Insurance Woes

I was told by one of the nurses that we’ll learn more about insurance companies then we ever wanted to know. They were so correct. Some insurance companies are great and cover everything. But more often then not, most aren’t that good. When I started my life with NHL I had a good insurance company that covered everything. In the middle of my treatment the insurance company pulled out of our state leaving me at the mercy of whoever my husband’s company chose. We currently have Aetna and am not pleased with them. When they say they cover 100% they only mean 100% of what they think they should cover, not of the actual bill. Every time I get a bill I’m on the phone with them.

One of my Message Board buddies, Mary Kay, provided some information for the rest of us to go to when we have problems with our insurance companies.

The following are examples she suggested:

• patientadvocate.org
• Your State office of insurance
• “Federal act 68 gives everyone in managed care insurance the right to file an appeal to denial of services (called a grievance). Must put it in writing and ask for expatiated appeal, that means the insurance co. has time frame of 24 to 48 hrs to give you an answer to your appeal. Ask your Onc. to join in with you on appeal and the insurance dr and your onc will have a conference to make a decision (called peer review). If that fails then definitely call state insurance office or insurance regulation office. Don’t give up, keep asking for supervisor or supervisors of supervisor or clinical director of your insurance until you get an answer. Call your state rep. or senator.”

If you or someone you know is having trouble with insurance companies please don’t give up. It’s your life and not theirs to mess with. Good luck.

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