Medical insurance companies are just in it for the money. They don’t give a rats ass about the people who pay their extremely high rates month after month just in case something dire should happen and god forbid actually need to use said insurance. Like here, a 37-year-old man is diagnosed with kidney cancer which then progressed to his lungs and brain when he finally died in pain earlier this month. Not only did their insurance company deem every single test and/or treatment to be experimental or unnecessary, he was denied morphine for his pain in the end because it was, get this, unnecessary. The man’s doctors appealed every single denial and even went as far as to write up a 27-page appeal specifically detailing that if this man did not get the treatment he would die.
Then we have another lady I saw on the news somewhat recently who was morbidly obese and her GI physician specifically stated that if she did not have gastric bypass surgery she would inturn end up in a wheelchair from the weight pressing down on her knees so she would not be able to walk for herself and other complications which she might/might not have at this point in time (wasn’t paying that close attention) to include hypertension, heart problems, breathing problems and possibly more that I do not remember. Eventually, it is possible she would die from all these complications. She had a popular insurance plan that denied it due to it not being medically necessary. Now excuse me but if a physician states that it is medically necessary who do the insurance people think they are to disagree?
Medicare which is for the disabled and/or elderly deems gastric bypass surgery as medically necessary when the physician so says. So I guess the lesson in this is pray you end up on disability and obtain Medicare while your young or try to hold on until your old just to have the surgery to save your life which might take years. The whole insurance system is so asinine.
I think what kills me the most about this second insurance plan is the fact that, according to them, gastric bypass is not medically necessary but yet they offer discounts for cosmetic dentistry, cosmetic surgery, botox, hair restoration and massage therapists to name just a few. Will any of these things be detrimental to a persons life if they do not have any of it done? Most likely not.
Now in the case of the first story, I say that lady should sue the insurance company for all their worth.
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Oh geez, I understand. Sadly I do work for a health insurance company and believe it or not in the appeals dept.
Uh oh, I forsee some possible questions/comments your way soon lol
I’m on disability (at 44) and have Medicare and the new prescription insurance. I have 3 meds that are outrageously expensive and if I were on regular insurance, they wouldn’t be paid for. Also I have Lupus, and many of the treatments for Lupus and its symptoms are considered unnecessary. Medicare isn’t perfect, but as long as I have it, I’m using it, getting treatment, and making no apologies for it. Thanks for visiting my site. Nice to be meeting new folks thru BlogMad.