I had a similar situation where insurance didn’t pay for stuff, but with only $800 at stake. My wife was pregnant, and our doctor ordered us(her) a test. Naturally, we go along with the doctor’s actions. It turned out that the test was not done at the correct (in-network) location, even though the doctor was in network and had ordered the test herself. We incorrectly assumed that if the doctor did all of the ordering, everything is covered. Wrong. So we appealed (with Guardian PHS) and they paid for the tests. Now we always have to chime in if the doc takes any action… What a hassle.
It was in the paperwork, somehow I just missed it. I have appealed. I was under COBRA extension of my policy and I was not paying very much for it – $300 a month, now I know why. They would have paid slightly more had I been hospitalized. They called it outpatient service. I have appealed. The company was SRC- an Aetna company. I got it through the temp agency Nike uses to hire their freelancers, I also let them know the situation. I will continue to spread the bad word.
Holy shit. Insurance only paid $1000? by what reasoning did they give? You gotta fight that. How can they claim any of that was medically unnecessary when you weren’t calling the shots, especially in your impaired mental state at the time. Fight the power!
Yeah, I had a little accident last summer. I was knocked out in a collision at the Newberg leg of the Oregon Trifecta. I was basically unhurt but they strapped me down put me in a helicopter and had me MRIed at the hospital. I was out of there and back at the skatepark within a couple of hours. I had a bruise on the side of my head and I was a little sketchy on my skateboard for a couple of weeks, but by three weeks I was totally myself again.
I figured I was okay because I had medical insurance. The insurance only paid $1000 of the $16,000 in bills. The helicopter ride alone was over $7000. Calling a helicopter costs $6000! I was able to get the hospital to take off $4000 but that
Man, these recent cartoons are hitting close to home for an old geezer like me (37)… Otherwise we’re all the same – free will vs free time, grateful vs entitlement, too funny – and now insurance. Is this cartoon based on reality? This makes me worried – my disability insurance provider asked if I flew airplanes or skydived, but they never asked about skateboarding. Maybe I gotta go read the fine print…
6 comments
Gene
I hope the appeal goes well.
I had a similar situation where insurance didn’t pay for stuff, but with only $800 at stake. My wife was pregnant, and our doctor ordered us(her) a test. Naturally, we go along with the doctor’s actions. It turned out that the test was not done at the correct (in-network) location, even though the doctor was in network and had ordered the test herself. We incorrectly assumed that if the doctor did all of the ordering, everything is covered. Wrong. So we appealed (with Guardian PHS) and they paid for the tests. Now we always have to chime in if the doc takes any action… What a hassle.
Conahan
It was in the paperwork, somehow I just missed it. I have appealed. I was under COBRA extension of my policy and I was not paying very much for it – $300 a month, now I know why. They would have paid slightly more had I been hospitalized. They called it outpatient service. I have appealed. The company was SRC- an Aetna company. I got it through the temp agency Nike uses to hire their freelancers, I also let them know the situation. I will continue to spread the bad word.
Kilwag (k.ed)
Holy shit. Insurance only paid $1000? by what reasoning did they give? You gotta fight that. How can they claim any of that was medically unnecessary when you weren’t calling the shots, especially in your impaired mental state at the time. Fight the power!
Conahan
Yeah, I had a little accident last summer. I was knocked out in a collision at the Newberg leg of the Oregon Trifecta. I was basically unhurt but they strapped me down put me in a helicopter and had me MRIed at the hospital. I was out of there and back at the skatepark within a couple of hours. I had a bruise on the side of my head and I was a little sketchy on my skateboard for a couple of weeks, but by three weeks I was totally myself again.
I figured I was okay because I had medical insurance. The insurance only paid $1000 of the $16,000 in bills. The helicopter ride alone was over $7000. Calling a helicopter costs $6000! I was able to get the hospital to take off $4000 but that
nweyesk8
never have i had insurance, i am not big on gambling
Gene
Man, these recent cartoons are hitting close to home for an old geezer like me (37)… Otherwise we’re all the same – free will vs free time, grateful vs entitlement, too funny – and now insurance. Is this cartoon based on reality? This makes me worried – my disability insurance provider asked if I flew airplanes or skydived, but they never asked about skateboarding. Maybe I gotta go read the fine print…