I was starting to feel optimistic.....still scared, but optimistic none the less....2 chemo's to go and scans to be booked, surgery consult and set up, surgery, radiation...etc.... Inexplicably, the scans have not been ordered, I suspect the insurance company is not pre-approving them, which is required before they are booked. UNITED HEALTH CARE IS HOLDING UP THE TREATMENT OF A CANCER PATIENT WHERE TIME IS OF THE ESSENCE!
United Health Care has not paid a single dime to our oncologist in the last 4 months, we were called into a billing office and told her treatment might have to be moved to the city hospital because although she has insurance and CANCER, they believe (I shit you not), that she got insurance knowing she had cancer in order to screw over United Health Care by making them (a medical insurance company) actually pay for someones medical bills.
Although all our doctors have provided them with all T's past medical records and have even called to tell them, this is, in fact, is NOT a pre-existing condition, UHC say they believe that it was anyway with admittedly no documentation what-so-ever, and so will continue to hold up all her claims indefinitely, which will prevent her from getting the best medical care available which she is entitled to and has been paying for. By the way, There is no evidence of a pre-existing condition because, THIS IS NOT A PRE-EXISTING CONDITION!
How outrageous of us to expect United Health Care to pay their insureds medical bills. How dare one of their customers have the audacity to contract a life threatening disease while insured by them. United Health Care is not only not upholding their part of their contract with their insured, they are in-fact endangering her life. To call this disgraceful is the understatement of the year!
So, in addition to fighting cancer we now have to fight the insurance company in hopes that they actually do their job!
I've got her doctor calling the insurance company again, I've contacted the insurance commissioner, the CT Labor Board, and the CT Insurance Patient advocate. I should have an official case number soon. We also have being 100% right on our side. This was NOT a pre-existing condition you f#cking morons.
I have no doubt we will win this fight, because we have right on our side, but why do we have to fight this battle at all? Isn't dealing with a life threatening cancer enough. Thanks a lot UnitedHealthCare, for nothing.
Oh and thanks for having your customer service department refuse to let me speak to a supervisor and also treat me like a criminal when I called to inquire why T's medical insurance was not paying her medical bills!
I'm pissed and worried that these criminals will get away with this....well, let's call it what it is, a crime!
Ok I understand that this is not a pre-existing condition, but maybe this will be helpful... My understanding is that HIPPA laws says if an individual has had 12 months of consecutive medical coverage an insurance carrier can not apply the pre-existing condition rule.
ReplyDeletehttp://www.cga.ct.gov/2006/rpt/2006-R-0694.htm
Refer to the section: Group Health Plan - Federal Law. If I remember correctly (its been awhile) the mumbo jumbo means that if there was no break in coverage... no prexisting rules can be applied. This was enacted to prevent people from being tied to a job/employer if they had a pre-existing condition. Which is the main reason for maintaining COBRA when a job is lost.
Also: http://www.ehow.com/list_7358534_state-connecticut-health-insurance-laws.html
Good luck
Thanks CAB, but she didn't have insurance coverage before this job that gave her insurance.
ReplyDeleteThe only reason she even went to the doctor was to get a note to go back to work after her mom's death. It seemed silly since she wasn't out sick, just out to plan funeral and stuff and mourn her mom.
Her job MADE her go to the doctor to get a note, and they happen to diagnose her then.
so sorry you are dealing with so much. living in Canada, i don't have to deal with all the mumbo jumbo of various insurance companies for this or for that. My mom had breast cancer, and she was treated, no bills, no insurance companies to deal with, and she did bounce back. same when she was diagnosed with lung cancer, it was just off to get the radiation treatments and no bills ever came in. the land of the free ain't so free there. the more i hear about the goings on in the USA, the more i am so glad to be up here, in the cold. :) take special care of one another. i do hope that the donations you have been receiving takes the edge off.
ReplyDeleteWell that sucks all the way around. How long was she covered before she went to the doc?
ReplyDeleteNot sure CAB, less then 12 months.
ReplyDeletePoet, I wish I lived in Canada....The donations helped pay about 1/2 of last years deductable. They raised it for 2011....joy....and if they get away with all this non-sense, I don't even want to think about it.
Angry one minute, scared the next....sigh....but I'm fighting this! They can't just lie to get out of paying, and expect me to roll over.
You know, I'm all for capitalism and making money and all... but when that becomes more important than the well-being of people... well... this is what happens.
ReplyDeleteI'm so sorry Kat. You will win this. This wasn't pre-existing. I can't believe this is happening 2 minutes before the reform will go into effect for it.
I'm so sorry... If I were you I would also write to every damn newspaper in CT.
I've contacted several TV stations so far.
ReplyDeleteGlad I live in Canada where this would never happen
ReplyDeleteI wish we were living in Canada right now too!
ReplyDelete