I have been on Cobra is I’m reaching the limit, so Cobra will end by the end of this year. So, I started to look for an individual insurance because to go into HIPPAA, the premium is increased over 100%.
However, I got rejected by Blue Shield stating I have several health issue. Even though my doctors said the blood result tests are not significant enough to determine it is an issue and they wrote letters to the insurance company on my behalf, the insurance company basically came back standing firm.
I believe the insurance companies such as Blue Shield is scamming consumers. They said they have all these plan options, however, in reality, unless you have “PERFECT” health, no one will qualify.
So, now, I am stuck with either paying high premium for the HIPPA plan or go work (which is not easy, given the high unemployment rate).
We need to have national plan that ties to individuals and not corporations, so that we don’t have to go through all these approval process every time there is a change.
Principal Health Insurance Co. is sitting on my preauthorization for cancer treatment. I switched my Dr.s to the ones in their network, three of whom have recommended Cyberknife treatment. The insurance company says they might take 30 days to decide whether I can have this life-saving treatment. My tumor continues to grow and I am in pain. I was told that one of the insurance company’s NURSES will decide whether or not I can be treated!!! How do these people even sleep at night???
I have a radical idea folks. IF tomorrow EVERYONE with medical insurance, suddenly DROPPED covergae…we’d get the lousy bastards quickly.
You see, without people voluntarily paying for the insurance scam industry it would FAIL.
That is the kind of action needed by a nation-wide organization to truly bring about CHANGE, and QUICK.
Otherwise, perhaps wear an engraved piece of jewelry that says: “You save, you pay.” So if you fall ill, and someone tries to rescue you, they know THEY will have to pay the bucks for YOUR care.
We have fought both Blue Shield of California, the Department of Managed Health Care in Sacramento and to no avail, both the insurance and our so-called “objective” Department of Managed Health care have refused physical therapy for our 9 year old son who has orthopedic impairments. Both the insurance company and the Department of Managed Health Care stated that the therapy was not medically necessary, despite 85 pages of documentation and letters of medical necessity from doctors at Lucile Packerd and Children’s Hospital Oakland. We have been paying out of pocket for the physical therapy (upwards of $20,000 annually including premiums to Blue Shield) and with this therapy our son can now walk independently. I have written letters to my local constituents, Don Perata, Governor Schwarzeneger and Mary Hayashi. Only Ms. Hayashi responded and tried to help, but could not pursue as once a decision is made by the Department of Managed Health care it cannot be appealed. The review that was performed by the Department of Managed Health Care was inaccurate did not consider all the therapy procedures involved nor did a representative visit the medical site to see first hand the therapies being administered. These same physical therapies are currently vendorized by the California Department of Developmental Services and State Regional Centers of which after a two year struggle we did secure a one-time exceptions funding. How can these therapies be approved as medically necessary by the Department of Developmental Services but not by Blue Shield and the Department of Managed Heatlh Care. The incongruities amongst insurance and state agencies are infinitely apparent. If the single payer system operates like our Department of Managed Health care it’s a bust (little or no regulation of insurance’s company’s, back pedaling on policies of medical necessity), but if functions like the Department of Developmental services perhaps there is hope.
My insurance story is not nearly as horrible as these posters, but I feel that it’s just the beginning of my problems with them. I have bipolar disorder and went for a long time without insurance coverage until my state passed the parity law. At that point, they had to cover biologically based mental illnesses equally to any other illnesses. With regular therapy and medication, I improved so much that I was able to work full time (which I’d never been able to do before) and even go to law school at night. The insurance company paid all my claims without question. Suddenly, a couple of months ago, they started denying my claims, saying the doctor was “out of network.” I called and someone looked it up and said, “oh, you’re right, he is a network provider, hold on.” Another guy came on and told me the doctor was NOT a network provider and that I would have to file an appeal. I wrote a very curt letter, including numerous exhibits from both the law and their own policy, but they never responded. I sent a copy of my letter to my doctor’s accounting people who also called and fought with the insurance company. Finally I got the idea to just call every day till I got someone who I could reason with. The next person I reached told me that I belong to a PPO and my doctor was a contract doctor. We argued for over 40 minutes, with me asking why he was paid in-network for over 8 years, and reading all the information from their website to her as we talked. Finally she put me on hold, and came back to tell me that the claims were being re-submitted and paid. So I asked whether he was indeed a network provider and she reluctantly admitted that he is. I have a feeling this is only the beginning of the war. Had I not been so persistent, they would have gotten away with it. I think they deliberately deny coverage in the hopes that most people won’t fight it and then they can save money that way. Crooks!
