5 ms·

100% agree. Insurance companies shouldn't get to pick and choose what drugs are in or out. I was at a company, and Wegovy was covered. Then randomly I got an

100% agree. Insurance companies shouldn't get to pick and choose what drugs are in or out. I was at a company, and Wegovy was covered. Then randomly I got an email from HR, "Your medication is no longer covered." The fuck is my insurance company doing telling my HR what medication I'm on? Even if they didn't say it outright, it wouldn't be hard to figure out giving the drugs that came off the list that were paid for that quarter. =P Going cold turkey on these drugs is hard... like the doctors tell you that once you start taking them, you really aren't supposed to stop taking them. Or if you do, you have to do so gradually. The drugs mimic the feeling of being satisfied from being full, by overloading your system with a synthetic version of that hormone that makes you feel that way. Now... imagine going from "my parents used food to control my behavior growing up, and 40 years of bad behavior cemented that conditioning in place, so now it takes a lot of food to make me feel full / content," to "Oh this is nice, thank you drugs! Now I don't have to eat so much!" to "You're on your own, kid! And by the way, now that your body was used to the drugs, virtually no amount of food will make you feel full / content now. Let's see what happens!" Fucking insurance companies. People are nothing but pre-existing conditions and behavioral patterns. It shouldn't be up to the insurance companies which ones they elect to cover. "Oh, did you think smoking was cool as a kid? Too bad, hope you die from lung cancer!" It just shouldn't be on them to choose.

nextaccountic 2y ago
> Then randomly I got an email from HR, "Your medication is no longer covered." > The fuck is my insurance company doing telling my HR what medication I'm on? Isn't this a straightforward HIPAA violation?
- MajimasEyepatch 2y ago
  No. HIPAA is rarely straightforward, and in any event it’s not uncommon for employers to have some degree of access to claims data. In a case like this I assume the company self-funds the plan.
  - nextaccountic 2y ago
    That's wild; HIPAA mainly exists to protect medical data from employers (among other threat actors) in the first place
- hypeatei 2y ago
  I'm 99% sure HIPAA just applies to medical personnel (i.e. nurses, doctors) so they can't outright share private information. Third parties (i.e. your mom or insurance companies) can share it all day without violating HIPAA. It does not protect your medical data whatsoever.
  - yunwal 2y ago
    Insurance companies are absolutely covered by HIPAA. If it’s true that the insurance company (and not some third party service or app) shared the information directly with HR this is definitely a violation. https://www.hhs.gov/hipaa/for-professionals/covered-entities/index.html https://www.hhs.gov/hipaa/for-professionals/covered-entities...
  - op00to 2y ago
    What’s the I stand for in HIPAA?
alluro2 2y ago
I know it's a worn-out stereotype to point out, but from an European, I just hope you realize how jarring it sounds that there is a medication that a doctor determined you need, and TWO companies - entities driven by and existing exclusively for profit - are involved in deciding and communicating with each other on whether you will get it or not. I do think that this should still actively be regarded as scary and abnormal, even if it's the norm for so many people in the US.
- Cumpiler69 2y ago
  IT IS a worn out stereotype. I'm also European and here the doctors are also limited by the national health insurance company on what medication and treatments they can prescribe you due to cost reduction pressure. Their hands are also tied except not by a private corporation but by the government. Often you'll encounter the infamous "these tests or procedures aren't covered by the national insurance anymore so you'll have to pay out of pocket", or they're covered, but the nearest appointment on the national insurance is 15 months away, at which point you'll either get better or you'll be dead. My boss recently moved from Germany to the US and was pleasantly surprised how much better the diagnostic, treatment and medication options are for his child who suffers from some rare mental disorder that's basically ignored in Germany by comparison. US seems to always be on the cutting edge of medical research and treatment which of course comes at a cost since research is very expressive.
  - pavlov 2y ago
    Your boss is presumably a high-value employee at a prosperous company. They will have good health insurance, but that’s not the norm for most people. When I worked for Facebook in the US, it was conspicuous how doctors would run extra tests on me because the health insurance was paying for everything and anything. That’s not balanced either because less fortunate people pay for that in their insurance premiums.
    - nxm 2y ago
      Companies negotiate for all employees without tiers for „high value” employees. What do you consider the norm? 90%+ of Americans have some form of health insurance. I don’t have a bad one, but it’s not as great as some public sector employees do. Am I in the norm? If so, that’s ok
gscott 2y ago
There are these weight loss companies producing the stuff you should buy it from them cost about $350 a month. https://ro.co/weight-loss/checker-path/ https://ro.co/weight-loss/checker-path/
Spooky23 2y ago
The insurance company is the face, the villain is your company. Most bigger companies are self insured. These drugs are expensive and blow up plan costs when everyone is on them. A relative has a self-insured Cigna plan that randomly fucks with you. The company hired another company to argue with them on your behalf. End of the day, Cigna is administering the plan they established.

