment for a routine teeth cleaning. Before I could get to the dentist chair, I got a call stating they could not take me. They did not accept Medicare. I asked, “Do you take cash?” “Of course, Mr. Weinberger, come on in.”

How a dentist could not take Medicare for seniors who will clearly need dental work still irks me. I’m now on my third dentist … fingers crossed!

The other thing I’ve learned is just because you have coverage doesn’t mean your bill will be paid in full. The one time I needed an MRI I received a bill for my portion. Maybe I needed supplemental to supplement supplemental Medicare insurance. Do they even have that?

Several months ago, I got a referral from my doctor to see a specialist, so I made an appointment. One month later — it was a six-week wait — I was told they no longer accept UHC. But the doctor is on the list of accepted physicians, I pointed out. Not any longer. At least they called before I walked in the door.

All these issues working the healthcare system finally seemed to make some sense after talking with a local acupuncturist. Being under the impression I had coverage for the session, the therapist apologized profusely, telling me how insurance companies would take months to pay her bills, then pay for only a portion, or require more paperwork for basic procedures. She just gave up trying to make it work. She was so sincere I gladly paid the bill.

It’s important to mention there are many excellent doctors and healthcare workers who excel in patient care. In some cases it’s in spite of our healthcare system. My family doctor, Dr. Randy Karu, and his staff are very dedicated and conscientious. It just seems the cost of staying healthy is so obscene, with so much paperwork from profit-minded providers, some offices need a small army to manage it all. I hope one day we can simply make it easier to take care of ourselves.

But until then … here’s to your health!


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