I Hate Blue Shield

RobinWolaner

Posted: Feb 21, 08 10:18am

I am happy to have medical insurance, and I wish all Americans did too. But it doesn't stop me from a cold white fury in dealing with my insurer's attempts to deny me the coverage to which I am entitled.

I had breast cancer two years ago. The Breast Health Center where I go for twice-yearly mammograms has recommended an MRI to replace one of those mammograms. My oncologist agrees. Blue Shield refuses to authorize it. Why? Because National Imaging Associates, the firm to which they assign decision-making authority, needs my "clinical and family hsitory, results of exam, prior imaging and therapies." All of which Blue Shield possesses, but doesn't share with NIA. Plus "copies of medical journals showing why this is the right treatment."

If you're lucky enough to have health coverage, here's a place to vent. i will report back after I beat Blue Shield into submission.

13 Comments // 12 Members

Posted: Feb 21, 08 11:29am

I am happy to have medical insurance, and I wish all Americans did too. But it doesn't stop me from a cold white fury i...

Although I have yet to find biblical reference to support my theory - I'm quite certain that pretty much everyone involved in the Health Insurance industry (primarily those that make decisions with absolutely NO regard for health) are going straight to hell . . .

Honeybee1
Honeybee1
Founding Member

Posted: Feb 21, 08 12:05pm

I am happy to have medical insurance, and I wish all Americans did too. But it doesn't stop me from a cold white fury i...

Ahhhhhhhhhhhhhhhhhhhhhhh ha, I'm with Ordinarygirl on this one.

Posted: Feb 21, 08 2:18pm

I am happy to have medical insurance, and I wish all Americans did too. But it doesn't stop me from a cold white fury i...

Good For You. Irember when they were a not for profit company & a basicly decent company. Alas no More!

Posted: Feb 21, 08 2:34pm

I am happy to have medical insurance, and I wish all Americans did too. But it doesn't stop me from a cold white fury i...

Well, Met Life is the very worst. Stingy. I am a provider, and you wouldn't believe the paperwork, written justifications per procedure, and hoops that must be jumped through by us (all invisible to the patient, but the patient eventually pays for them, of course) as demanded by nearly all insurance companies. Often, we must submit additional xrays or diagnostics that have been done purely for insurance needs, not for any direct clinical purpose. And, it seems that many insurance decisions are made by fairly "low-level" employees, not by doctors.

Posted: Feb 21, 08 2:56pm

I am happy to have medical insurance, and I wish all Americans did too. But it doesn't stop me from a cold white fury i...

I'm self-employed and get private insurance through NASE, the national association for the self-employed. The theory is you have strength in numbers with other nase members and get a better rate with MEGA. I pay $666 a month (a coincidental number? I think not) for 2 people and in return we get almost nothing.

- They will not pay for my yearly pelvic exam or pap.

- They will not pay for anything relating to my brain because of my migraines, even though the migraines haven't managed to kill me in the 31 years I've been having them.

- Any time I've gone to urgent care, they will maybe pay 25%.

- The urgent cares in town have switched their hospital affiliation and won't accept Mega now.

Anyone LIKE their insurance company? because I'm starting to shop around.

Posted: Feb 21, 08 3:00pm

Well, Met Life is the very worst. Stingy. I am a provider, and you wouldn't believe the paperwork, written justification...

The Insurance and Pharmacutical companies are a business, a money making business period, they care nothing for any individual.

They have far too much power and answer to no one, it's scarey that our lives are in their hands.

Our health care system is broken, I feel it is wrong and inhumane to put a price on human life, especially, when it is not necessary.

Many other countries provide health care or insurance to all their citizens, not just those with money. How can the greatest nation on earth have health care comparable to a third world country?

Posted: Feb 21, 08 3:37pm

I am happy to have medical insurance, and I wish all Americans did too. But it doesn't stop me from a cold white fury i...

Robin,

I’m so sorry to read you’re going though a Kafkaesque nightmare with Blue Cross; BTDT last year with Aetna. I hated Aetna enough to change insurers.

Good luck, you’ll need it!