By the way, the only thing I made up here is the joke about the PET scan. Everything else came from actual comments/anecdotes from followers

I'm not even american and this makes me furious. How are the people who write these policies not being chased through the street by a torch wielding mob?

I'm a pharmacy tech, and the amount of times I've heard a patient tell me "My insulin is HOW MUCH?!?!?!, well, guess I'll die" is... more than it should be

Can confirm that I’ve experienced at least 80% of these scenarios with patients. Hey, we may even hit 100% by Christmas. UHC is Santa’s coal in the stocking for all the bad doctors who try too hard to provide care without insurance overlords.

The truly awful part... these phone calls only happen AFTER it's been denied, then you've called, and been on hold for 45 minutes.

"Trust me, I'm a man speaking confidently." Perfection.

Having to file an appeal for my daughter while she was in the NICU and I was postpartum from a traumatic birth was the lightbulb moment that acknowledging our healthcare system is completely messed up is a non-partisan issue.

I get that this is supposed to shed light on the situation but at the same time it makes me angry how messed up the US Healthcare system is

You know how they say the best satire is funny because it's true? I was playing a bit of a bingo game with all the different denials I've personally experienced. The worst is having to prove-every single year-that I still have Crohn's disease and I still need treatment, to the EXACT SAME INSURANCE COMPANY going on 5 years now! Last year they wouldn't approve the treatment I was on until June, meanwhile my doctor ran out of free sample medication and I came out of remission and required a major surgery. Thanks, Cigna!

I had no clue that doctors in health care workers had to go through this just to make sure patients got the right to medications. I thought it was just the patience doing all the work. Thank you for your information and humor Dr

As a Type 1 Diabetic that has had to work with my endo to assure my insurance that I still have the same T1D Ive had since I was 8 years many times over the past 20+ years, and had to explain to them that I will die within days without my insulin and their processing times are in fact a matter of life and death.... yeah this hit really close to home

Toddler takes the pill form, chokes and goes to ER. United Healthcare denies the visit. It's a pre-existing condition because he choked on a marble before.

You missed one of my favorites. “We can’t approve the medication the patient has been on for three years unless we have evidence that he has failed the preferred drug first. I know you say that he had a near fatal allergic reaction to the first line medication three years ago but we require him to have tried it and failed it in the past 180 days before we can approve the second line therapy”.

When I was pregnant with my first, United Healthcare denied my Group B strep test (completely standard routine pregnancycare which prevents newborns dying of meningitis), because they wanted it to be the rapid strep. Which isn't even the same strep species.

Doctors need to record these conversations they have with health insurance companies and put them on blast, on mass media, youtube, senate hearings, etc... let them justify denying life-saving procedures to the outrage mob.

“A PET scan? We barely cover human scans.” 😂😂😂

I assume one of the many reasons the service of health care is so expensive is because of the amount of overhead a medical practitioner has to employ just to fight the insurance companies to insure he/she gets paid.

My fiancé is a radiation oncology tech and yesterday he had to call UHC because they decided that she can do the cheaper treatment that comes with way more side effects than the more expensive one that has less side effects. They also said her treatment isn’t emergency even though it’s treatment for her windpipe and it’s getting worse everyday and she can’t breathe really. Insurance can either be super helpful or your worst enemy.

The antisocial healthcare crowd really did a number on this country when they started calling insurance healthcare

The scariest thing is that there's a very high chance that all of those exact phrases were used at least once

God almighty this series needs to be seen by everyone in the United States 😩😩😩

As a diabetic, yeah.... id recommend looking into New England Home medical to see some horror stories of medical suppliers. They repeatedly lie to you about sending medical supplies (taking over a MONTH to fix their own failure to ship despite me callinf nearly dailt) and will randomly stop covering supplies without telling you. Truly a nightmare. Also, double charging is... way too common in healthcare.

