makes me think about
Moving to another country with national healthcare coverage! I swear, why have insurance if we cannot even use it for an emergent cause even after we pay for something out of pocket! That's ridiculous. What about a facial infection after a facelift?? Not covered?
I paid out of pocket for laser eye surgery and I was seen in the ER to rule out an emergent eye condition, then sent to a specialist for an emergency consultation and it was all covered by my insurance.. I did make a call to the Triage center and speak with a nurse who directed me to the ER so I had followed insurance protocol tho believe me I had already decided to hit the ER and was just doing it as matter of protocol, nothing more..
It sucks that there is a group of non medical personnel making decisions as to what is going to be covered upon review and what isn't and so forth.. some of the reasonings I've seen in review have been ridiculous and totally incorrect from a medical standpoint (talking about UR decisions here which is Utilization Review used in Work Comp cases now and HMOs/Managed Care). And don't even get me started about underwriting because if you ever ask to see the underwriting for the policy you are thinking about taking out or have taken out, there are so many things that aren't covered that I'm surprised ANYTHING is anymore!!!
Ok, sorry about my rant but hey, it's not right. Might as well not have insurance if we cannot use it when needed esp. if there is a monthly payment going out from somebody's pocket and these premiums are pretty steep these days~
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