"My Health Insurance Company Is Risking My Life"

[appalachiablue]

Daily Kos, Aug. 6, 2022.

Last month I was diagnosed with a melanoma inside my right eye. I had some vision blurriness, so immediately went to my optometrist. He spotted what he called a “freckle” in my eye, and gave me an emergency referral to an ophthalmologist.

The ophthalmologist diagnosed a “large melanoma” in my right eye. Dr. Google told my wife that survivability with a large melanoma in the eye is less than 50% at five years. She fell apart. I was sent to an ocular oncologist and got in the next day. She diagnosed the melanoma as “small” — which is a function of the thickness, and said I have a much better chance of long-term survival than we thought... More + 109 Comments,
https://www.dailykos.com/stories/2022/8/6/2114933/-My-Health-Insurance-is-Risking-My-Life

[lark]

1. OMG, I m so sorry for this horrid handling of your care.

Insurance companies are the devil - that's for sure. Hope you have a good insurance commissioner in your state.

[appalachiablue]

2. Not me, but I feel for this couple. I hope the crisis is resolved, what an abominable system.

[lark]

3. Well, glad at least it's not you.

But the situation is definitely intolerable and I hope and pray they get the intervention needed!

[Pobeka]

4. What a con game. Seems like the old bait and switch technique.

Everything is covered. So you think that means everything, then when the final part of the procedure has to happen or you go blind (or worse), the insurance company refuse to pay, knowning full well the patient has no choice. I wish this individual the best of luck, and if they have the desire and stamina, a good lawyer. That insurance company deserves to be sued.

Better yet, we deserved to have for profit insurance companies eliminated in this country.

[woodsprite]

5. I'm going through something similar right now.

Evicore (the approval/auditing company that BC/BS goes through denies any scans for endometrial cancer followups. They cover a CA125 blood test every 3 mo, but that isn’t a reliable test for or even a marker for many types of endo cancer.

My urologist just had to back off in a test that he ordered because they told him endo cancer patients don’t need to do comparison CT urogram (w/ and w/o contrast). The uro wasn’t evaluating my endo cancer. He ordered the tests to check on 2 large kidney stones, do a comparison of kidney/bladder flow, and possible kidney damage due to rads that could require stents. Evicore said they would pay for one, not both.

Due to seeing an enlarged lymph node which is in an inoperable, unbiopsiable area, my onco is going to try to order a PET scan but doesn’t know if he can get it approved. If not, he said he’d order another CT scan in 3 mo. If it’s bigger, we’ll start Keytruda. If it’s the same or smaller, we’ll scan again in another 3 mo. Since Evicore says endo cancer doesn’t require scans, I’m expecting denial and having to fight for the test.

[Diamond_Dog]

6. All these tragic stories

Fall on deaf ears among the wealthier conservatives in Congress. How the American people continue to accept this system just boggles my mind.

[question everything]

7. Honestly, not much new. He did not mention the name of the company

but no doubt it is UnitedHealth Care that, for some reason is promoted by AARP. And some here expressed their satisfaction.

But it is traded on the stock exchange. The CEO last year made $142 million

https://www.startribune.com/former-unitedhealth-ceo-made-142-2m-last-year/600171979/

Their first responsibility is to their stockholders, not the patients.

I hope that this person went ahead with the needed procedure and than got a pro bono attorney to sue them. And if he can, change to not for profit carrier.