I love that my surgically proven endometriosis patient with antiphospholipid syndrome who has failed an attempt at bleeding suppression with a Mirena was told that she had to try ibuprofen before they would approve a GnRH agonist. 🤦‍♀️We are waiting for her to start her new job and the new health insurance to see if we will have better luck with them. 🤷‍♀️

With each day I get more depressed by this series . 😥 This is just so inhumane tactics... 🤬 Thank you for shining light on this practise so people can understand this misery...

Having ADHD my whole life. That line near the end about ADHD medications hit a bit hard. Nothing like talking to the Dr every 30 days to have a 90 second conversation about how the meds I've used for years are still working just fine and could I please have 30 days of my dose.

American healthcare system just breaks my heart

I've been watching this series everyday and I'm always simultaneously interested and terrified to watch it.

At the start of September: "Wow, Dr. G's going to upload daily for an whole month, lucky us!" At the end of September: "Noo, make it stop!"

I was waiting to see my ob/gyn and overheard the angry doc say to his assistant about another patient: "how can they deny diagnostic tests for a75 year old woman with vaginal bleeding and severe pelvic pain ???&*@!!"

I feel like I'm just walking on eggshells in my healthy body, hoping something doesn't go wrong and make me poor forever

Dr. G, thank you so much for this series. It brings light to a very dark situation here in the United States. The more information gets out to the general public, then maybe, just maybe, we can change things for the better. Thank you!

I had an initial consultation with a psychiatrist about a possible ADHD diagnosis, then went back a couple of weeks later to actually get tested. United proceeded to deny the claim, and when the psychiatrist and I asked why, we were told : First, the wrong charge code was used/UHC doesn't have a contract with him to do the testing (he copy and pasted from the last person he did an ADHD diagnosis for with United, and that had been approved); second, that testing and consultation were done on the same day (they weren't, and United's bill said they weren't); third, that the psychiatrist hadn't gotten prior authorization (he had never had to before, and didn't get a notice of a policy change. Plus, it's prior authorization for a computer test?), and fourth, "no", as his appeal was denied and they didn't bother responding to the one I had to fax in. This was after I had to spend three months trying to get them to pay for an appointment to the nurse practitioner that had referred me to the psychiatrist, because UHC didn't have the correct tax ID numbers on file. If UHC doesn't know why the claim is being denied, how on Earth am I supposed to figure out if a claim is going to be paid for ahead of time?! During one of these calls where I was told the problem was prior authorization, the rep had the gall to say "you didn't do anything wrong, your doctor didn't follow the correct procedure", and it took everything in me to not yell at the minimum wage worker that my assumption was the neither of us did something wrong, and that United had either screwed up or made something so complicated that it would be impossible for anyone to get it completely right.

I hate this so much because it's true, I have UHC and i've had these conversations with them trying to get them to cover anything or explain why I owe thousands more than their own website says I would have. I've been lied, misled, and denied by them more times than i've ever had anything covered.

Last year my CPAP was dying and I needed a new one. Had to redo the sleep study to show that my chronic lifelong condition that can't be cured hadn't been cured. When I said this verbatim to the tech who set me up, he gave me a very resigned and definitive "Yep."

Violence, so much violence. Make united need it's own healthcare.

“Trust me, I’m a man speaking confidently” absolutely killed me 😂😭

“If the chemotherapy causes nausea then we’ll talk” had me laughing for an hour

UHC just denied Thyrogen for me yesterday-needs prior authorization. I'm living and loving these videos.

"Trust me, I am a man speaking confidently" pretty much sums up health insurance and why we're still in this mess

"Counterpoint... No." Well that's just insurance in a nutshell, isn't it?

Note on insulin: Walmart sells vials of both short and long for $25 each.

I’ll add a story. My dad has Parkinson’s and as you know, that’s a degenerative disease. One of the things that really helps him and improve his quality of life is speech therapy and loud therapy. My mom has to pester the insurance company for referrals. They only give him a small handful of sessions at a time. Then they have to wait and evaluate and then maybe they’ll authorize more sessions. But it’s never continuous (which it should be!) Just once I want to scream at their insurance company.

