Trans who was just browsing offered a personal case worker from the insurance company to make sure everything goes smoothly navigating their medical system. Anyone here ever gotten that for their normal or even very-serious medical procedure?

submitted by BettysBitterButter from reddit.com

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[–]Huffleterf 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (0 children)

There are some conditions with some insurance companies where you can get a case manager.

I had one with one insurance company. Then I switched companies and they only offered it for about 10 things (pregnancy, cancer, heart disease, diabetes, etc). They couldn’t give me one because my condition wasn’t on that list even though I have constant problems with med coverage and need continuous treatment. 😡

I wasn’t offered a case manager the first time, a friend told me to ask for one because of all the problems I was having with my medicine.

The post does sound to me that he was speaking to a salesperson reading from the book, but they would provide a case manager for the transition.

It’s bullshit, everyone with a chronic condition or major surgery should be offered a case manager.

[–]our_team_is_winning 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (1 child)

My guess is there's so much money to be made off these pricey surgeries, that it's similar to a well-heeled buyer walking into a Mercedes dealer and getting the luxury treatment. Or the Celebrity Center that Scientology run -- maybe a better analogy for the cult!

[–]BettysBitterButter[S] 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (0 children)

The insurance company wouldn't be making money off covering these surgeries. Their MO is to deny coverage to everyone for everything and then make it difficult like pulling teeth to have anything approved.

[–]MarkTwainiac 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (0 children)

If this happened in the US, the fact is that the services offered by private insurance companies vary greatly depending on the particular insurance company, the state you're in, and the specific plan you're enrolled in.

Obama-era regs said all insurance plans must do certain basic things, but they did not limit services and perks that could be provided. Insurance plans purchased through the Obamacare state exchanges vary enormously depending on the company/provider, coverage level you choose (bronze, silver, gold or platinum) and of course the price you pay each month. In turn, there's great variety amongst the private insurance plans that employers, unions, and educational institutions etc negotiate on behalf of their employees and (college/uni/grad) students. Plus there are many companies and institutions that opt to go the "self insurance" route.

There's huge variations in Medicaid and Medicare coverage in the US as well, again depending on the state you're in and the provider (a lot of private companies provide Medicare - the differences between the vendors and options is very complicated and daunting). As for Medicaid, in states like Massachusetts it's top-notch, but it's a very different story in the 12 states where Medicaid has not been expanded.

[–]Jalaces 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (0 children)

I got a caseworker when hospitalized for epilepsy. It was offered by the hospital, not insurance, as I had no insurance at the time.