Insurance Company Rules

[seasat]

Run time: 01:42 https://www.youtube.com/watch?v=bVpX5fUvPlg   Posted on YouTube: July 19, 2008 By YouTube Member: Views on YouTube: 0   Posted on DU: July 21, 2008 By DU Member: seasat Views on DU: 1445

 
A funny video that highlights a sad truth. This was put out by Health Care For America Now.

Those of us who've had to battle health insurance companies to get coverage realize that we need a big change in our system. I had them retroactively deny an approval for second cochlear implants for my twin sons. Only after lawyers got involved did we finally get another approval for the procedure.

[psychmommy]

1. i am gonna use those rules at work.

how long do ya think i'll keep my job. hahaha.

[annabanana]

2. Oh they are GOOD!

Americans will DEMAND decent healthcare.

[whathappened]

3. rules

humana is messing with me right now , doc gave me celabex for arther and humana says it not on there list , will have to try 2 diff drugs befor i can take it and they will pay for it , i already did this , so next they send letter that ya got to be 64yr old befor you can take it and they pay for it , boy i would like to sue them , but just don't no if anybody could beat them with all there money and protection

[seasat]

4. We were fortunate that we didn't have to pay for the lawyers

The manufacturer of the cochlear implants has a team of lawyers to help with insurance problems. These implants are expensive and since the manufacturer makes a lot of money off of them, it benefits them while benefiting us. Of course when it came to pay for the speech therapy that is required along with the implants, the insurance company would only cover 20 visits per their contract. We had to turn to Shriners to get help with that.

[Agent William]

6. I know how you feel.

Our insurance company did something like that with my mother. They refused to pay for her ankle replacement surgery since she wasn't over 65. We had to appeal it and that process took about a month, in that month her pre-opp ankle was destroyed. She finally got the surgery, but was it worth an extra month of extreme pain? I feel your pain, and I'm always making sure I don't take youthful health for granted.

good luck playing with insurance company rules. =]

[unapatriciated]

9. What state do you live in?

California has some very good laws but it takes a lot of paperwork to get the insurance companies to comply.

There is a very good book called "Fighting The Blues" by William Sheranoff (I think that is how his name is spelled) I actually met him back in 1992 when my son first became ill and I had to fight my insurance company to get long term physical therapy for him. They only wanted to cover him for 90 days, they based this on stroke victims and not on an on-going disease.

With regards to prescriptions you need to get your doctor involved. Be careful with Celebrex especially if you have any heart problems. My son took it for awhile and it did relieve his joint pain but had to stop because he had existing heart damage from his long fight with Dermatomyositis.

He has medical marijuana now and that actually works better than any prescription drug he has been on.

[DailyGrind51]

12. Humana's reputation for denying treatment is so notorious,

"LifeTime" did a "made for television" movie about the doctor hired by Humana to deny treatments who became so guilty regarding the consequences of her decisions that she testified against Humana.

[unapatriciated]

5. I know all about "retroactively" denial of services.

and being left with huge medical bills that should have been covered. I fought my insurance company for fifteen years to provide coverage for my son's illness. The sad thing is a lot of people are too sick to fight them and they know it.

[sasquatch]

7. This will be the next greatest battle in America I'm afraid

And the Repiglican party will fight us all the way too.

[Mr_Jefferson_24]

8. K&R. Bravo, point well made -- and my pleasure to be the 5th.

[silverweb]

10. Well done!

:kick:

[fasttense]

11. I don't think I've ever had a medical bill that didn't require 3 phone calls

to get the insurance company to pay.

Now they have moved my son (when he turned 21, unbeknown to me) to a different insurance plan, which of course cost a lot more. Which makes absolutely no sense because he would not be eligible to be on the insurance unless he was my dependent and I didn't change my insurance plan.

And this is the medical insurance provided by DOD.

[AwakeAtLast]

13. That is brilliant!

:applause:

K & R!

:kick:

[DailyGrind51]

14. Here is where your Humana premiums are going.

Michael B McCallister
Total Compensation
$3.33 mil (#343)

5-Year Compensation Total
$15.10 mil

Michael B McCallister has been CEO of Humana (HUM) for 6 years. Mr. McCallister has been with the company for 32 years .The 53 year old executive ranks 22 within Health care equipment & services
http://www.forbes.com/lists/2006/12/AG0Q.html

You would think he was the only one responsible for generating profit for all the money they give him!

[seasat]

15. We're with Unitied Health Care, their CEO was paid $124 mil in 2005

Their current CEO is poor by those standards only receiving 4 million a year. William McGuire, the previous CEO, made 3rd highest rank for CEO pay in 2005. Somehow they can't afford to provide for more than 20 speech therapy visits per year for my twin sons.