I work a doctor’s office and do authorizations for medications which the doctor prescribes and the insurance company denies. First you have to pre-authorize the medication and 80% of the time the eighth grade non-health care person on the end of the phone line says it is denied. Then you appeal the denial. United health care requires the patient to either sign over their power of attorney to go through the process with the doctor (which our doctors’ will not accept) or write a letter stating why they whould get their medication. Not to mention all the Medicare Part D companies who change what medications they cover in January when the date patients’ can file by ended in December. And they don’t warn aqnyone about the changes. The patient goes to get their prescription filled and they can’t get it. So Sorry. Please run through our red tape and we may authorize the medication.
IF WE ALL THIS SITE ADDRESS TO OUR EMAIL SIGNATURE MORE PEOPLE WOULD KNOW THIS WAS HERE. I WILL ADD THIS TO MINE IN A FEW MINUTES. I HOPE YOU ALL DO THE SAME. I WILL ALSO PUT IT ON MY EBAY PAGE AND GOOGLE PAGE. THIS IS WORTH CHECKING OUT AND WE ONLY HAVE 95 COMMENTS SO FAR? YOU CANT SWING A CAT AND NOT HIT A BILLION PEOPLE WHO ALL HAVE A HORRIBLE STORY ABOUT INSURANCE COMPANY ABUSES. I URGE ALL OF YOU TO SHARE THIS SITE WITH THE WORLD. A CHALLENGE TO SEE IF IN A WEEK MAYBE WE CAN AT LEAST TRIPPLE THE LOW NUMBER OF RANTS IT NOW HAS. COMMUNICATION IS POWER AND THE AMERICAN PEOPLE HAVE LOTS TO PUT ON THESE PAGES!!!
#85 youre an insurance co employee — thats the song and dance we get at aetna.. we only gain 3% (yes of billions) you could do it with 1% … but the industry wants to see the most dollars so they decline and deny and make you beg for your care. They blame doctors, drug companies, bad health etc.. in the end …. the stock splits and they all go home to eat cake! Aetna sends emails to all of us to join grassroots for reform that “include keeping the insurance giants in business” Im all for grass roots but not for keeping the giant fed and happy. I’d gladly wait tables again and see a universal health plan than continue to work at a company with no respect for human life, for its employees or for anyone other than the board of directors.
I work for Aetna. As an employee we are pushed to do our very best. to try and make our company above and beyond what people expect from us. To use our Aetna values system for the good of the members we serve. when our benefits begin in January of each year, we the employees who make this company what it is, find our benefits to fall short again. Ron Williams has openly stated that “our” employee benefits are par with the industry. I am offended how in his comparing benefits we are par, but when it comes to doing business he expects us to be way better than the rest (at that point he doesnt want us par). I like the idea of not for profit insurance carriers putting their members first. It does not take any intellect to understand that if a company is out to serve its stock holders, YOU the member are not number one. I’m all for everyone making a dollar. Im disgusted by insurance carriers trying to make ALL THE DOLLARS. Look at the salaries these corporate heads make. Educate yourself when shopping for a carrier. Ask yourself, “does this company want to impress its shareholders or make sure I get good care?”. While we raise the price of healthcare on the statement that doctors and medicine cost so much we have no choice except to raise your premium, take a good look at our stock prices and how many times in last 7 years it has split. HEALTHCARE REFORM NOW!
