Heath “Care” in America

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Here’s a timeless subject, huh? Even with “Obamacare” we’re all still screwed. Know why? The insurance companies are still in charge.

Recently, my husband was admitted to the hospital with a blood clot in each lung. The guy looked like Death warmed over. He really did. He spent a horrible night in agony before breaking down and going to the ER where he was diagnosed and admitted. He spent 3 days there. It’s over now, he’s fine, taking his meds, and he’s back to work. All is well there. Thank the Gods. It was pretty damn scary for a little while.

On his second day there, we were told that we didn’t have insurance! I thought that odd since I was the one who filled out the insurance forms and he submitted them. But…no. According to HR those forms were “blank”. Yeah. Right. Ok. I fill them out again and the hospital submitted them to United Healthcare.

You can groan now it’s ok, I knew we were screwed when I filled the forms out the first time and saw our new “insurance” was UHC. Dealt with them at the chiropractor’s office and most doctors around here–including hubby’s Ortho–do not participate with UHC because they’re so horrible they’re not worth the aggravation.

Any-hoo, they were “kind” enough to back date the forms to his original hire date–the date I filled out the forms the first time around before they suddenly became ‘blank’–and then we were “covered”.


Yesterday, we received a Denial of Benefits in the mail. Reason given: you weren’t having difficulty breathing.

Excuse me?

He could hardly catch his breath at all. What the hell are they talking about?

So now we get to go through the Appeals Process–something UHC is infamous for–and, in so doing, they want his medical records.

HUH? I’m sorry but doesn’t UHC already have those? If they didn’t how they could possibly judge whether or not he was having difficulty breathing? How would they even know anything about it? It’s just an obstacle purposefully placed in my way, his way, and your way too, so UHC can drag out not paying. We’ll get those next week when he goes to see the hemetologist and we’ll submit them to UHC and see what happens.

In the end, what was my husband supposed to do? What was the hospital supposed to do? The doctors? Look at him and say; “Yeah, you’ve got a nice sized clot in each lung there so here’s some Xeralto, take them, go home, rest a few days, come back and see us in a week or two, ya know, if you’re not dead by then. Cya.”

I guess pulmonary embolisms are now an Outpatient thing that don’t require hospitalization. Well, ya know, at least according to UHC.

If UHC has to face the fact that he did need to be hospitalized I’m sure they’ll come back with something about us not being covered at the time of the event. Which, of course, we most definitely should have been given the fact that ALL of the other forms/paperwork filled out and submitted at the exact same time went through like a wet dream.

Yep, even when you pay full-boat for your health insurance, you still get screwed. I’ll keep you updated on this on-going process.

Should be fun. Oh joy.

About lbdarling

Beware...the truth is spoken here. If you can't handle that...buh-bye.

Posted on 07/10/2015, in Uncategorized and tagged , , , . Bookmark the permalink. 2 Comments.

  1. Mary Preston

    You need to be living in Australia. I had a major operation, two theatre visits – on the emergency list both times – a week in hospital, umpteen dozen tests. No health insurance – excellent care – private room – FREE. Once I was cleared by the doctors I just walked out. All done.

    • Believe it or not, there have many times over the years I thought about moving to Australia…or New Zealand. Either of those would be find with me. Glad your operation went well and that you’re ok.🙂

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