That’s a shame. Maybe if you replace the PNHP logo with the FOX “News” logo in the FAQ and send it to him that way he’ll come around.
Poor uncle. Being able to afford his health care out of pocket.
I don’t have health insurance. I can’t afford shit.
“I’m not yet defending the insurance company”. Heh. Well, at least you made your biases quite clear from the get-go, eh?
It doesn’t say that he could afford it; it says that he paid it. He may have had to sell his house or spend all his retirement savings.
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That’s very true.
Of course, if he had a house to sell or retirement to spend, he’s also very lucky.
I got $7 in my bank and nothing to sell. My parents are also pretty broke, and I don’t have rich uncles. But since I am a child less adult in Arizona, I qualify for exactly nothing.
I wouldn’t be able to pay for it, period.
I hate to break it to you folks, but all healthcare plans have rules and limits. That goes for VA, Medicare, Medicaid and foreign healthcare services as well. Some countries won’t even allow certain drugs in order to save expenses. And that’s beside the fact that none of them (government or profit or non-profit) like paying for experimental treatments.
On top of that, individual states regulate what insurance companies can get away with. They put limits on things because resources are finite. Remove those limits, and the bill goes up.
I forget which one, but the pattern sounds about right.
Which part of my comments offended you with my “biases”?
I work with many small businesses’ HR departments, and part of that job is helping them and their employees get their claims paid by insurance companies. I act as an advocate for my clients, not for insurers. I see a handful denial letters weekly.
I consider my viewpoint very middle of the road between the insurance industry and healthcare consumers (and let’s not forget the healthcare industry). Where is yours? Can you say you’re free of bias?
…and to the rest of the attacking, angry comments, all I asked for is more information. I wanted a photocopy of the letter so I could read, for myself, what the denial wording actually said.
I gave you a direct quote from my denial letter. The letter itself was part of a purge a few years ago and thus no long available to be copied, but I’ll never forget the line because of the sheer ridiculousness of the excuse.
So, with all your professional experience, explain it to me.
P.S. I did have one more child after that one. Not that any of it would have been covered, anyway.
In your case, you’re wondering why you were denied a health insurance policy while in the middle of your pregnancy? Aka… You wanted a reasonably priced policy in return that they pay for your inevitable, considerable, medical expenses and all future expenses?
Insurance is a contract which you pay someone else to assume the risk of your financial loss. Your risk was 100%.
They denied you for the same reason home owners insurance denies an application for a house in the middle of a hurricane or auto insurance denies to insure a car at the scene of an accident. The risk is a 100% loss of money.
Would you enter into a contract where you receive say $600 a month knowing that there was potentially $20,000 to $100,000 of liability coming down the road? Not me. Not any smart business.
If you think health insurance is a right, then that’s your opinion. Thats where government and government aide comes in. But I also think saying no to a contract guaranteed to be a huge financial loss is also a right.
Not even close. Read what I wrote in my original post. I applied for catastrophic insurance: no infertility treatments, no prenatal, no labor & delivery, no well-baby checkups…just an insurance policy for a true catastrophe. When I applied, I wasn’t pregnant, but the process took long enough that by the time they responded I was 4 months’ pregnant. They turned me down saying I had a “potential for future infertility”. That was the written reason given for why they were turning me down for catastrophic-only insurance.
So, explain that to me.
quoting chgoliz:
I was turned down for catastrophic medical insurance (no coverage for
prenatal care, delivery, or infertility issues) when I was 36 and 4
months pregnant because BCBS said I “had the potential for future
infertility”. I believe it’s called menopause.
It looks to me like she wanted a policy where they do NOT pay for her inevitable, considerable medical expenses, but just things like “getting hit by a bus” or, possibly, “something happened in the pregnancy that will kill me.” You know, CATASTROPHES. Nothing guaranteed to be a huge financial loss: most pregnancies probably don’t involve catastrophes. The risk was higher, sure, and probably higher than they wanted to pay.
Even if you agree that they had a right to turn her down because the risk was too high, you should at least acknowledge that claiming to do so because “there is a potential for future infertility” is a BS reason.
But yes, I do think health insurance is a right of any civilized society. A shame the health insurance industry you’re defending is spending hundreds of millions of dollars, not taking care of the people they insure, but lobbying to make sure that the people of the US don’t get universal health care.
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I’m Janet Freeman-Daily, the blogger who wrote “Insuring the Terminal Patient.” btw, I’m female.
If you read my blog post, you saw that I quoted the section of the letter that explains why my appeal was denied:
” … in this case the member is already known to have progressive Stage IV Bronchogenic carcinoma even after therapy. Specifically identifying the histopathology of this right upper lobe lesion is not going to affect long-term health outcomes.”
The paragraphs preceding this section reiterated info I stated in my appeal letter as well as BCBSIL’s stated reason for denying my initial claim (it’s policy). The subsequent paragraphs provided information on how to appeal again.
As a science writer, I take great care to ensure my information is as accurate and unbiased as possible. I realize you don’t know me, and so you might question whether this quote accurately reflects the content of the letter I received from BCBSIL. True, I could take the time to scan in the letter, redact the personal information, post the image to my photobucket account, and link that to my blog post.
However, I want to ask you a question first. If you don’t believe that what I posted is an accurate quote from the letter I received, would you really believe that any image I post is a true copy of the letter I received?
An update to my post:
BCBSIL called me Friday and said they were overturning their denial of my appeal. The caller did not know the reason. I’m looking forward to receiving the letter that explains why.
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Congrats on getting through with your appeal, whatever the reason. Why somebody would call to inform you without any knowledge about the reason escapes me, except to silence you as fast as possible
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My guess? Negative publicity; sometimes that seems the only way to get things done these days.
In any case, good news!
Well of course he loves his bloody dog. Otherwise he wouldn’t have taken it to the bloody vets when it was ill, would he?
His dog had a severe allergic reaction to something, most likely insect bites, which was causing him distress & making him lose his fur, due to the inflammation, and the dogs scratching of same. So, weirdly enough, the vet prescribed antihistamines. Because it was fucking well allergic to something.
As it goes, he told the vet where to stick it, and bought 14 generic ones from the chemist for a pound. Fond of it though he is, he’s not stupid.
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The point was that when you start valuing dogs as if they were human you will be subject to the same abuses from the medical-industrial complex that are visited on humans. Like medication price-fixing, etc.
Personally, I probably would have either let the dog tough it out, trained it not to scratch, or just euthanized it. It would depend on the dog, though. There have been a few that I’d consider medicating.
