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.
Sounds like discrimination based on sex. A clear violation of the Civil Rights act of 1964.
That’s what I was thinking. Sounds illegal.
Car insurance companies are literally allowed to discriminate by sex and will openly tell you that they do so, why would health insurance be different?
Civil Rights Act of 1964 prohibits different treatment of insured persons on the basis of their sex in connection with pension funds. This was a supreme court ruling, so kind of linked but not quite.
https://www.jstor.org/stable/253100
Interestingly, in UK and EU it became illegal to discriminate by sex for car insurance from about 2012, without very careful use of data - which doesn’t happen. It is allowed to be linked on things like jobs though.
newsflash: US never cared about civil rights and despite it being “law” it gets regularly ignored on an institutional scale
It might be, but some health related coverage is legitimately divided along sex lines. I don’t know what the answer is, but it might not be so simple.
Stupid either way though.
Different genitals. But all genders have bladders so why the hell wouldn’t the insurance just cover it for everyone
So a few things. This is a CVS minute-clinic visit, not a visit to a general provider. The minute clinics have contracts with insurance companies that look a bit different in terms of what and who they are permitted by the insurance companies to treat. There are some really odd variations in these contracts by insurance companies for reasons that are not always grounded in science.
This, as you’ve noted, is an unfortunate reality of a for-profit health care system that is dictated by private companies, insurance companies, and mind-bogglingly complex contracts that sit between providers and patients. The most annoying part IMO is that insurance companies provide zero transparency into these contracts and the justification behind decisions. It’s all “business decisions” at the end of the day, not decisions that are medically sound and in the best interest of the patient.
And for those wondering why OP maybe just didn’t go to a “regular doctor” - the U.S. has a horrible shortage of general practitioners (primary care) physicians. This shortage is worse in some areas than others. And even if you’re lucky to live in an area that has general practitioners, the waiting list to get into their practices might be long. This leaves many people relying on a “doc in the box” aka CVS Minute Clinic or some similar outfit. These doc in the box clinics often only have a nurse or nurse practitioner on site, with a supervising physician off side. They are for-profit entities and they work with the insurance companies to design their contracts to maximize profit.
If you ever find yourself in OP’s physician, one easy way to get around this is to indicate that the visit is for something more general, like abdominal pain or unexplained fever. While the staff still might refer you off to another provider, it might be a good way to at least “get in” with someone.
Another option is to visit a local urgent care clinic if one is available and covered by insurance. These are often staffed by actual physicians so they can treat a wider range of conditions. Many often even have testing facilities right on site for a number of issues.
Finally, another option is to call your insurance company and see if they have an over-the-phone nurse consultant available. They can usually help direct you to the right location for treatment based on your symptoms and insurance coverage.
But yes, OP, I agree with you that we need something better. Medicaid and Medicare have slowly been expanding and my hope is that they will eventually expand enough to cover all Americans. it has been proven that they can still operate without completely decimating the insurance industry (see Medicare and Medicaid managed care). While I don’t agree with for-profit health insurance, the reality is that they are a lobbying force that has to be worked with if we are going to get everyone universal coverage.
Source: Health policy professional by trade, extensive experience within the health care industry
How is the us a real place wtf?
And it’s not like we learn this stuff in school. It’s not written out anywhere. We have to rely on word of mouth, people with experience, or people like the commenter above you who are familiar with the ins and outs.
The bottom line is that it is complicated on purpose and designed to wear you out so you don’t get coverage for your most basic human needs - like peeing without your urethra being on fire.
Back in my day we always pee’d with our urethra on fire after we walked to school and back uphill both ways - and we liked it!
Back in my day we peed on each other around the fire and instead of school a man would come around the house and hit us over the head with an encyclopaedia for 6 hours in the hope we’d learn by osmosis, and we were happy to have that.
