I have a great medical insurance plan through my employer. But over the years I have seen the way the insurance “manages” the people it insures. Doctor referrals, prescription approvals and disapprovals, and second guessing or outright disagreeing with my physician over treatment. What gives them the right to dictate what is good for me when they do not know who I am or the circumstances around my health issue?
Once I went to urgency care because I fell while riding my bicycle. At the doctor’s office I listed my reason for being there as an accident due to me falling from my bicycle. About two weeks later I get a letter from the insurance company wanting to know if anyone else was involved and did they have insurance? The more I read the letter the more I realized they were trying to get someone else to pay for the office visit and prescriptions.
When I was diagnosed with diabetes my insurance company denied so many prescriptions my physician prescribed for me, I finally called the insurance company to confront them. I asked them which medication did they think I should take because they seemed to know more about my diagnosis than my doctor.The problem with insurance companies is they know they have you by the balls and they are merciless.
Today I read on Reuters about a judgment against Health Net. It seems Health Net canceled a womans policy after she had 3 of 8 chemotherapy treatments. The arbitrator awarded the woman $9.4 million and in his opinion arbitration judge Sam Cianchetti wrote,
It is difficult to imagine a policy more reprehensible than tying bonuses to encourage the recision of health insurance that helps keep the public alive and well.
Yeah that’s right! Health Net offers bonuses to employees for finding reasons to cancel insurance policy’s.
There is another case pending involving a newborn boy whose Health Net coverage was canceled after he was born blind and with cerebral palsy. I am glad to hear an insurance company being held accountable for it’s actions.
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Tags: health
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February 24th, 2008 at 8:04 pm - Edit
It is so hard to believe that they could cancel the cancer woman’s insurance! But I know, even with insurance, I still have tons of medical bills from my chemo.
February 24th, 2008 at 8:10 pm - Edit
To me it is appalling what insurance companies do and continue to get away with. I am always glad to see someone take a stand and does something about it. Sad part is you know an executive for the company is most likely responding by saying they will just raise rates to pay for the judgment.
March 9th, 2008 at 4:19 am - Edit
And I thought the NHS was bad…
October 12th, 2009 at 8:37 am - Edit
My child was born 7/7/09 and went for a wellness check up on 8/19. When they were a month old they got a couple of shots and a look over $283.00. Health Net rejected the claim. When I called them up and asked why they said that my child was not on the plan. I said that I pay the family plan for my other child so I was paying the correct amount. They said that I had 30 days to put my child on the plan and if not they dropped the child. I said that you knew that my wife was pregnant and that my child was born. Could they have sent me a letter, the guy “Brian K.” he said that he is not allowed to give his last name. Anyway he said that in my instruction booklet that I got when I got the insurance “2 years ago” states this. So for 3 months my child has had no health insurance. So child is on now but they will not cover the last three months of bills!!!!! I hope they can sleep at night!!!!!
March 20th, 2010 at 10:56 am - Edit
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