Good afternoon Joe. Wanted to let you know how much I appreciate your blog and all you do.
I have a big problem and I was wondering if anyone is experiencing or has experienced this type of health insurance issue. I recently started a job back in February of this year. Everything seemed to be going along fine with my prescriptions and doctor's appointments until now. On June 3, I went to John Hopkins Hospital to seek advice about a back problem that I have been having. I am currently prescribed pain medication for that issue. The purpose of me going to see the physician at John Hopkins was to see if there was something else that could potentially be done to relieve my back issue as well as get me off of all the medications that I am taking. Plus the pain medication is not as effective as it once was because I have been on it over a period of time. John Hopkins recommendation was to do a nerve block. So I scheduled the procedure in the hopes that this would provide me the relief I wanted and needed to get off of the meds. The day before the procedure the stupid insurance company calls and said that they have not approved the procedure yet. So I have cancel my appointment, go back to my new employer and explain everything and wait for the insurance company to call back. The next morning they contact John Hopkins and say that the procedure has been approved. So I call back to John Hopkins and reschedule the procedure. They've just called me to let me know that they will NOT cover the procedure because it was a pre-existing condition. I call my Human Resources individual who said call the insurance company and explain why you want the procedure done. Called the Insurance Company and they said call Human Resources back and that they MAY approve this for February of 2010. Hello!!! You idiots at the insurance company are you listening?? I want off of the pain medications!!! That's OFF!! Not increased dosage, not adding an additional one in, not Lidocaine patches. O-F-F!! I think people get the point. You hear about so many people being addicted. So if I go into cardiac arrest because of my medications and an ambulance has to be called, are you not going to cover that either because it was a direct result of my "pre-existing condition" (the one you won't pay to help me get better). I know the first thing that is going to come out of everyone's mouth is going to be, why don't you just stop taking them? My life consists of me getting up going to work, suffering all day with pain, coming home and collapsing. I'm not talking about normal every day pain. I'm talking about it hurts when I breath pain. I could go on and on about this issue but I won't. Is anybody else having such a hard time with insurance company now? Is there any help or advice? It's just nice to no that the freaking insurance company has M.D. after there name.
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If you really want something done, then go and have it done.
ReplyDeleteNegotiate the rate in advance, and then pay the bill yourself.
Why endure pain and suffering simply because someone else doesn't want to pay for it?
Insurance and medical applications are so complicated you need an attorney to figure out what you are reading.
ReplyDeleteSounds like they are willing to cover the meds as a short term (cheaper) solution to a long term problem rather than paying out now to remedy the situation for good.
The cart before the horse syndrome. I don't even want to think what health care will be like if the damn government gets involved.
I would call the ins. co. back & ask to speak with a supervisor or the grievence department. They can't keep changing their minds whether they're going to cover it or not. If you still get nowhere call the MD Insurance Commission. It's worth a try.
ReplyDeleteOk,
ReplyDeleteSo for starters, let me say that this story is heartbreaking.
I am a sceptic however. I have NEVER been treated this way for any medical issue that I or my family have had.
If this IS for real, this guy needs to get a lawyer, ASAP.
If I were him I would be calling Dewey, Cheatam, and Howe and start talking about pain and suffering, because this is utter crap!
If this guy is a scammer who doesn't want to work, then he needs to hit the road jack-
Your employer probably got health insurance that does not cover pre-existing conditions. Thats a reality today. Some creative diagnosis by your physician indicating a new problem may help get the insurance of their asses.
ReplyDeleteI am sorry your going through this...I have had trouble with my insurance company as well. No one on the eastern shore likes to take my insurance but i have no choice because it's what my husband's company that he works for pays for..I had to get a particular procedure done and they would not accept it if it was done at the surgical center...only at the hospital...well to be honest i feel like the procedure wasn't even done at all because i am still having problems...but the thing that got me was..it was thousands of dollars cheaper to do it at the surgical center than it was at the hospital...try figuring that one out...i hope they get their act together for you soon.
ReplyDeleteGee, you are having problems with health insurance? But I thought it was so great as privatized? My advice: support universal health care.
ReplyDeleteHave you lost your mind?
ReplyDeleteDaddio, I appreciate your advice about paying for it myself; however, I live paycheck to paycheck and there is no way I could afford such an enourmous bill at this time. The consultation for one doctor consultation for the visit was $165.00. I saw two that day. That's not counting the bill of what outpatient is going to charge. I think basically I'm screwed. There is a pre-existing condition clause in my employer's policy. I have talked to HR and they need a certificate of coverage from the last time I had insurance. Then they will determine if they will authorize to pay for it or not. I think I'm going to be SOL.
ReplyDeleteBTW, 9:36 if you think Universal Health Care is going to work you are seriously mistaken. It has been tried and failed in other countries. Why that dumb a$$ in office wants to try something so stupid is beyond me. It will never happen. There are too many politicians paid by the Medical Association of America as well as these pharmaceutical companies to even think about passing it. Until they throw the lobbiests out, we will not have to worry about it.
