3 ms·

Have you actually tried getting a big claim paid by them. My GF is currently embroiled in a dispute with United Healthcare over a temporary insurance plan she b

Have you actually tried getting a big claim paid by them. My GF is currently embroiled in a dispute with United Healthcare over a temporary insurance plan she bought to cover the gap between graduating college and when her full time position started covering her (wouldn't it have been great if the new healthcare law was in effect at the time and she could have stayed on her parents insurance). Anyway, she had a hospital visit for $3k and United Healthcare is denying her simply because she didn't stay overnight. We thought we had insurance, but as soon as push came to shove it really doesn't mean anything if you are an individual buyer because they will just screw you over and theres no reason not to.

georgieporgie 16y ago
I have not made a claim on this insurance policy. It is Blue Cross, though, and I've made various claims over the years on other B.C. policies without any trouble. I had a trip to the hospital thanks to a careless taxi driver, and I think that was on Blue Cross, as well. Totaled about $10k before insurance just to be poked, x-rayed, and released, which really woke me up to the horror that is our health care system.
rikthevik 16y ago
This is the very frightening thing. You fill out your forms, you pay your premiums and you still get screwed. I know that in Canada, if I am sick, I will be looked after. I won't go bankrupt trying to pay for my treatment or trying to pay for the legal bills in a court battle, trying to get my insurance company to pay out. The American system is so truly and completely fucked, I can't understand why anyone would defend it. Better hope you've got good genetics, good luck and a good lawyer. If any of those things isn't in your favor, one quick illness and your financial life is over.
- cookiecaper 16y ago
  Is it cheaper to hire a good lawyer or just to pay the bill? Unless it's catastrophic it's probably cheaper to just pay the bill than to fight it.
jseifer 16y ago
United denies everything they possibly can and they make "mistakes" that take so long to find you get past their dispute time. Do not go through United trying to get them to pay this. Prepare for a day spent on the phone with the hospital until you find the person in the billing or services department who can really get to the bottom of it. They will figure out for you which technicality the insurance company is trying to use and what the correct one is. I had something similar happen and, after a day on the phone, was able to get the incorrect code that was used, how much they were supposed to pay, and what to say to them (this needs to be reprocessed according to X agreement). From there you need to write a letter to United saying you want the case appealed. Send it certified mail and be prepared for the first response acknowledging your letter and the second one, about 30 days later, with the result of your appeal. PS: I would have emailed this to you but couldn't find any contact information in your profile.
- cookiecaper 16y ago
  Again, health insurance does this because insurance is all about paying for something and not using it. Since everyone uses health insurance, insurers resort to schemes like this to keep their profits where they like them. Insurance is a completely horrible paradigm for medical billing.
  - jseifer 16y ago
    This was really meant more as advice to the commenter I replied to, having been through it before and learned how to deal with that particular company.

georgieporgie 16y ago

I have not made a claim on this insurance policy. It is Blue Cross, though, and I've made various claims over the years on other B.C. policies without any trouble. I had a trip to the hospital thanks to a careless taxi driver, and I think that was on Blue Cross, as well. Totaled about $10k before insurance just to be poked, x-rayed, and released, which really woke me up to the horror that is our health care system.

rikthevik 16y ago

This is the very frightening thing. You fill out your forms, you pay your premiums and you still get screwed. I know that in Canada, if I am sick, I will be looked after. I won't go bankrupt trying to pay for my treatment or trying to pay for the legal bills in a court battle, trying to get my insurance company to pay out. The American system is so truly and completely fucked, I can't understand why anyone would defend it. Better hope you've got good genetics, good luck and a good lawyer. If any of those things isn't in your favor, one quick illness and your financial life is over.

cookiecaper 16y ago
Is it cheaper to hire a good lawyer or just to pay the bill? Unless it's catastrophic it's probably cheaper to just pay the bill than to fight it.

jseifer 16y ago

United denies everything they possibly can and they make "mistakes" that take so long to find you get past their dispute time. Do not go through United trying to get them to pay this. Prepare for a day spent on the phone with the hospital until you find the person in the billing or services department who can really get to the bottom of it. They will figure out for you which technicality the insurance company is trying to use and what the correct one is. I had something similar happen and, after a day on the phone, was able to get the incorrect code that was used, how much they were supposed to pay, and what to say to them (this needs to be reprocessed according to X agreement). From there you need to write a letter to United saying you want the case appealed. Send it certified mail and be prepared for the first response acknowledging your letter and the second one, about 30 days later, with the result of your appeal. PS: I would have emailed this to you but couldn't find any contact information in your profile.

cookiecaper 16y ago
Again, health insurance does this because insurance is all about paying for something and not using it. Since everyone uses health insurance, insurers resort to schemes like this to keep their profits where they like them. Insurance is a completely horrible paradigm for medical billing.
- jseifer 16y ago
  This was really meant more as advice to the commenter I replied to, having been through it before and learned how to deal with that particular company.