Insurance Woes

Lots of random thoughts this morning, might be the rain. Anyway, CBS News has an article, Canceled Cancer Patient Awarded $9 Million
California, Insurer Will Begin Using A Review Panel Before Dropping Policies, that just appears to prove what I've been saying all along - that insurance companies follow the deny all, permit by exception method of taking care of their customers. As I have stated many a time, this is great computer network policy, however not a good policy for healthcare. You will note that this case has taken 5 years to reach this point.

Our family has been lucky in that I was able to retire to fight the insurance issues that have arisen over the last 7 months. My husband's job has been to recuperate, mine has been to deal with insurance. The hell of this is, we supposedly have some of the best insurance around. Scary isn't it?

My husband worked for his company for 34 years before retiring. During that time, he, personally, used the insurance probably 4-5 times. The kids and me used it considerably more. Since the plan is administered in AL, but is actually out of MI, this has been a minor headache over the years, but not a major one.

When he was admitted to the hospital for emergency care, the last thing on our mind was insurance troubles. What greeted us when we arrived home after 11 days in hospital was a letter from the insurance company saying his hospital claim was denied. Thankfully, we have good doctors also, who helped take care of this issue as this was just the beginning.

Everyone doesn't have the luxury of doctors' that take the time to help with such issues, spouses that can retire or quit to handle these issues as well as try to help the patient during recovery, a friend that's a lawyer that the spouse can bounce questions off of, etc. A great amount of our transplant coordinator's time is spent on insurance matters, and most of the things she's dealing with shouldn't keep coming up again and again. I am pretty sure she cringes when she sees yet another message from me that I need her to call this person or that pharmacy yet again, because the insurance says they're not going to cover what the doctor prescribed yet again.

I do not know the answer to all of this, but I do know that insurance companies should not be allowed to just willy nilly decide who they are going to cancel or deny coverage to without some accounting for those decisions. The $9 million awarded in the CA case really wouldn't have made the family feel a whole lot better if their loved one had passed away.