Wat
The bottom line is that it is complicated on purpose and designed to wear you out
The real kicker is you’re wrong. It’s not designed that way. That’s just a happy accident of capitalism run amok. Almost no one involved in the system is an intentionally bad actor. Almost everyone wants to do the right, good thing.
The doctors want to provide care, but they can’t because their boss says, “No.”
Their bosses don’t want to say no, but they have to refuse some people so they can help the rest or the insurance companies won’t pay at all.
Insurance companies wan–actually, no, they’re fucking evil soul-sucking sacks of shit that can die screaming in a fire. Fuck 'em.
No sorry that is wrong. The need for profit and growth in profit absolutely pushes health insurance organizations to limit their costs, and denying service is routine, planned and not some mysterious accident.
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undefined> The real kicker is you’re wrong. It’s not designed that way. That’s just a happy accident of capitalism run amok. Almost no one involved in the system is an intentionally bad actor. Almost everyone wants to do the right, good thing.
That statement.,
Keep reading…
Oh my. Y’all really didn’t read the whole comment did you?
You should really look into the history of modern US healthcare. Johnson nearly passed a public health system. They consciously decided to go with this instead. This is absolutely by design. The people in charge simply fire anyone not making a profit until they find someone willing to do anything to create a profit, legal or not. (See Wells Fargo for this too, it’s an old playbook at this point.) They play naive but they are totally aware of what is done to create those profits.
Also we recently found this with the Opiate stuff too and that entire family exchanging messages clearly indicating they knew the illegal activities and lies being told for profit. They just played dumb publicly.
Just ask yourself, could a rich person make money off of this? And it all falls into place. Over the last several decades the people of the United States have been increasingly treated like a mined resource.
First world country which treats its citizens as third world, that’s what we live in. Follow the money, because if something isn’t making money for someone, then we don’t get it.
A lot, and I do mean it, of third-world countries have better access to medical care and universal healthcare than the US.
This is great. Thank you for providing such great info to lemmy. A lot of people in the US suffer from a lack of information, and this more than certainly helps.
That’s more than mildly infuriating…
Are you sure this isn’t just a CVS thing? It says the same thing for me and I know my insurance covers UTIs for everyone. Maybe try an urgent care?
This is correct… there is 2 things to remember here
- CVS only has nurse practitioners, nurses, or pharmacists that are doing the screening, and must refer for certain cases
- There are 2 types of UTIs….
- complicated and uncomplicated
- Men ALWAYS have a complicated uti due to the anatomy of where the uti is located
- women can have either, these NPs are only allowed to treat UNCOMPLICATED UTIS and must refer all complicated cases to a physician.
FYI it has nothing to do with insurance
My friend, you need to do two things –
One, get treated. It seems you’ve visited urgent care. They are “real” doctors and, assuming the hospital or clinic the urgent care is associated with is well-staffed and stocked, should be able to get your sorted today. Be sure to get any prescriptions you need filled on-site, if possible, before you leave.
Two, review your healthcare plan. While the Affordable Care Act mandated certain minimum coverages several things happened since that allow people to purchase plans that do not conform to the ACA mandates. On those so-called “catastrophic” plans, insurers can deny or decline to cover all sorts of things. Patients often simply shop by monthly premium cost and don’t check coverages. Make sure your health plan is ACA-compliant, and, if not, look into a way to get covered by a compliant plan.
If it IS ACA-compliant, then treating a UTI, even in a male, is covered. You may be selecting providers that are not in-network, or do not have the proper staffing to treat this fairly rare condition, though. It may be worth a visit to your primary care provider if you can’t get something like CVS or another “Doc in a Box” to treat it.
I think you’re just supposed to die now…
I don’t believe I can afford to, though. 😓
That moment when it’s better to live in Russia than in US…
There are 0 objectively good reasons to live in Russia.
Free healthcare in this instance.
For non citizens?