This is painfully real. Just had a Code 3 Critical Care transport get cancelled by the ordering facility because apparently being vented and on full life support wasn’t good enough of an excuse for their insurance company. God bless the American EMS/Healthcare system.

Soon "To be alive will require prior authorization"

I have a large cyst growing on my ovary. I needed to have a CT scan for it. So, I scheduled the CT scan at the hospital where I was told by my doctor to go. A week after I had the scan, a guy from our insurance called and suggested that I go have the scan at an orthopedic office because it was cheaper. I said I'm pretty sure they don't do those there. He insisted on keeping talking. I just started laughing. I didn't know what else to say.

I am blown away daily by the truthful, hard-hitting, and yet humorous videos that you produce. We must do something to get them out to the powers that be, so the system and hijinks can be altered.

I always picture claims inspectors as the type of people to dream of using live people as household furniture.

Soy española, tenemos un sistema sanitario que lo cubre prácticamente todo. No es perfecto, hay poco personal y listas de espera. No pagan demasiado bien y los profesionales se van a otros países. Por eso y por qué lo pagamos todas las personas q trabajamos con nuestros impuestos, hay gente que quiere q tengamos lo q hay en estados unidos, por q en la tele se ve q tienen muchas novedades, recursos y hospitales estupendos y aquí no lo parecen, sin darse cuenta que allí te puedes morir si no tienes dinero para pagar cosas que aquí se tratan sin problema. Ojalá todos los países tuvieran mínimo lo q tenemos, y ojalá no acabemos como vosotros Gracias por tus vídeos, soy enfermera y me encantan 😂

Doc, I'm a huge fan and hv been following this series from the onset. But this one is the one that broke me. As a medical student who really just wants to make things better for people who are suffering, this was heartbreaking on so many levels Insulin, Pacemaker Batteries, Birth Control, Multiple Open Fractures?!?! Is there even a light at the end of this tunnel?

My depression and anger are through the roof. Our healthcare system is awful and needs to stop. Your life is forfeit, while the executives make record profit.

I hate hate hate United. I have no idea how they have gotten away with this for so long. They sent me a job link and asked me to apply. I told them you make my life a living hell everyday, why would I do that? Although it was tempting to go work there and approve as many rehabs as I could before I got fired.

0:29 I had this exact thing happen to me. Working in an electrical shop, any kind of chest pain was an automatic 911 call. It should have been worker's comp, but I was on file with the hospital so they billed my insurance, who denied the claim because I hadn't actually had a heart attack.

Oh the appeal process. They hate me when I appeal their decision. I go toe to toe with them and usually win because they try using nonsense to deny extending the treatment, just like he showed here.

Blue Cross Blue Shield did the it wasn't a heart attack so it wasn't an emergency to my ex husband (this before I met him so more than 20 yrs ago). He had inflammatory costal condritius (inflammation of the rib muscles) and thought he was having a heart attack so called an ambulance. They tried to deny covering any of b/c it "wasn't a real emergency." He appealed under the thought of I'm not a medical doctor how was I supposed to know it wasn't a heart attack and actually won...but this was 20+ yrs ago

Everything my Dr requested for the last 6 months has been initially denied by insurance requiring him to resubmit it with additional information, causing delays and twice the amount of paperwork. The industry is killing itself and convincing more people we need universal healthcare.

This got published on YT as I was literally fighting that UHC denied prior auths twice for PrEP despite being on it for years and it being mandated under the ACA

I had a patient coming in last week with headaches with a bunch of red flags. UHC approved an MR the same day and her scan showed a 6 cm bleeding intracranial tumor that turned out to be a glioblastoma. In conclusion, your documentation is going to help your patient get the test they need.