More facts about where your healthcare premiums go:
ANNUAL COMPENSATION OF HEALTH INSURANCE COMPANY EXECUTIVES (2006 and 2007 figures):
• Ronald A. Williams, Chair/ CEO, Aetna Inc., $23,045,834
• H. Edward Hanway, Chair/ CEO, Cigna Corp, $30.16 million
• David B. Snow, Jr, Chair/ CEO, Medco Health, $21.76 million
• Michael B. MCallister, CEO, Humana Inc, $20.06 million
• Stephen J. Hemsley, CEO, UnitedHealth Group, $13,164,529
• Angela F. Braly, President/ CEO, Wellpoint, $9,094,771
• Dale B. Wolf, CEO, Coventry Health Care, $20.86 million
• Jay M. Gellert, President/ CEO, Health Net, $16.65 million
• William C. Van Faasen, Chairman, Blue Cross Blue Shield of Massachusetts, $3 million plus $16.4 million in retirement benefits
• Charlie Baker, President/ CEO, Harvard Pilgrim Health Care, $1.5 million
• James Roosevelt, Jr., CEO, Tufts Associated Health Plans, $1.3 million
• Raymond McCaskey, CEO, Health Care Service Corp (Blue Cross Blue Shield), $10.3 million
• Daniel P. McCartney, CEO, Healthcare Services Group, Inc, $ 1,061,513
• Daniel Loepp, CEO, Blue Cross Blue Shield of Michigan, $1,657,555
• Todd S. Farha, CEO, WellCare Health Plans, $5,270,825
• Michael F. Neidorff, CEO, Centene Corp, $8,750,751
• Daniel Loepp, CEO, Blue Cross Blue Shield of Michigan, $1,657,555
• Todd S. Farha, CEO, WellCare Health Plans, $5,270,825
• Michael F. Neidorff, CEO, Centene Corp, $8,750,751
The insurance companies make huge profits and their CEOs make millions, while the rest of us, employers and workers alike, face skyrocketing healthcare costs, impossible bureaucracy, and life-diminishing insurance denials.
Again, the huge insurance company profits could provide healthcare for the entire US, and pay physicians adequately for their work.
We need to get the insurance companies OUT of healthcare. The only solution is a NON-PROFIT, SINGLE-PAYER healthcare system – and the single payer should not be an insurance company or a group of insurance companies.
I have been on Cobra is I’m reaching the limit, so Cobra will end by the end of this year. So, I started to look for an individual insurance because to go into HIPPAA, the premium is increased over 100%.
However, I got rejected by Blue Shield stating I have several health issue. Even though my doctors said the blood result tests are not significant enough to determine it is an issue and they wrote letters to the insurance company on my behalf, the insurance company basically came back standing firm.
I believe the insurance companies such as Blue Shield is scamming consumers. They said they have all these plan options, however, in reality, unless you have “PERFECT” health, no one will qualify.
So, now, I am stuck with either paying high premium for the HIPPA plan or go work (which is not easy, given the high unemployment rate).
We need to have national plan that ties to individuals and not corporations, so that we don’t have to go through all these approval process every time there is a change.
Principal Health Insurance Co. is sitting on my preauthorization for cancer treatment. I switched my Dr.s to the ones in their network, three of whom have recommended Cyberknife treatment. The insurance company says they might take 30 days to decide whether I can have this life-saving treatment. My tumor continues to grow and I am in pain. I was told that one of the insurance company’s NURSES will decide whether or not I can be treated!!! How do these people even sleep at night???
I have a radical idea folks. IF tomorrow EVERYONE with medical insurance, suddenly DROPPED covergae…we’d get the lousy bastards quickly.
You see, without people voluntarily paying for the insurance scam industry it would FAIL.
That is the kind of action needed by a nation-wide organization to truly bring about CHANGE, and QUICK.
Otherwise, perhaps wear an engraved piece of jewelry that says: “You save, you pay.” So if you fall ill, and someone tries to rescue you, they know THEY will have to pay the bucks for YOUR care.
