Stupid health insurance

[Ken]

My wife has been having some strange symptoms lately, a nervous twitch, similar to parkinson's but not as frequent. She's been in to the doctor several times. Eventually the doctor sent her to get 2 MRIs. One for her brain, one for her neck. The brain one was approved, neck denied. They said we could fight it, but we did not have time, we are trying to get this resolved. So we paid for the neck one out of pocket.

Guess what, she has a problem in her neck and requires surgery very soon with a risk of paralysis if she doesn't get it done. But our insurance thought it wasn't needed. Stupid, stupid insurance.

So now we paid out of pocket for the MRI, AND we have to pay for the deductible on the surgery. If insurance had *correctly* paid for the MRI, we would be all set with our deductible.

Why do I pay for insurance when they can just go against our doctor's recommendations and deny a test that was going to say that my wife could be paralyzed if we didn't do it?!?

[GwynnInTheHall]

My wife has been having some strange symptoms lately, a nervous twitch, similar to parkinson's but not as frequent. She's been in to the doctor several times. Eventually the doctor sent her to get 2 MRIs. One for her brain, one for her neck. The brain one was approved, neck denied. They said we could fight it, but we did not have time, we are trying to get this resolved. So we paid for the neck one out of pocket.

Guess what, she has a problem in her neck and requires surgery very soon with a risk of paralysis if she doesn't get it done. But our insurance thought it wasn't needed. Stupid, stupid insurance.

So now we paid out of pocket for the MRI, AND we have to pay for the deductible on the surgery. If insurance had *correctly* paid for the MRI, we would be all set with our deductible.

Why do I pay for insurance when they can just go against our doctor's recommendations and deny a test that was going to say that my wife could be paralyzed if we didn't do it?!?

Sorry to hear the frustration, but happy you caught this in time. Wish her the best--you too.

yeah Insurance is a mess in this country no doubt. Hopefully it will start down the path of common sense soon.

[umjewman]

Sorry to hear, Ken. Hope all turns out well on the medical side (obviously).

Health insurance companies are the worst. Eveeeery year, they try to give my wife the generic instead of Synthroid. And eveeeeery year, she has to get the same note from her doctor that the generic gives her heart palpitations. They just assume most people won’t bother to challenge. I had surgery a few years ago and they wouldn’t pay a follow up visit to the surgeon because it wasn’t “medically necessary.” Apparently you’re not supposed to have any follow up with your surgeon after the operation.

[The Feral Slasher]

My wife has been having some strange symptoms lately, a nervous twitch, similar to parkinson's but not as frequent. She's been in to the doctor several times. Eventually the doctor sent her to get 2 MRIs. One for her brain, one for her neck. The brain one was approved, neck denied. They said we could fight it, but we did not have time, we are trying to get this resolved. So we paid for the neck one out of pocket.

Guess what, she has a problem in her neck and requires surgery very soon with a risk of paralysis if she doesn't get it done. But our insurance thought it wasn't needed. Stupid, stupid insurance.

So now we paid out of pocket for the MRI, AND we have to pay for the deductible on the surgery. If insurance had *correctly* paid for the MRI, we would be all set with our deductible.

Why do I pay for insurance when they can just go against our doctor's recommendations and deny a test that was going to say that my wife could be paralyzed if we didn't do it?!?

That sounds really frustrating to say the least. Hope the surgery and recovery go well

[madducks]

Health insurance companies are evil.

I hope everything goes well for your wife Ken.

[Sour Masher]

I echo what everyone else has said. Really glad you caught it. Health insurance is such a flustercuck in this country. It is a bloated, costly, heartless mess of a system.

[The Feral Slasher]

I echo what everyone else has said. Really glad you caught it. Health insurance is such a flusterfuck in this country. It is a bloated, costly, heartless mess of a system.

*flustercuck

[Kevin Seitzer]

Echoing what everyone else said, and hope it works out okay.

[heyelander]

A lot of companies offer a fringe benefit of concierge medical/insurance assistance. Basically, you tell them the insurance company is being difficult on this and they will spend the time fighting it for you. It's the kind of benefit that when you first get hired you read about and immediately forget, but things like this, and legal advice and whatnot are great to take advantage of.

Not saying you had this, but my bet is more than a few of us do and have completely forgotten or ignored it.

Glad someone caught it. T&P for your wife.

[Moonlight J]

Hope everything works out.

After my first surgery to repair my torn labrum, insurance (United Healthcare) approved all of 9 PT sessions when prescribed therapy from surgeon was 3x a week for 3 months.

Most recently, my son's doctor ordered a test, said most patients are charged no more than $300 on it, and we got a bill for $5000 because insurance said they didn't have enough time to evaluate the request.

Can't wait until we're closer to universal healthcare

[The Feral Slasher]

I saw this and it reminded me of this thread. If you like your health insurance you can keep it, I guess. And if you don't like it you can also keep it.

https://www.propublica.org/article/how-one-employer-stuck-a-new-mom-with-a-bill-for-her-premature-baby

Lauren Bard opened the hospital bill this month and her body went numb. In bold block letters it said, “AMOUNT DUE: $898,984.57.”

Last fall, Bard’s daughter, Sadie, had arrived about three months prematurely; and as a nurse herself, Bard knew the costs for Sadie’s care would be high. But she’d assumed the bulk would be covered by the organization that owned the hospital where she worked: Dignity Health, whose marketing motto is “Hello humankindness.”

[Hornsby]

I saw this and it reminded me of this thread. If you like your health insurance you can keep it, I guess. And if you don't like it you can also keep it.

https://www.propublica.org/article/how-one-employer-stuck-a-new-mom-with-a-bill-for-her-premature-baby

Lauren Bard opened the hospital bill this month and her body went numb. In bold block letters it said, “AMOUNT DUE: $898,984.57.”

Last fall, Bard’s daughter, Sadie, had arrived about three months prematurely; and as a nurse herself, Bard knew the costs for Sadie’s care would be high. But she’d assumed the bulk would be covered by the organization that owned the hospital where she worked: Dignity Health, whose marketing motto is “Hello humankindness.”

Confused...did she or did she NOT have health insurance? If no, why in the world would you expect an employer to cover your bills just because they have a cutesy slogan?

[The Feral Slasher]

Confused...did she or did she NOT have health insurance? If no, why in the world would you expect an employer to cover your bills just because they have a cutesy slogan?

You could try reading the article, lol. I suspect it would answer your question.

[Hornsby]

You could try reading the article, lol. I suspect it would answer your question.

Or you could just answer the question, but that seems to be out of the question.

[The Feral Slasher]

Or you could just answer the question, but that seems to be out of the question.

She had health insurance.