Oddly enough, I’ve pretty much bounced from ADHD medication to ADHD medication without ever hearing anything from insurance. My mother’s stage 4 colon cancer? Oh man when my dad’s work switched healthcare providers (cigna/aetna?) they wanted to put her from what was working back onto something that not only didn’t work but also she was extremely allergic to because she needed to “fail” those treatments first. Well my dad’s bosses bosses boss, my dad, and the healthcare rep had a nice meeting and suddenly she didn’t need to switch treatments.

I'm not calling for anyone to be harmed, but there are people in our society deserving of harm.

Yes, every insurance company employee should watch this. But they still wouldn't care. This country is full of greedy and corrupt people. But you're awesome ❤😂😅 Thanks!!

The bit about not taking the placebo birth control pills killed me omg 😂😂😂 (i had a doctor straight up tell me it didn't matter that my endometriosis was only msnageable when they removed the period, I was to take them as prescribed and I should just walk off the pain and symptoms)

"aaaaand it's January!" Folks who don't work in healthcare don't really get this to the full... from January until...about May or June is what we call "Peak Season". That's when insurance changes. All of it, but mostly Medicare and Medicaid. Not just formularies (fuck you UHC and your non form of a drug that was form a fucking week prior) but also dispensing pharmacies and co-pays. That line about the "he has to fail two ADHD meds before we'll approve the one he's been stable on for a year" happens every fucking January. And not just with ADHD meds, with serious life-sustaining meds. The "we only cover pill form" happens on meds that don't even come in tablet form, and they won't approve capsules and require prior auth for any other form. WHY ARE WE NOT RIOTING!?

Day 6 of Asking when does US Healthcare become Eugenics against the poor

Since I'm a physician I understand. But this makes me very furious and angry. It's like all the guidelines and research we put into diagnoses and treatment were simply thrown in the trash.

Having experienced this firsthand with patients it's incredibly funny but immensely sad at the same time.

As a therapist, watching my ADHD patients go through all the shit they have to go through with my meds is endlessly frustrating

The 10mg tablets one got me! My behavioral therapist had to fight OptiumRX over that *exact* thing.

1:24 Thank you Dr. G for throwing this one in there for all the menstrual migraine, endometriosis, PCOS, etc. patients out there! It’s even worse when trying to prescribe birth control patch this way. The boxes only come with three patches. 😤

Thank you, thank you, THANK YOU! Personal AND professional with United Health Care captured precisely in this episode.

I’ve tried to explain this to extended family members who blame their physicians for failing to approve treatments. I call it the congress effect. You blame the guy in front because it’s a lot harder to delve into the inner workings that allowed your system to rot in the first place

Former UHC Tier 2 Insurance Adjustor here: I got to see almost all of these. This brings me great pain and that job drove me to day drinking my way to an early grave! Thanks for shedding light on the Bullshittery they pull. It's fucking soulless.

My heart is breaking for all US citizens... How can a society function like this? How is it possible that so many people refuse to acknowledge where the common good is? I say this because I have read online of many Americans talking about how they think socialized Healthcare is bad and a waste of your money... I just don't get it...

The preventative healthcare laugh was so scary. Don't they realize how much money they would save oyn the long run of e patients were healthier?

I love these so much. I imagine people from countries with civilized medical systems think these are ridiculous exaggerations, but they are not. Not at all.

I got one for you. NP sent in a request for a sleep study for sleep apnea. It was denied because all of the conditions suggested I DO have sleep apnea so no need for the sleep study. The NP was confused and didn't know where to go from there. So nothing was done and I had a heart attack a few years later. So now they're paying for my $600 in prescriptions every 3 months.

