This is hard for me to understand. No one in my family has ever been denied coverage or procedures. Young, old, or infirmed. Perhaps it's timing, but years ago we had United Healthcare... had a major brain issue with a teen, all covered.
I just don't understand why some are and some aren't.
I would say the same for me, but the difference is that when I was working, I was with huge companies that were self insured and their coverage for employees was of the "Cadillac" variety. Everything my doctors threw at them before I retired, was covered, meds too.
I know others who unfortunately work for organizations that have cheap plans and they encounter rejections frequently. Usually for a utilization review, or if the recommendations are approved by in house DR's and Nurses. At that point, you're at their mercy, dragged thru the process, hoping you'll just go away.
I agree, I’ve never even heard of any health insurance company rejecting things that the policy states are covered. Of course an insurance company might suggest you do certain things before approving either expensive surgeries or drugs or whatever but that’s understandable
Notice how people say the companies just generally “reject coverage”. Well if your health plan doesn’t include the thing you need done then of course they’re gonna reject it. If I ask my health insurance to cover my eye exam it will be rejected because that’s not part of the plan.
Yeah, I had United when I needed an emergency c-section and had no problem getting it covered, and they also didn’t give me any problems with having a scheduled c-section the second time around. My out-of-pocket max was crazy high though, but my BCBS plan that I have now is the same way. If anything I blame hospitals more than insurance companies. The prices that were on my hospital bill were obscene. They billed my insurance $80k for each c-section/2 day hospital stay, and that was with no major complications or special care.
This is hard for me to understand. No one in my family has ever been denied coverage or procedures. Young, old, or infirmed. Perhaps it's timing, but years ago we had United Healthcare... had a major brain issue with a teen, all covered.
I just don't understand why some are and some aren't.
I would say the same for me, but the difference is that when I was working, I was with huge companies that were self insured and their coverage for employees was of the "Cadillac" variety. Everything my doctors threw at them before I retired, was covered, meds too.
I know others who unfortunately work for organizations that have cheap plans and they encounter rejections frequently. Usually for a utilization review, or if the recommendations are approved by in house DR's and Nurses. At that point, you're at their mercy, dragged thru the process, hoping you'll just go away.
I agree, I’ve never even heard of any health insurance company rejecting things that the policy states are covered. Of course an insurance company might suggest you do certain things before approving either expensive surgeries or drugs or whatever but that’s understandable
Notice how people say the companies just generally “reject coverage”. Well if your health plan doesn’t include the thing you need done then of course they’re gonna reject it. If I ask my health insurance to cover my eye exam it will be rejected because that’s not part of the plan.
Yeah, I had United when I needed an emergency c-section and had no problem getting it covered, and they also didn’t give me any problems with having a scheduled c-section the second time around. My out-of-pocket max was crazy high though, but my BCBS plan that I have now is the same way. If anything I blame hospitals more than insurance companies. The prices that were on my hospital bill were obscene. They billed my insurance $80k for each c-section/2 day hospital stay, and that was with no major complications or special care.