Tree of Souls - An Avatar Community Forum

Tree of Souls - An Avatar Community Forum (http://www.tree-of-souls.com/)
-   General Discussion (http://www.tree-of-souls.com/general_discussion/)
-   -   I hate insurance companies.... (http://www.tree-of-souls.com/general_discussion/802-i_hate_insurance_companies.html)

rapunzel77 04-08-2010 05:22 PM

I hate insurance companies....
 
I don't hate much of anything but I have a particular loathing for medical insurance companies. Why you may ask? Well, I'll tell you. My husband developed a condition a couple of years ago that he couldn't get treated very much because he had no insurance. Then, about two 1/2 years ago, he got the insurance but due to a pre-existing condition, he was denied the surgery that would fix the problem until the time was up for that. So, we tried to get it done again, last year. They said everything was a go until about a week before he was supposed to have the surgery, they said that they couldn't cover part of the procedure and so he didn't get his surgery.

Then, a few weeks ago, we decided to send the claim in again. The doctors are willing to try. Yesterday, we received a letter from the insurance company saying that my husband is covered and that he can get the surgery done. I personally called the insurance company yesterday to here it from their lips. We were happy. We even celebrated by having a glass of wine.

Then, today, my husband calls the doctor to set up a time for the surgery. He was told that the insurance company called the doctor's office to say that a part of the procedure will not be covered. So, we are back to square 1 again. It seems that they are playing a game with us. We have gone from being elated to being depressed and in pain. I have been crying for most of the morning.

I did call the insurance commissioner for the state. He is going to conduct and inquiry into this mess. I HOPE that that will put enough pressure on the insurance company. The whole problem is that this particular part of the procedure is not part of their contract with my husband's employer. As a result, he has been denied care now three times.

I don't know what to do. If the inquiry doesn't not solve it, it looks like we will have to find a lawyer. I'm so upset right now and in so much pain. I told my dad on the phone but he thought he was giving me "comforting" words but they weren't. In fact, they made things worse :(.

txen 04-08-2010 06:04 PM

Sometimes you are supposed to be angry. This is one of those times. You need to aggressively work the system. You must stay calm while talking to them. Loosing your cool will not help. I have a feeling that you still have a way to to inside the system. There really is no point in getting lawyers involved until you have a good iron clad denial. I've had to go many rounds with medical insurance companies in past and it's no fun. Most of the time I managed to prevail in the end.

Don't give up and continue fighting the good fight. Don't loose hope for success, because you will get there.

rapunzel77 04-08-2010 06:08 PM

Quote:

Originally Posted by txen (Post 15776)
Sometimes you are supposed to be angry. This is one of those times. You need to aggressively work the system. You must stay calm while talking to them. Loosing your cool will not help. I have a feeling that you still have a way to to inside the system. There really is no point in getting lawyers involved until you have a good iron clad denial. I've had to go many rounds with medical insurance companies in past and it's no fun. Most of the time I managed to prevail in the end.

Don't give up and continue fighting the good fight. Don't loose hope for success, because you will get there.

Thank you Txen. I needed that. I hope we can work within the system. This is still heartbreaking. I hate how they toy with our emotions. I will stay calm though. There has to be a way around this.

ZenitYerkes 04-08-2010 06:15 PM

Sorry to hear that. I hope people needn't to get through that every time they need serious surgery. All you can do now is ask again and start from the beginning; it's not the best thing to do but it's the only way to get your husband cured.

And use all the patience you have when dealing with those people. If you yell at them you might receive a lawsuit instead of an acceptation letter.

Anyway, that people only cares about the benefits, not the persons. How they toy with them is something that really upsets me.

rapunzel77 04-08-2010 06:28 PM

Quote:

Originally Posted by ZenitYerkes (Post 15781)
Sorry to hear that. I hope people needn't to get through that every time they need serious surgery. All you can do now is ask again and start from the beginning; it's not the best thing to do but it's the only way to get your husband cured.

And use all the patience you have when dealing with those people. If you yell at them you might receive a lawsuit instead of an acceptation letter.

Anyway, that people only cares about the benefits, not the persons. How they toy with them is something that really upsets me.

Thank you for your encouragement Zenit :). I needed that.

Human No More 04-08-2010 06:31 PM

That's bad... :(

Well, good luck, hope things start to go better for you.

Fkeu'itan 04-08-2010 07:35 PM

I'm really sorry to hear this Rapunzel, I hope it all comes good for you in the end, I really do. :(

rapunzel77 04-08-2010 07:59 PM

Thank you for all the kind responses. My husband received some news from the doctor's office a short time ago. The insurance company will cover all but one part of the procedure. It is possible that we can finance the part that still needs to be covered even thought we have terrible credit. We will try that. Meanwhile, we'll see what the state commissioner can do. Somehow, some way, my husband will get this done.

ballju 04-08-2010 08:39 PM

yes this is the reason why i want REAL HC reform not the small stuff passed by obama grr what insurance do is nothing short of greed at the expense of peoples lifes. Hope everything works out in then that they will pay and you can pay the rest.


All times are GMT +1. The time now is 05:58 AM.

Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2019, vBulletin Solutions, Inc.
Content Relevant URLs by vBSEO ©2011, Crawlability, Inc.
All images and clips of Avatar are the exclusive property of 20th Century Fox.