i am glad i am insured, but i HATE insurance companies... Went to doc for cancer screen

[peacebird]

preventive skin check. Doc finds suspicious mole and removes it for lab to check. My insurance pays 100% for cancer screenings - no deductible, no copay.

EXCEPT that because the doc *found* something to check, now the insurance company is "applying it to my deductible" because it "is diagnostic, not prevention screening". :wtf: AND they are applying the surgery to remove the mole and the lab fees to dedutible as well. Nice little $400 "free cancer screening"...

Last year I had a colonoscopy. Again - this screening is supposed to be covered 100% - no copay, no deductible. EXCEPT they found five polyps which they removed, and so the insurance company claimed it was diagnostic NOT preventive screening. And they got out of paying. THAT was a pretty penny too.

I guess stuff is only covered as preventive screening if they find nothing suspiicious which needs to be checked? What the hell sort of logic is THAT?

I had a pap smear that they refused to pay because my appt ended up being 355 days after the previous one instead of >356.

They try telling me I don't need mammograms because I'm too young, regardless of the fact I've already had lumps removed and my doc wants me to have mammos yearly.... by the way - well woman checks are also supposed to be 100% covered, no copay, no deductible, but somehow the insurance company always finds a way not to pay.

Sorry to rant, just got off the phone with an overly perky insurance lady who kept saying "it wasn't preventive because they found something, so it was diagnostic, don't you see?"
ARGHHHHHHH>>>>>>>>>>>

[barbtries]

1. greedy motherfucking pig insurance companies

aargh. i mean, i share your frustration.

eta: you can and should dispute the ruling on the mammograms. they are medically indicated in your case and the ins company does not have a leg to stand on.

[TZ]

2. I sooo understand

I have a rare chronic condition and I have to fight tooth and nail to get approval of my expensive but effective meds..fortunately the doctor who gave it to me is at Mayo clinic, so I have them to fight for me but the slimy bastards keep trying to find any loophole to get out of paying..I loathe health insurance companies...:grr:

[DesertFlower]

3. i went to the emergency room for

an allergic reaction. the emergency room doc charged $598. the insurance company allowed it, but guess what? i had to pay because i hadn't satisfied my deductible. i also had to pay $96 to the hospital. the doctor spent less than 5 minutes with me.

[madmax]

4. I'm going through similar crap

I was diagnosed with cancer 6 months ago but, they can't find the primary source. I'm scheduled for a PET Scan tomorrow but, the ins. company tried to get out of it stating they don't see the benefit since the one 3 months ago didn't show a primary source. WTF So let's wait until it spreads all over the place and I die. Hmmm, guess that would make them happy.

My husband and my doctor got it straightened out and I'm having the scan done. Wish me luck, send good vibes, say a prayer for me if you're inclined to pray. I'd appreciate it - I'm a nervous wreck.

[DesertFlower]

6. good luck.

[Lars39]

7. Best wishes, madmax.

:hug: Isn't that weird that they wouldn't want you to have a PET scan? You can't be staged properly and get the correct treatment if they don't know the particulars. My brother has no insurance and can't get a PET scan. :(

[bkkyosemite]

13. Prayers sent your way. My friend of 40+ years was just diagnosed with lung cancer..prayers to her

too.

[madmax]

20. Thanks love

Prayers to your friend, also. When one hears the word 'maligant' well, it's just indescribable the emotion one feels. The word cancer to many = death and although we all know we're going to die 'someday' it gets weird when someday could be sooner than you expected.

[madmax]

19. That's terrible!

The cost of a PET Scan is 5k. I told the Dr. I don't want to buy the damn thing - just rent it for an hour! Big Pharma, the entire congress are s.o.b.'s. Thanks for the good wishes.

Has your brother tried any clinics? That is such a disgrace that in this country you can't get proper medical care.

[slipslidingaway]

8. Sending good thoughts your way :) nt

[peacebird]

16. positive vibes and thoughts winging their way to you MadMax -

:hug:

wishing you best of luck! Please keep us informed.

[nadinbrzezinski]

22. Good luck

[handmade34]

5. your rant is justified...

[slipslidingaway]

9. knr nt

[chill_wind]

10. It's lunacy, a total racket, and the joke is on us. Insurance is great as long as

you only pay a lifetime of premiums--- and never file any claims to actually use it.

Great FOR THEM.

[Thickasabrick]

11. I hate insurance companies too, but I actually see the logic here.

If they find something because of the screening - it's not a screening anymore. If they didn't find anything, you wouldn't have paid anything - which is a pretty sweet perk (I don't have that freebie screening part in mine).

Sorry I can't see the reason for outrage here.

[Ohio Joe]

12. Keep going up the ladder

Don't just take what the first person you talk to says, ask for their boss, then that persons boss, and on and on. Don't get angry with them (call when your calm) but be persistent and don't give up. Offer to have your doc send a note that says it was preventative. You can get it covered but they will resist.

[peacebird]

15. Thank you! I will keep trying ... (calmly)

[AwakeAtLast]

14. That's how the CEOs get their fat bonuses

:grr:

[proud patriot]

17. I am thankful for my insurance but I too Hate my insurance co.

I'm not equipped to do battle .

but Insurance Co's demand a battle to
cover medical bills .

I fucking hate Ins. companies.

[Ohio Joe]

21. You are correct

I've worked for insurance companies. More then one, and it is the same at all of them. It is pretty much unspoken, I've never heard the real result of it said aloud at work. Bonuses. The amount of your bonus has nothing to do with individual performance but rather how your department does as a whole. It may not sound like it would make a difference but in the world of office politics (and they are fierce), the pressure to do what will make everyone a bonus is real. It comes from the top down, again, never specifically said but everyone knows who you are if you are not doing what will make the company the most profits... People, a lot of them, fold under the pressure that they might be known as one of "them" that cost the department their bonus. It plays on peoples desire to do more for themselves and people they know rather then what might be good for everyone.

[me b zola]

18. Your money or your life

Isn't that what robbers always say on tv/in the movies? For profit "health care" is inhumane.

[old mark]

23. Who is your insurer? Sounds like a fraud to me, not that that's unusual.

When I was looking for private insurance, one company went so far as to cash my check before they sent me a letter rejecting me - NO insurer except Blue Cross will cover anyone - like me - who has had heart surgery, or bypass surgery. Blue cross wanted a mere $800/month for bad coverage just for me.
I am sure they pay as much to the politicians as they do in claims.

The are all frauds.

mark

[avaistheone1]

24. You have just described a perfect case of why we need single payer health insurance in this country.

We need to stop the insurance company nonsense.

[Mythsaje]

25. Sneaky semantic games

designed to confuse and frustrate the consumer. It's a bait and switch, really. "Oh, don't worry--preventative screenings are 100% covered--of course, it stops being one of those if they find anything. They're not going to be preventing anything if that's the case. So not only do you now have to worry about more extensive medical procedures, but we're going to be charging you for what we'd initially told you would be free. And we don't have to answer to it to anybody. I mean, we've got the cleanest pockets in town, given that we've got politicians of all persuasions sucking the lint out for us. What are you going to do--tell us to go fuck ourselves? You can't AFFORD to."

[earthboundmisfit]

26. And WHY are these motherf*ckers so goddamn essential to everything again?

They don't help provide healthcare - they help PREVENT it. They are an OBSTACLE.
Every time I have been "lucky" enough to have insurance with an employer, any time I actually used it, I had to play a goddamn game with them to get them to pay anything on ANYthing.