There is some information missing here before I can blame your insurance company. What is your back problem? Did your personal doctor give you a referral to see a specialist? Have you had an MRI? Have you been to a physical therapist? Have you tried an Chiropractor? Have you tried the AquaCare Rehab by the stadium?
ReplyDeletePain Medication is not always the answer. Yes it will relieve the pain but something is still wrong with your back to cause the pain.
Back pain is terrible. I have degenerative disc disease and Im only 26!! The doctor said my back is comparable to a 45 year old. I inherited from my grandfather. Most days I suffer with lower back pain. Sometimes its worse and sometimes it doesn't bother me. I try to avoid pain medication. I might have an Ibuprofen every once in a while. In my situation stretching is my best pain reliever.
My advice would be to ask your doctor for a referral to see a physical therapist (Try the AquaCare). They will show you stretching techniques to help your back. And try walking....
Buck up and live with it, I do.
ReplyDeleteI've been to 3 physical therapists, 1 chiropractor, neurosurgeon here on the shore (who said nothing can be done from a surgical standpoint), pain management here on the shore (who collapsed my lung and caused me to have a stroke). I've had MRIs, CT scans, x-rays, you name it I've done it. As far as what happened to my back I stepped off of a curb wrong 4 years ago and haven't been right since. I'm not a complaining individual (although you might think so from seeing this post). I'm not trying to sue anybody. I'm just your everyday average individual who was just curious if anybody else had the same BS I was having with the insurance company. I'm just very frustrated and felt like venting. It took me so long to get an appointment at John Hopkins and I sincerely think they are very proactive in helping me.
ReplyDeleteYes , this has been going on for years.
ReplyDeletei was told by the insurance company that i had to leave the hospital after one day, that was after major back surgery. I had to crawl around my house for 2 weeks.
So it is not an obama policy that caused it , it is from the greddy insurance companies that can do what they want.
You still have the right to chose insurance co,but they have the right to refuse .
In the end you will lose one way or the other.
9:36 has been drinking the KoolAid... I'd rather have private insurance and be seen in 3 months than have Universal and have to wait 2 years... look at Canada and Europe... IT DOESN'T WORK! It's pretty sad when the Canadians and Europeans are hoping it doesn't pass because then, "where would we go?" The system may be broken but it's better than Universal... let's deal with the real issue of greed instead of saddling everyone with something that is proven to no work.
ReplyDeleteInsurance is a waste of your time and money anymore, just another corporate scam to get your money. It will only get worse as time goes by.
ReplyDeleteThis is the game the insurance companies play, they work for profit. Yet the Republicans do not think we need a public option or socialized medicine.
ReplyDeleteThis is a great example how health care is already rationed in this country.
11:28 Your the one drinking the Glen Beck KoolAid. I lived in Paris for a while and had to go to the hospital ER once it was a breeze and totally free. The people there love their system.
ReplyDeletei think everyone needs to see a couple of movies i thought were very interesting.. Sicko, Zeitgeist 1 and 2. they will show you how messed up our government is. not saying i agree with universal healthcare, but there has to be some kind of better way! insurance companies dont care about us, they just want our money.. its cheaper to them for us just to die. im self-employed and dont have insurance, it would be nice but then id have all the beaureacratic bs to contend with. hopefully i stay healthy long enough to see something positive happen! just in case...
ReplyDeleteI feel, or should I say, felt your pain. My back problems started when I was 16, and became a chronic condition when I hit my 30's. Then I spent 20 plus years going from one specialist to another to try to get relief. I finally ended up in a wheelchair because I couldn't stand up for more than 5 minutes before the pain would put me down. I can't tell you how many hoops I had to jump through to finally get back surgery. I had to stop working in September, and it was April before I finally got the surgery I needed. I can't tell you how much I hate Percocet, oxycodone and epidural injections.
ReplyDeleteI have no solutions for you, unfortunately. I do have two suggestions, however. Do NOT go to a chiropractor; go to an osteopath instead. I highly recommend Dr. Sebastian. Also, if you need to lose some weight, do it. I had residual problems after the surgery---sacroiliac and knee pain, but after losing 60 pounds, I am pain-free.
I empathize with you-I have a coworker with chronic back pain who has also tried everything to treat it successfully.
ReplyDeleteInsurance companies should not be second-guessing doctors on how to treat patients.
Its cheaper for the insurance companies to push pain pills over other therapies but at what cost?Long term use of opiate drugs causes irreversible damage to the body.
My suggestion would the same as 9:08-contact the Health Insurance Commissioners office in Baltimore.
12:55 - The ER is not the same as waiting in line for months or years to see a specialist...
ReplyDeleteI was 37 when I was diagnosed with osteo in my back. I'm 52 now and arthritis doesn't get better. Pain, get used to it, there is no cure for the aging process.
ReplyDeleteCall your Congressmen and tell them to support the public option amendment in the upcoming health care bill.
ReplyDeleteYour problem won't be solved until a public option exists where you can't be dropped for pre-existing conditions. And don't listen to 11:28. If they tried to get rid of the the NHS in Great Britain, there would be a riot. Same for Canada. Look at any poll on the topic in countries that have Universal Coverage. They would NEVER get rid of it.