Pt denied glaucoma medication they’ve been on for 6 yrs and for which same insurance company approved last yr. Sent appeal with reason why needs meds (allergic to most others) and copy of their letter of approval which expired 3 months ago. Appeal denied! Give me strength. Signed PA coordinator for 10 yrs who is ready to give up

I’m a Peds practice manager and the stupid “step therapy” for ADHD and changing formularies for stable pts makes me SO mad I wanna break stuff 🤬 I tell parents EXACTLY what the issue is and to call and file a complaint with their insurance. Won’t work, but at least their voices get heard! I’m surprised all of us in healthcare don’t have wine habits yet 😅

I'm not sure whether to laugh or cry...I've been through so many of these as a chronically fabulous (ill) person. I get occipital nerve blocks, supposed to be every 3 months, and the last one was in December...as of April if diagnoses of "headache" or "migraine" are ANYWHERE in your records, denied! So my drs office dragged their feet on submitting the application, and in that time, my insurance company changed the formulary to keep me from getting these necessary treatments. It's like, "F you in particular!" 😮‍💨

Getting a PET scan for a 4 year old with suspected Ewing’s Sarcoma is ridiculously hard to get covered. At least they don’t think he’s a pet though.

That was infuriating even for me, and I'm not even American. But at least I feel happy afterwards for having free universal healthcare here. Idk how do you still survive with such a mess

Oof! Gut punched by how realistic some of these are from personal experience.

"we only cover 10mg tablets...ans if your patient even thinks about splitting them" My doctor litterally prescribed finasteride with 5mg and told me to split them 4 ways 😂

This video was a timely release as my roommate's orthopedic doc was talking about insurance denials and this was the KZfaq video that was first when I opened up KZfaq to show her your series on US Healthcare. (Too much crap that my roommate has to go through to get a knee replacement due to a work injury 3 years ago.) Also, UHC has an ad out now (that I muted and didn't pay attention to) which I suspect is trying to head off this video series' roasting of them.

I work in health care. You are spot on with UHC but Aetna is a very close second.

"Multiple open fractures" HEY, UHC Bro!!!!!

As a type 1 diabetic, this is painfully accurate.

Laughed, then was hit with an overwhelming sense of grief. The unadulterated rage behind his eyes reflects the rage of all medical professionals who deal with this bull on a daily basis while their patients get denied lifesaving treatments and investigations.

Mom spent the last year of my dad's life arguing with insurance. They'd been together since high school. 💔

As a family physician these videos give me a pit in my stomach with how accurate they are. Somehow I can’t help but watch them though. Thankfully where I practice we don’t have a ton of United Healthcare. Unfortunately we have Blue Cross instead.

"Okay but the chest pain didn't end up being an emergency" HOLY MOLY.

I think that last one is also how some news outlets decide if something is experimental.

Thank you so much for making this series. It's so helpful in explaining to my family, friends and sometimes patients about why our job is so hard. Family Med here and I feel exactly how skewed glasses guy looks most days.

At least my Zofran didnt need prior authorization. Both my migraine meds did though because I didnt fail more than one drug. Failed triptans because they make my brain feel like it on fire.

Its scary to me how much material he has for this

The only way this gets funnier would be to have Deadpool as a guest commentator , in a MST3K style " review " of insurance company commercials . If you haven't been hot with a blizzard of C and D letters yet , they probably aren't coming no matter what . But , if they do start coming , you can add a " fan mail " segment so we all know who everyone is working for , their names , addresses , etc .. You know , in case folks want their autograph . Or , appendages... I don't judge .

Cardiologist-attorney here. Been there, done that. Perhaps we should push to have the insurers’ absolute ERISA immunity statutorily converted to, at most, qualified immunity dependent upon the insurer’s review being: 1) conducted in good faith; 2) based on substantial medical evidence; and 3) with physicians being reimbursed for the cost of providing said patient data beyond that accessible in the electronic medical records. To tamp down unjustified lawsuits against the insurers, we could 1) establish specialized “medical necessity approval” courts; and 2) adopt the British rule on attorney’s fees and costs-loser pays.

This whole damn month has been scary!

Love this series!

Keep up the message! Nobody knows until they've experienced it...

This happened to me when I had breast cancer and authorization of MRI..😢