Share

cover art for Like pulling teeth.

An Arm and a Leg

Like pulling teeth.

Season 8, Ep. 7

When a car hit Susan and knocked out a bunch of teeth, her health insurance was supposed to pay for her oral surgery, and she knew it. So why has she had to chase them for 18 months and counting? 


Getting insurance to pay for anything dental is usually hard, but this had us asking ourselves… is it usually this hard? 


We connected Susan with law professor Jacqueline Fox — who, when she was practicing law, fought insurers on behalf of patients. And who says Susan has “done everything right.”


We’ve started to wonder whether Susan’s troubles could be related to broader accusations against her insurer, Ambetter, the largest provider of plans on the Obamacare marketplace.  


Here’s a transcript of this episode.


We’d love for you to support this show.


Now is a great time to do it. This month, every dollar you donate is DOUBLED, thanks to NewsMatch and the Institute for Nonprofit News.


Holy cow, what a deal. Here, go for it.


Send your stories and questions or call 724 ARM-N-LEG.


More episodes

View all episodes

  • Staying on Medicaid seems tougher than it should be

    23:05
    We take our first look at Medicaid— the big, federally-funded health insurance program for folks with lower incomes— for two reasons: First, it’s a huge part of our health-care system. Medicaid covers a quarter of all Americans, and four in ten children. Second, it’s timely: In the last year, more than 20 million people have lost Medicaid — even though there’s evidence to suggest a lot of those people probably still qualify. More than two-thirds have been dropped for “procedural reasons” — basically, missing paperwork.Of folks who’ve been dropped, 70 percent have ended up either uninsured, or — in most cases — back on Medicaid. This is all because of a process called “the unwinding” of COVID-emergency protections that kept folks from getting dropped at all for a few years. It’s been messy.We’ve been hearing the stories of folks who got dropped, and their fights to get re-enrolled.  In this episode, we hear about two families in Tennessee who lost coverage they were entitled to — including one family who lost their coverage after their mail got sent to a horse pasture — with help from KFF Health News reporter Brett Kelman. Here’s a transcript of this episode.Send your stories and questions. Or call 724 ARM-N-LEG.Of course we’d love for you to support this show.
  • 6. We’re digging into “facility fees.” We need your help.

    10:22
    We’re launching a brand new project and need your help!We’re zooming in on charges that are becoming more and more common on your medical bills: facility fees. Facility fees are charges tacked onto your bill for visiting a doctor’s office or clinic related to a hospital or larger health care system… or even talking with a doctor who’s in one of those places on a telehealth visit. If you’ve ever seen a charge for a facility fee on your medical bill, we want to hear from you. ... and if you haven't, we'd love your help spreading the word!Consider sharing our posts on any of these networks:Instagram | TikTok | Facebook | Ex-Twtitter | LinkedInWe’ll be back with more new episodes in a few weeks. In the meantime, send your stories and questions. Or call 724 ARM-N-LEG.And of course we’d love for you to support this show.
  • 5. The Hack

    21:38
    When a subsidiary of the giant UnitedHealth Group got hit by a cyberattack recently, a big chunk of the country’s doctors, pharmacists, hospitals and therapists just stopped getting paid. It’s been a huge disruption, with some providers wondering if they can keep their doors open.But thanks to their huge size and reach, the situation may have had a silver lining — for United.Which seems like a big problem, and got us wondering: What can we maybe do about it?The answer turns out to be: Maybe more than we think, via antitrust enforcers at the Federal Trade Commission and the U.S. Department of Justice.Strap in for a wild ride — and then maybe check out FTC Chair Lina Khan’s talk with Jon Stewart on The Daily Show. We include some short excerpts, but the whole thing is worth a watch.Thanks to reporters Brittany Trang (STAT News) and Maureen Tkacik (The American Prospect) for guiding us through their reporting.And to the novelist/journalist/activist Cory Doctorow, who has been writing about antitrust enforcement for years. Here are a couple of his columns about Lina Khan and what she and other antitrust enforcers are up to.If you want a deeper dive on the new antitrust movement: It’s summed up in a terrific (and short) book by Tim Wu, a Columbia University law professor and former White House adviser: The Curse of Bigness: Antitrust in the New Gilded Age. And you may be able to get it for free! If your local library uses a system called Hoopla, you can borrow it as either an audiobook or an ebook.Super-fun tangent: Cory Doctorow and Tim Wu went to elementary school together — and apparently played a lot of Dungeons and Dragons — when they were kids in Toronto. Here’s a transcript of this episode. Send your stories and questions. Or call 724 ARM-N-LEG.And of course we’d love for you to support this show.
  • 4. Son of Medicare: Attack of the Machines

    30:05
    Reporter Bob Herman from STAT News unpacks his blockbuster investigation about the country’s biggest health care company.   Covering the American health care system means we tell some scary stories. But this episode is almost like a horror movie. It’s got some of Hollywood’s favorite tropes: Machines taking over. Monsters from separate franchises meeting face to face in a new movie, like Godzilla and King Kong, or Jason and Freddy. And a couple perceptive folks warning everyone, ”Hey, look, something really bad is happening!” Those folks are Bob and his STAT News colleague Casey Ross. The monsters are United HealthGroup — a “behemoth” as one expert called them in an episode from last year — and Medicare Advantage, which we looked at in our last episode. And the “machines” belong to United.Bob describes what some of United’s own employees said about the result: “For some of us, it's creating this moral crisis. Like we know that we are having to listen to an algorithm to essentially kick someone out of a nursing home, even though we know that they can barely walk 20 feet.” Scary stuff. But Bob and Casey’s reporting has caught the eye of some powerful people in government, and right now, Medicare Advantage plans are on notice from the federal Centers for Medicare and Medicaid Services, the U.S. Senate is holding hearings, and the Department of Justice reportedly has an anti-trust investigation in the works. Here’s a transcript of this episode. Send your stories and questions. Or call 724 ARM-N-LEG.And of course we’d love for you to support this show.
  • 3. The Medicare Episode

