Wednesday, March 17, 2010

US Insurance Reform? How about some health care justice!

Sure, I think we are all in agreement that the US Health Care system is in need of reform. Its quite a ridiculous system, I've learned especially over the last several months of my life. Why does our family pay over $1500 per month in insurance premiums for insurance to cover so little?

I'm sure many of my readers might be sick of hearing me complain about Aetna health insurance by now, and I know that Aetna is not happy about it. Well good! Instead of overlooking my complaints as my own, lets take a look at how health insurance policies affect us all, affect us in a very negative way. I have learned that it is standard operating procedure for Aetna (and other health insurance companies) telephone representatives to give misleading and incorrect information over the phone, and then for the insurance company not to stand by what was said by their representatives. In talking to all the health care providers that I am dealing with, I find out that I am not alone, "this happens all the time". Is what I have heard from every single one of them. Five different health care providers, to be exact, have told me the same thing. They have all learned that no one can take what the insurance company representative tells you over the phone. Why? Why is that? In any other business, a corporation has to be held liable for what their employees say. Each policy is written differently, and so convoluted, so verbose with legal jargon, who understands it? Well I can tell you the employees at Aetna don't understand it, that's for sure, I get a different story every day from different people.

I believe that everything happens for a reason, and the reason this insurance nightmare hit me is because, I am not going to go away, I am not going to shut up. I am going to continue bringing the story of my insurance problems with Aetna to the public via my blog for anyone and everyone to read. And in hopes that someone, somewhere can do something about it. We need change and evidently its on me to show America what a family has to go through.

My issue is not what my plan covers for therapy for a child with Cerebral Palsy (which is very minimal), my issue is what I was told it covered and what it really does cover. I was lied to. Not sure whether it was intentional lies or just misinformation; however based on the information I was given, I continued her therapy did not make efforts to switch her to Medicaid sooner because I thought that my health insurance would cover it and since I was paying so much for it, I wanted to get the most out of it.

I haven't posted an update in several days, because I was trying to take a break from it, but I am back and will have the last few days chronicled and up tonight.

Thanks for reading. Please subscribe to my blog and pass it along to anyone who might want to know what else is wrong with the US health care program and Aetna insurance company.

If you are reading this for the first time, this is only a piece of the puzzle and the drama that we have been put through. You can see details on this whole insurance debacle with Aetna on my blog: and if you would like to help, feel free to link to the blog and share my story with anyone and everyone who will listen. I am not just doing this for me and my family, I am doing this for all the families who have been wronged by Aetna and other insurance companies who make it their policy to deny claims in hopes you will not notice, make it hard enough to fix problems that they hope you will give up, and state incorrect things over the phone just to get you to shut up and hang up and then they do not stand behind what was said.


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Tammie said...

I believe my friend that you have found your cause. It certainly is a good one.

My question is this. How is it that the insurance company can decide that some meds are "not necessary" or that the dosage is too high so they don't cover it. As you know, David is on some amazingly expensive stuff. BC/BS FL decides constantly that his doc must be wrong & has prescribed an incorrect dosage so they'll cover only a portion. Do these doh-dohs have a medical degree? From where?