These stories come from the real people who live with a broken health care system. Some have health insurance and some do not. Many of these stories suggest potential solutions* that lead to quality, affordable health care we can count on. One thing we all agree on is that the we cannot trust the insurance industry to fix themselves. To learn more about what Health Care for America Now stands for read our Statement of Common Purpose.
We wanted to give you a chance to speak for yourself, in your own voice, about the need for Health Care for America Now. Do you have something to say? Tell us your story.
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Sara
San Diego, CA
Late last year, I needed to get a battery of bloodwork done; I contacted my health insurance company to find a preferred provider in my area to make sure that I fulfilled my obligations in finding and visiting a 'preferred provider'. After making an appointment with this preferred provider, whom my heath-insurance told me to contact, I contacted the provider again to ensure that all lab-work and blood-work done would go to a participating laboratory; the doctor's staff ensured me that it would.
Let's fast-forward three months and I'm receiving bills in the mail for more than $500 dollars from the lab that did my blood-work, but I'm also receiving notices from my insurance company that they're denying my claims because I didn't see a preferred provider. Of course I called both the lab (who assured my insurance company was on their 'preferred provider' list, and that they didn't understand why my insurance company was refusing to pay). I was also receiving letters from my insurance company explaining that they wouldn't cover the lab fees because I'd seen a non-preferred-provider. I called my insurance company and explained that I had been directed to the doctor and the laboratory that I'd beeb to by *them* and that I didn't understand why they weren't covering my bills, as I had done what they had instructed.
Well, fast-forward literally six months. By this time, I'd spent over eight hours on the telephone with my insurance company trying to convice them that yes indeed, not only was my doctor, but the lab my doctor sent my blood to, a preferred provider. My call had *finally* been escalated to a supervisor, who authorized that yes, indeed my insurance claims were legitimate and that my lab work, was indeeed performed by a preferred provider, and that the supervisor was 'overrriding' the claims saying this wasn't the case and forwarding her override to the claims department. Finally, I had won (or so I thought)! The insurance company was admitting their wrong and I was going to have my lab-work paid for, as it should have been.
Well, four weeks later, I received a letter from the claims department telling me, once again, that the lab-work I had done was out of network and thus uncovered (though I had proof-upon-proof that the lab was in-network and was participating, and should have been covered). Additionally, at this point, I'd also recieved a bill from the lab saying that since my insurance company had refused to pay, and that my account at this point was over nine months overdue, and that my bill would soon go to collections. At this point I gave up. I paid the lab bill and gave up with my insurance compnay. I had spent hours and hours on the phone with them regarding this matter. I'd even gotten a supervisor to conceded that the lab work I had done was covered and that the insurance company should pay the bill. However, none of that mattered, as none of it ever panned out. And might I add, that this is not a rare incident in the privitized healthcare world that we live in. This sort of thing happens all the time. We are robbed--not at gunpoint, but we pay our premiums, and our deductibles, and the insurance companies shirk their responsibilites and literally take money from our pockets. This system is broken and desperately needs fixing.
Sincerely,
Sara Gunderson
*Health Care for America Now is not responsible for the content of these stories. These stories are submitted by individuals in the online audience and have been edited in some cases. Health Care For America Now does not endorse any of the solutions or policy positions suggested in the content of these stories. Health Care for America Now is a coalition of organizations that agree to the Statement of Common Purpose.
See our coalition partner list.
Read the Statement of Common Purpose.