    29:11
    Health insurance sucks. Which leaves lots of us counting down the days until we turn 65 and can get on Medicare – the federal government’s health insurance program for seniors. But Medicare is a lot more complicated – and costs more money – than a lot of us realize. (Also, it involves insurance companies.) And:t There will be huge, complicated decisions to make when you turn 65, that can have huge consequences. The biggest, and most consequential: Choosing between original Medicare and Medicare Advantage – the privatized version sold by health insurance companies that’s advertised everywhere seniors look. Some folks who pick Medicare Advantage later regret it — but find there are no do-overs. We get the scoop from Reporter Sarah Jane Tribble, who’s been covering the story for KFF Health News and the Washington Post. And we get a preview: What do we all need to know before we hit 65 about the choices we’ll face? There are a lot of options, and a lot of price tags. Sarah Murdoch from the Medicare Right Center gives us an outline of those choices and their consequences — and supplies both tips and resources. The biggest: When it’s time for you -- or anyone you care about -- to make choices around Medicare, every state has a free source of unbiased advice and information: Here’s a link to find your State Health Insurance Assistance Program (or SHIP).Here’s a transcript of this episode. Send your stories and questions. Or call 724 ARM-N-LEG.And of course we’d love for you to support this show.
  • 2. Wait, is insulin cheaper now?

    25:17
    A listener wrote to us at the beginning of the year with a query, “I was just reading the news about the price of insulin going down to $35! Is that for everyone?”It turns out, there is a lot of good news about the so-called “poster child” for the high cost of prescription drugs. But to say it costs $35 now is an oversimplification – and diabetes activists don’t think this fight is over.Senior producer and self-proclaimed “insulin correspondent” Emily Pisacreta took a hard look at the recent developments. Plus, what does the explosion of drugs like Ozempic and Wegovy have to do with the price of insulin? We break it down. Here’s a transcript of this episode. Send your stories and questions. Or call 724 ARM-N-LEG.And of course we’d love for you to support this show.
  • 1. Self defense 101: Keeping your cool while you fight

    24:57
    Dealing with the American health care system as a patient means lots of tough moments – unexpected bills, meds not covered, insurance and hospitals making you go back and forth without a clear answer, endless hold times and phone trees… the list goes on. So listeners ask us all the time: How do I stay strong and fight for my rights without totally losing my s---? We’re bringing back one of our most useful episodes ever: How to keep your cool in a tough moment, according to a self defense expert. In late 2020, Dan hit up self defense expert Lauren Taylor to get strategies for standing up for yourself, and hear how she’s applied her approach in her own fight for health care coverage. Since then, she’s published a book! It’s called Get Empowered: A Practical Guide to Thrive, Heal, and Embrace Your Confidence in a Sexist World. Extra tip: At the moment, the site bookshop.org, which supports independent bookstores, has the best price.Here’s a transcript of this episode. Send your stories and questions. Or call 724 ARM-N-LEG.And of course we’d love for you to support this show.
  • 9. One last tip before 2024

    04:13
    Real quick: Now's the best time to support this show! Thanks to a few super-star Arm and a Leg listener/donors, your donation is matched two for one right now. Here's the link to donate.Ok, now: We’ve got a mini-episode for you today, a four-minute coda to the epic story we brought you in December.It features a last tip for anyone who might want to ask a hospital about charity care — which, as we learned from these recent stories, is most of us.And it comes with my big thanks for being part of this show’s community this year. You’re our reason for being, and our best sources.  You’re also our biggest source of financial support, so I will ask one more time to pitch in now if you can.  Thank you so much! We'll catch you in 2024.
  • 8. When hospitals sue patients (part 2)

    36:36
    Hey! The BEST time to support this show with a donation just got even better. Right now, any gift you make, up to $1,000, will be matched TWO for ONE, thanks to a few super-generous Arm and a Leg fans who’ve pooled their dough. . It’s a great deal, and it will set us up to kick maximum butt in 2024. Here’s the link, go for it!And… are you ready for our most-ambitious story yet? We’ve been working on this investigation all year, with our partners at Scripps News and the Baltimore Banner. With those partners, we’ve dug up some surprising (and possibly uplifting) news about lawsuits in three states – Maryland, New York and Wisconsin — and what that news might mean for the rest of the country.  This is part two of a two-part series. In part one, we examined the phenomenon of hospitals suing patients in bulk – sometimes hundred or thousands at a time – over unpaid bills. We learned that in many cases, those patients are struggling financially, and that the lawsuits aren’t very lucrative for hospitals anyway. So why did they happen in the first place? As one former collections industry insider told us, those decisions are “philosophically based.” In this episode — before getting to those surprising/hopeful findings — we try to understand that “philosophy,” perhaps best described as: business-as-usual. We speak with a former hospital billing executive and a representative from the third-party collections industry. This series is produced in partnership with the McGraw Center for Business Journalism at the Craig Newmark Graduate School of Journalism at the City University of New York.… and supported by the Fund for Investigative Journalism.