nextaccountic 2y ago

> Then randomly I got an email from HR, "Your medication is no longer covered." > The fuck is my insurance company doing telling my HR what medication I'm on? Isn't this a straightforward HIPAA violation?

MajimasEyepatch 2y ago
No. HIPAA is rarely straightforward, and in any event it’s not uncommon for employers to have some degree of access to claims data. In a case like this I assume the company self-funds the plan.
- nextaccountic 2y ago
  That's wild; HIPAA mainly exists to protect medical data from employers (among other threat actors) in the first place
hypeatei 2y ago
I'm 99% sure HIPAA just applies to medical personnel (i.e. nurses, doctors) so they can't outright share private information. Third parties (i.e. your mom or insurance companies) can share it all day without violating HIPAA. It does not protect your medical data whatsoever.
- yunwal 2y ago
  Insurance companies are absolutely covered by HIPAA. If it’s true that the insurance company (and not some third party service or app) shared the information directly with HR this is definitely a violation. https://www.hhs.gov/hipaa/for-professionals/covered-entities/index.html https://www.hhs.gov/hipaa/for-professionals/covered-entities...
- op00to 2y ago
  What’s the I stand for in HIPAA?

alluro2 2y ago

I know it's a worn-out stereotype to point out, but from an European, I just hope you realize how jarring it sounds that there is a medication that a doctor determined you need, and TWO companies - entities driven by and existing exclusively for profit - are involved in deciding and communicating with each other on whether you will get it or not. I do think that this should still actively be regarded as scary and abnormal, even if it's the norm for so many people in the US.

Cumpiler69 2y ago
IT IS a worn out stereotype. I'm also European and here the doctors are also limited by the national health insurance company on what medication and treatments they can prescribe you due to cost reduction pressure. Their hands are also tied except not by a private corporation but by the government. Often you'll encounter the infamous "these tests or procedures aren't covered by the national insurance anymore so you'll have to pay out of pocket", or they're covered, but the nearest appointment on the national insurance is 15 months away, at which point you'll either get better or you'll be dead. My boss recently moved from Germany to the US and was pleasantly surprised how much better the diagnostic, treatment and medication options are for his child who suffers from some rare mental disorder that's basically ignored in Germany by comparison. US seems to always be on the cutting edge of medical research and treatment which of course comes at a cost since research is very expressive.
- pavlov 2y ago
  Your boss is presumably a high-value employee at a prosperous company. They will have good health insurance, but that’s not the norm for most people. When I worked for Facebook in the US, it was conspicuous how doctors would run extra tests on me because the health insurance was paying for everything and anything. That’s not balanced either because less fortunate people pay for that in their insurance premiums.
  - nxm 2y ago
    Companies negotiate for all employees without tiers for „high value” employees. What do you consider the norm? 90%+ of Americans have some form of health insurance. I don’t have a bad one, but it’s not as great as some public sector employees do. Am I in the norm? If so, that’s ok

gscott 2y ago

There are these weight loss companies producing the stuff you should buy it from them cost about $350 a month. https://ro.co/weight-loss/checker-path/ https://ro.co/weight-loss/checker-path/

Spooky23 2y ago

The insurance company is the face, the villain is your company. Most bigger companies are self insured. These drugs are expensive and blow up plan costs when everyone is on them. A relative has a self-insured Cigna plan that randomly fucks with you. The company hired another company to argue with them on your behalf. End of the day, Cigna is administering the plan they established.