A whine about US healthcare

General

The US is a hellscape when it comes to healthcare and insurance. I feel ridiculous to whine about this, but it messed up all my plans for this year.

I'm on Briumvi, and got my infusion in February of this year. Last year I had no issues, got my PA, got billed my max out of pocket of 7k, and the drug manufacturer paid it. This year there was a hiccup somewhere. My insurance paid for my IV placement and pre-meds within a few days, but EOB literally said nothing about the actual infusion. It wasn't denied, it just had nothing and the claim was closed. My infusion center had it as pending insurance still. I figured it was just going to take a bit more time.

Towards the end of April I messaged the infusion centers billing, just saying that the claim appears closed on my end. They tell me it's still pending and just to keep waiting. The next week i see the claim has been reopened.

Two weeks later, my insurance paid the infusion center the entire bill. I had no copay, they just fully paid for it.

Which I feel kind of ridiculous complaining about, because who gets upset when they don't get billed for something? The problem is that it means I'm not anywhere near my deductible now, so I can't afford any other health care. I was dependant on the drug manufacturer paying it so that I could afford medical things.

The allergist I was hoping to see? $250, plus whatever tests they run. The neuropsych evaluation? $600. Or the dermatologist, or urgent care, or PT for my degenerative disc disease, or just therapy, are now just not in the budget for this year. Even my MS neurologist visit scheduled later in the year, it will be $250 if i haven't met my deductible. I just turned 40, so I should be due for a mammogram this year too.

I'm hoping my next infusion in August gets billed to me so I can get it paid for, so maybe i can recieve some other care this year because especially in this economy, who can afford this? Other than people in every other first world country of course...

Posted May 6, 2025, 6:17 PM UTC

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