I’m in the unfortunate position of having to get individual health insurance. While I love being self-employed, trying to get reasonable rates and decent coverage is very difficult in the United States. I recently found out that a number of health insurance claims that were denied by my provider were done illegally. Fighting them takes hours and reminds me of the typical Frank Kafka novel. MSN Money has a site that can help in some ways. The Know Your Rights section includes links to numerous articles about health insurance, and how you can deal with it. Some useful articles:
From the latter article:
When a health-care claim is denied, you may feel like you’ve hit a dead end. Money is the last thing you want to deal with when you or someone in your family is sick, and now you’ve got to expend energy fighting for what you’ve been promised.
The reality is that denials of health-care claims, even for named benefits, happen all the time. A denial isn’t the last word — it’s the beginning of the appeals process, the next stage in the game.
Of the cases the Patient Advocate Foundation oversees, 94% were initially denied benefits that were published benefits in the health plan. “Receiving a denial of benefits is not unusual — it is completely usual,” Davenport-Ennis says. “Be confident that there is an appeals process and immediately begin it.”
I’ve spent many hours researching different insurance options, ranging from HSA-compatible plans to those that claim to actually provide benefits to keep people healthy. And, I hope I’m not the only one that thinks that human beings shouldn’t have to fight (or bid) for healthcare. This might be a good time to remind everyone that we’re living in one of the richest countries in the world (and one that barely thinks twice about spending $12 billion per week in Iraq).
My main problem with the U.S. healthcare system is that we don’t have any form of arbitration or appeal. Shouldn’t the government represent me in a case against an insurance provider? I certainly can’t afford to do it, and the odds are certainly stacked against me. Clearly, the goal in America is unbridled profit (which leads to greed). Until there are some major changes to this system, the best individuals can do is fight for a while until they’re worn out.