Health insurance help please

   / Health insurance help please #1  

deere755

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Location
central Illinois near Lake Shelbyville
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As most of you probably know I had a TIA back in July. After many tests they found out I had some blockages in my heart also. September the 3rd I had a Quadruple by pass surgery. I am recovering great according to all my Doctors and will probably have a second surgery the first week in October. For 24 hours the Dr. ordered blood draws every 3 hours. My insurance company has ther own lab for this. The problem is it is not in the hospital and it is not open 24 hours a day. I was in CCU and there was no way I could go to there lab. The insurance company will only pay like $8 per draw. I can't tell you how many chest x-rays I had but the insurance company is only wanting to pay $10 on each one, they run about $70 a piece. The surgeons bill was $9400 the insurance company paid him $478. This is just a tip of the iceberg. All of these expences they are saying do not apply to my out of pocket expence and do not apply to my $1500 deductable. My total bill so far is around $130,000. It looks as if right now I may be stuck with $40 to $50 thousand of my total bill. Is there anything I can do to get more out of them. Is there an agency that would help me with this. Any suggestions would be appreciated.
 
   / Health insurance help please #2  
Call your congressman is good advice.

One has to wonder about these health insurance companies and hospitals.

I recently took a fall and decided to go to the hospital emergency room (it was July 3) My insurance company was fine with it even though I went without their approval and only paid 25 dollars. Saw the total bill this weekend and the hospital charged a total of $925 to the insurance company. Guess they are both out to get is much as possible.
 
   / Health insurance help please #3  
You're just going to have to be patient and work through this with the insurance company and medical provider.

Do what you can to fix things (without paying a dime), then get a lawyer. Every family needs a good lawyer. If you don't have one yet, now's as good a time as any to find one. Fortunately, we have a family friend that I trust more than most anyone, including some family.:D
 
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   / Health insurance help please #4  
you should look for a health insurance advocate in your state. google health insurance advocates or health care advocates. otherwise, read your policy and find out what its supposed to pay for. also, all states have an insurance commission that oversees insurance business in your state. if you have a legitimate complaint (after reading and understanding your policy)you should contact them or the better business bureau.
 
   / Health insurance help please #5  
You're just going to have to be patient and work through this with the insurance company and medical provider.

Do what you can to fix things (without paying a dime), then get a lawyer. Every family needs a good lawyer. If you don't have one yet, now's as good a time as any to find one. Fortunately, we have a family friend that I trust more than most anyone, including some family.:D

Bungee, I think that is good advice, there really aren't many options. I think it's good to inform your Sen/Rep and tell them there are are problems out there they are not fixing. But I wouldn't expect them to help individual cases.
Dave.
 
   / Health insurance help please #6  
you should look for a health insurance advocate in your state. google health insurance advocates or health care advocates. otherwise, read your policy and find out what its supposed to pay for. also, all states have an insurance commission that oversees insurance business in your state. if you have a legitimate complaint (after reading and understanding your policy)you should contact them or the better business bureau.

This may help... depending on what they charge. Your insurance only paid 5% of the surgeon bill which sounds like a bad joke. Having someone who knows what they are looking at go over your insurance plan sounds like a good idea.
 
   / Health insurance help please #7  
Glad you are getting better, and good luck on the next surgery Hopefully that will get you back to 100 percent.
 
   / Health insurance help please #8  
how is a congress man going to fix an insurance problem that an individual purchased and signed on their own.

by the way i am sorry for the spot you are in, Talk to your doctors and the hospital. They will work with you. When i first got married i had no maturnity insc. The Doctors, and hospital worked with us and set up a payment plan for us to pay them back. They were very understanding, i never got calls or reminders of out standing payments (i did pay the bill on time every month) and after we payed the final bill we got a nice thank you card:rolleyes:
 
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   / Health insurance help please #9  
Find each doctor or service supplier and ask them to drop the charges.
 
   / Health insurance help please #10  
Folks. Keep the politics out of this thread. Several posts have already been removed and a few more will be edited or removed. Please just answer the man's questions without the politics. Thanks. :cool:
 
 
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