No one in A&E checks your passport. I mean I’m not in Russia, but in the UK and the only reason some medical professional might check your ID here is when you’re signing up for GP services - these are territorial in the UK. Otherwise you just go to the clinic or hospital and get a treatment. I’m migrant from an xUSSR country, so healthcare there should be close in structure to Russian I believe. And again - no one checks your IDs, except for when you sign up for GP.
And even when you need a GP, there is usually a framework for non-citizens. Usually when you sign up for GP they check your tax paying status. You pay taxes? Free healthcare for you! And in the UK if you don’t work and don’t pay taxes you can pay NHS contributions separately and then you will get all the treatment you want.
So I believe Russia should be somewhere along these lines as well.
Someone, ie insurance, has to pay for that medical coverage. I’m Czech and when I go to my doctor I give them my insurance card before I get treated. However, medical insurance isn’t “free” (well, government funded) for non citizens here either.
I’m pretty sure this is one of them…
That is a fully incorrect statement. Just because objectively its better to live in US than Russia at this moment, does not mean that there is 0 good reasons to live in Russia. Stop thinking in extremes, every place has pros and cons, its just that some places have a lot more cons than pros.
The entirely of modern America could be summarized with “Mildly Infiruating”, tbh.
It is utterly baffling to me how the US has not figured out nationalized healthcare. Literally every other developped nation in the western hemisphere has at this point.
Its crazy that a politician could come out and say “my number one priority is to ensure that every American has access to healthcare, paid for by the state”, and would instantly be villified by like half the country.
The covid national emergency is declared over. Potentially up to 15 million people will lose Medicaid expansion. Florida already kicked off 600,000 people. An 87 year old who had a daily care taker lost access even though they were qualified after the cut. A 7 year old boy will now die because they took access to his leukemia treatment. About half the people still qualify but they are making everyone reapply.
My dad some how affords stupidly expensive healthcare. Premiums are $4,000 a month. ER copay is $1000. ER deductible is $18,400 per family. My mom is now on a medication that costs $1400 a day. With other meds her medication is $15,800 a month for the rest of her life (she is 59). With insurance it goes down to $28 She has had $100,000 in medical bills. She has some super rare condition. Our insurance said one of the out of network doctors was covered. My mom verified multiple times. Now they don’t want to cover that doctor so we are stuck with a $25,000 medical bill. My mom says she will put it on the lowest amount a month for the rest of her life.
In other words if my dad couldn’t afford this insurance she probably would be dead now or in a few months.
Crazy is that we are all Canadian and if we lived there we could go on OHIP plus extra insurance for a few hundred bucks a month. For those who say Canadian’s have wait times, so do we. The difference is you will be seen and will not go medically bankrupt or denied care because you are too poor.
The excuse is that Canadians come to America for better doctors with lower wait times. They do. But when you realize they come to the States they don’t have long term insurance. Meaning they pay out of pocket. So it’s wealthy Canadians that can afford insanely high prices.
All my family in Canada says my father is pissing away money. He is.
God Bless American Healthcare! /s
TLDR Doug Ford can sod off and go to hell.
Because the healthcare industry makes money. A shitload of money. Why would they “fix” that? The problem is the fact that it is an industry.
The extreme profit oriented business culture of the US combined with the human nature of bandwagons make these sort of disgusting practices possible.
Corporations are justified, by default, in anything they can do to increase profit, and will do so until there’s enough public backlash to negate the amount of profit that practice makes.
The public backlash is tied to the social momentum the idea has. Because profitability is the default idea to be promoted, you can’t say something like “don’t do this obviously profitable thing because it’s bad for people” unless there’s enough people around you who’ll get on the bandwagon. If suddenly some influential person or a critical number of schmucks say the opposite, then everyone is defending the corporation’s, not only the right, but the duty to be profitable.
It’s an unpleasant way to live, really, but people are creatures of habit and won’t easily go against the culture they grow up in.
You are presuming that it is a UTI and and coding it wrong for insurance purposes. Do a visit for something more generalized that is covered like abdominal pain and doctor will know how to code it properly for insurance.
