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Originally Posted by savoir-faire |
Doctors like those, and the health insurors and drug companies really make it tough to trust them at all. Everybody has to make money. But bending to greed makes some want to make a killing at the expense of the health of average people.
I have Aetna health coverage, and they have recently denied a claim for a drug my wife has to have. They did that because of the expense. We got coverage for the drug by doing a little extra work with the doctor. I don't trust Aetna at all, partly because of this:
Aetna Health Management, LLC
Aetna Fined by Texas for Fraud: "Aetna is among the 21 insurers fined by Texas Department of Insurance Commissioner Jose Montemayor this year for allegedly violating the state's rules on prompt payment of claims." [Source: San Antonio Business Journal, 1/4/02]
Aetna Agreed to Pay $470 Million For Defrauding Doctors: "Aetna Inc. has agreed to a $470 million settlement with more than 700,000 doctors who alleged in a class-action lawsuit that insurers wrongly cut payments to them and interfered with their recommended treatment for patients." [Source: CBS News, 5/22/03]
Paying to Play: Health Care Companies, Campaign Contributions and Medicare Drug Discount Cards
Of course, a lot of insurors do illegal things to make money, not just Aetna.
Anyway, anybody reading this, if you are denied a claim, fight it with phone calls and letters to the insuror. They know most people give up easily, and having told you 'no,' they probably won't get any argument. But if you make some noise, you will likely win, and get coverage for your needs.