We have fought both Blue Shield of California, the Department of Managed Health Care in Sacramento and to no avail, both the insurance and our so-called “objective” Department of Managed Health care have refused physical therapy for our 9 year old son who has orthopedic impairments. Both the insurance company and the Department of Managed Health Care stated that the therapy was not medically necessary, despite 85 pages of documentation and letters of medical necessity from doctors at Lucile Packerd and Children’s Hospital Oakland. We have been paying out of pocket for the physical therapy (upwards of $20,000 annually including premiums to Blue Shield) and with this therapy our son can now walk independently. I have written letters to my local constituents, Don Perata, Governor Schwarzeneger and Mary Hayashi. Only Ms. Hayashi responded and tried to help, but could not pursue as once a decision is made by the Department of Managed Health care it cannot be appealed. The review that was performed by the Department of Managed Health Care was inaccurate did not consider all the therapy procedures involved nor did a representative visit the medical site to see first hand the therapies being administered. These same physical therapies are currently vendorized by the California Department of Developmental Services and State Regional Centers of which after a two year struggle we did secure a one-time exceptions funding. How can these therapies be approved as medically necessary by the Department of Developmental Services but not by Blue Shield and the Department of Managed Heatlh Care. The incongruities amongst insurance and state agencies are infinitely apparent. If the single payer system operates like our Department of Managed Health care it’s a bust (little or no regulation of insurance’s company’s, back pedaling on policies of medical necessity), but if functions like the Department of Developmental services perhaps there is hope.
My insurance story is not nearly as horrible as these posters, but I feel that it’s just the beginning of my problems with them. I have bipolar disorder and went for a long time without insurance coverage until my state passed the parity law. At that point, they had to cover biologically based mental illnesses equally to any other illnesses. With regular therapy and medication, I improved so much that I was able to work full time (which I’d never been able to do before) and even go to law school at night. The insurance company paid all my claims without question. Suddenly, a couple of months ago, they started denying my claims, saying the doctor was “out of network.” I called and someone looked it up and said, “oh, you’re right, he is a network provider, hold on.” Another guy came on and told me the doctor was NOT a network provider and that I would have to file an appeal. I wrote a very curt letter, including numerous exhibits from both the law and their own policy, but they never responded. I sent a copy of my letter to my doctor’s accounting people who also called and fought with the insurance company. Finally I got the idea to just call every day till I got someone who I could reason with. The next person I reached told me that I belong to a PPO and my doctor was a contract doctor. We argued for over 40 minutes, with me asking why he was paid in-network for over 8 years, and reading all the information from their website to her as we talked. Finally she put me on hold, and came back to tell me that the claims were being re-submitted and paid. So I asked whether he was indeed a network provider and she reluctantly admitted that he is. I have a feeling this is only the beginning of the war. Had I not been so persistent, they would have gotten away with it. I think they deliberately deny coverage in the hopes that most people won’t fight it and then they can save money that way. Crooks!
I work a doctor’s office and do authorizations for medications which the doctor prescribes and the insurance company denies. First you have to pre-authorize the medication and 80% of the time the eighth grade non-health care person on the end of the phone line says it is denied. Then you appeal the denial. United health care requires the patient to either sign over their power of attorney to go through the process with the doctor (which our doctors’ will not accept) or write a letter stating why they whould get their medication. Not to mention all the Medicare Part D companies who change what medications they cover in January when the date patients’ can file by ended in December. And they don’t warn aqnyone about the changes. The patient goes to get their prescription filled and they can’t get it. So Sorry. Please run through our red tape and we may authorize the medication.
IF WE ALL THIS SITE ADDRESS TO OUR EMAIL SIGNATURE MORE PEOPLE WOULD KNOW THIS WAS HERE. I WILL ADD THIS TO MINE IN A FEW MINUTES. I HOPE YOU ALL DO THE SAME. I WILL ALSO PUT IT ON MY EBAY PAGE AND GOOGLE PAGE. THIS IS WORTH CHECKING OUT AND WE ONLY HAVE 95 COMMENTS SO FAR? YOU CANT SWING A CAT AND NOT HIT A BILLION PEOPLE WHO ALL HAVE A HORRIBLE STORY ABOUT INSURANCE COMPANY ABUSES. I URGE ALL OF YOU TO SHARE THIS SITE WITH THE WORLD. A CHALLENGE TO SEE IF IN A WEEK MAYBE WE CAN AT LEAST TRIPPLE THE LOW NUMBER OF RANTS IT NOW HAS. COMMUNICATION IS POWER AND THE AMERICAN PEOPLE HAVE LOTS TO PUT ON THESE PAGES!!!