Yea it will. Just not at a minute clinic. You need to go to an actual urgent care or primary care doctor.
Just want to throw my 2c in. I’m a physician and from our perspective male UTIs are rare and warrant a much more thorough medical evaluation by a professional, compared to female UTIs which are extremely common and don’t require a thorough (or even in-person) evaluation in most cases. If I had a male patient with a UTI and no other know medical history I would insist they are seen by a physician for a complete evaluation. From other comments here it seems that CVS does not employ physicians in their clinic.
So the guy gets no care because the system is not fit for purpose?
Seems like they’d be liable because a male uti could end up not clearing up and creating an antibiotic resistant strain? Either way it’s a lot harder for a man to get a UTI and it means something is really fucky. Examples of a complicated UTI include: Infections occurring despite the presence of anatomical protective measures (UTIs in males are by definition considered complicated UTIs) Infections occurring due to anatomical abnormalities, for example, an obstruction, hydronephrosis, renal tract calculi, or colovesical fistula. UTIs are less common in men than in women, as men have a longer urethra that makes the passage of bacteria into the bladder more difficult. Overall, people with vaginas are more prone to UTIs. However, penile UTIs are more difficult to treat, and may require longer courses of antibiotics. This is because the bacteria that causes these infections may linger inside tissues of the prostate gland.
Again I think a nurse should not be allowed to treat something that dangerous.
No, not what I said. His insurance will cover a primary care visit. The staff at the cvs are simply not qualified to treat a male UTI.
People are dense. You straight out said this man needs more complete care to ensure that he can be helped because his condition could be more serious than if he were female, and they read “more thorough treatment” as “no treatment” like morons.
CVS MinuteClinic is for super minor stuff. Doctors are for more serious things.
This is a CVS thing and not an insurance provider issue. If you go to an in-network provider, they will treat your UTI.
Two years ago I passed a kidney stone, that led to a UTI, and then sepsis. My insurance treated me without blinking. In fact, the only out-of-pocket costs I paid, was a $50 co-pay for the ER/hospital stay, and $8 co-pay for my aftercare antibiotic.
What the hell? Was someone drunk when they drew up that policy?
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Too much cocaine
I can’t help but wonder what happens to girls 15 and under when they get UTIs. Insurance company says sucks to be a girl?
Probably.
We knowingly vote for this shitty health care system every two years, so why would they ever change?
At the federal and state levels, we knowingly vote against King Heron so he doesn’t eat all the frogs. (That is, we vote against Republicans who are actively working to neuter democracy).
Getting social safety net stuff, justice reform or even election reform will require grassroots pressure bigger than yhe George Floyd / BLM protests.
And without those things, instead were going to get genocide politics and civil war.
I think we convince ourselves we’re voting the way we do for good reasons, but since Reagan, our votes have resulted in conservative outcomes no matter who we elect. Obama even had a supermajority for six months of his presidency, and we still had to hear the usual excuses people make in order to deflect from criticism of Democrats.
I say this as someone who voted Biden fully expecting him to govern as a conservative because I thought we needed a cultural victory against the resurgence of fascism. And, even with the 1/6 domestic terrorist event, we haven’t seen any real movement to stop those elements. If anything, they’ve grown stronger.
I agree with your main point though, meaningful change is impossible now. It would take an existential threat greater than COVID for it to happen, and in a country where 40,000,000 people can’t afford to miss a day of work, it’s just impossible.
There are different regulations regarding treatment dispensed directly by a pharmacist than those dispensed by a physician. Under 16 would generally have to be seen by an a doctor, often a pediatrician.
thats what you get for having a penis.
Or being born American.
smh should have known better
The grass is the same color everywhere.
There’s grass where you at? I wouldn’t know. Ain’t no grass around here.
![[Final Update] My insurance won't cover UTIs for males. Yes, I'm in the US.](https://lemmy.world/pictrs/image/3f7f2fe9-6596-4427-a750-ca0a16636fcc.png){kind=link}