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Insurance Companies S**k!

Jul 21, 2008 03:18PM - 9 comments

I just have to vent. The hospital where I had my surgery called and they said that my insurance company is doing some kind of review, going back 5 years to see if I had this problem (I guess) when I signed up with them.  I cannot believe that I went through this last year with all the heartache and disappointment with the doctors not believing in me, only to have the emergency surgery and prove I was right all along, to just now probably get screwed by the insurance company.  If they don't pay for this surgery, I will fight it to the end!!!

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by TrudieC, Jul 21, 2008 03:29PM
Oh that is nasty.  Jan might have some good advice to you from a legal point of view.  Hope this goes away and doesn't cause you too much aggravation.

by kimmywah, Jul 21, 2008 03:49PM
Oh they do s**k.  These medical companies are raking it in and sometimes are so slow to pay, and pull this cr*p, but whoa betide anyone who misses a payment to them!
Good luck my friend and yes Jan will know how to 'sick it to them' haha no pun intended.

Peace and Love....Kim

by cirella, Jul 22, 2008 11:17AM
I thought the insurance people ask for some kind of report before you sign up?  Maybe not.  Colleen, don't worry...something will work out.  I'll be praying for you and ALL these situations that are coming up suddenly.  My goodness...you have a wedding to plan!  Don't need this, too.

Love ya

by lady452008, Jul 25, 2008 10:02PM
Insurance companies are ALWAYS wanting and HOPING someone else will pay.  It's a pain and I hear some insurances are being done away with leaving people WITHOUT.  I know when our daughter went through her bad car accident I learned all about the insurances asking all kinds of questions in HOPES someone else was liable for the bill.......  I TRULY HOPE it works out for you Colleen.  Keep us all posted.  :)

by marie3B, Jul 25, 2008 10:07PM
This is so sickening I can't even think of a comment.  So far my insurance has been okay, but I have heard such horror stories from so many people.  It is a huge problem.   Marie

by lvfrogs, Jul 26, 2008 07:12AM
Thanks for all the response to my venting. I will just deal with it once I hear something final. I will be so glad to go on Jerry's insurance when we get married. He has great coverage! And yes, Lori, you do fill out all the paperwork before you sign up, it is just like Sharon said though: they "hope" they can find someone else to pay! Stinks and it should be changed in this country!

by JC145, Jul 26, 2008 08:02AM
Some insurance plans have a "pre-existing" clause .. in which case if they can prove that this condition was documented when you signed on, it may not be covered.  By documented, I mean an MD has stated you have a definite diagnosis.  Since it's taken all of this time to get a diagnosis, I can't see how they can prove you had it 5 years ago.  Not all plans have "pre-existing".  

Don't pay anything ... make them prove you are responsible for the $$.

Judy C

by Jaybay, Jul 26, 2008 03:02PM
The pre-existing clause only applies if you have not had continuous coverage since the original condition was diagnosed.  When the HIPPA laws went into effect, the idea was to stop the pre-existing condition nonsense, but of course, there is always a loophole.  The insurance industry has very effective lobbyists and our politicians are always willing to be bought off.  

Here's how it works.  Say you had coverage 5 years ago when you were first diagnosed with a condition.  Then you leave your job, get fired, laid off, whatever.  If you did not keep up your COBRA coverage (pay your own premiums) until getting new insurance either from a new job or through a spouse or privately purchased a policy, all bets are off.  You start from ground zero and any previously diagnosed condition can and will be held against you.  If you have all of your continuing coverage certificates from previous policies, no problem.

I've had so many medical issues over the years and it nearly bankrupted us to keep up those COBRA payments, but it was worth it in the end.  We would be completely hosed by now otherwise.

Call the insurance company (or your benefits coordinator if this is a policy through your employer) and get a copy of the actual policy.  Not the 100 mile overview of benefits, but the actual policy.  It's not an unusual request, so don't worry about it.  The fine print in the policy is what you need to read to fight this thing.

by lvfrogs, Jul 27, 2008 06:42AM
Thank you Judy and JayBay for your information on the insurance. I know about the "pre-existing" policy and of course, that is what they are checking on. My insurance is personal insurance, I don't have insurance through work.  I had this insurance for 18 months before I was diagnosed.  So it really shouldn't be a problem, but I will call and get the actual policy in case I have to fight it. Thank you both!!!

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