#85 youre an insurance co employee — thats the song and dance we get at aetna.. we only gain 3% (yes of billions) you could do it with 1% … but the industry wants to see the most dollars so they decline and deny and make you beg for your care. They blame doctors, drug companies, bad health etc.. in the end …. the stock splits and they all go home to eat cake! Aetna sends emails to all of us to join grassroots for reform that “include keeping the insurance giants in business” Im all for grass roots but not for keeping the giant fed and happy. I’d gladly wait tables again and see a universal health plan than continue to work at a company with no respect for human life, for its employees or for anyone other than the board of directors.
I work for Aetna. As an employee we are pushed to do our very best. to try and make our company above and beyond what people expect from us. To use our Aetna values system for the good of the members we serve. when our benefits begin in January of each year, we the employees who make this company what it is, find our benefits to fall short again. Ron Williams has openly stated that “our” employee benefits are par with the industry. I am offended how in his comparing benefits we are par, but when it comes to doing business he expects us to be way better than the rest (at that point he doesnt want us par). I like the idea of not for profit insurance carriers putting their members first. It does not take any intellect to understand that if a company is out to serve its stock holders, YOU the member are not number one. I’m all for everyone making a dollar. Im disgusted by insurance carriers trying to make ALL THE DOLLARS. Look at the salaries these corporate heads make. Educate yourself when shopping for a carrier. Ask yourself, “does this company want to impress its shareholders or make sure I get good care?”. While we raise the price of healthcare on the statement that doctors and medicine cost so much we have no choice except to raise your premium, take a good look at our stock prices and how many times in last 7 years it has split. HEALTHCARE REFORM NOW!
More facts about where your healthcare premiums go:
ANNUAL COMPENSATION OF HEALTH INSURANCE COMPANY EXECUTIVES (2006 and 2007 figures):
• Ronald A. Williams, Chair/ CEO, Aetna Inc., $23,045,834
• H. Edward Hanway, Chair/ CEO, Cigna Corp, $30.16 million
• David B. Snow, Jr, Chair/ CEO, Medco Health, $21.76 million
• Michael B. MCallister, CEO, Humana Inc, $20.06 million
• Stephen J. Hemsley, CEO, UnitedHealth Group, $13,164,529
• Angela F. Braly, President/ CEO, Wellpoint, $9,094,771
• Dale B. Wolf, CEO, Coventry Health Care, $20.86 million
• Jay M. Gellert, President/ CEO, Health Net, $16.65 million
• William C. Van Faasen, Chairman, Blue Cross Blue Shield of Massachusetts, $3 million plus $16.4 million in retirement benefits
• Charlie Baker, President/ CEO, Harvard Pilgrim Health Care, $1.5 million
• James Roosevelt, Jr., CEO, Tufts Associated Health Plans, $1.3 million
• Raymond McCaskey, CEO, Health Care Service Corp (Blue Cross Blue Shield), $10.3 million
• Daniel P. McCartney, CEO, Healthcare Services Group, Inc, $ 1,061,513
• Daniel Loepp, CEO, Blue Cross Blue Shield of Michigan, $1,657,555
• Todd S. Farha, CEO, WellCare Health Plans, $5,270,825
• Michael F. Neidorff, CEO, Centene Corp, $8,750,751
• Daniel Loepp, CEO, Blue Cross Blue Shield of Michigan, $1,657,555
• Todd S. Farha, CEO, WellCare Health Plans, $5,270,825
• Michael F. Neidorff, CEO, Centene Corp, $8,750,751
The insurance companies make huge profits and their CEOs make millions, while the rest of us, employers and workers alike, face skyrocketing healthcare costs, impossible bureaucracy, and life-diminishing insurance denials.
Again, the huge insurance company profits could provide healthcare for the entire US, and pay physicians adequately for their work.
We need to get the insurance companies OUT of healthcare. The only solution is a NON-PROFIT, SINGLE-PAYER healthcare system – and the single payer should not be an insurance company or a group of insurance companies.