I really don’t get how your insurance company can be like “you need this treatment to live” (Or anaesthesia is vital for an operation, and an insurance company just be like “nah…”.

[–] Kit@lemmy.blahaj.zone 29 points 1 week ago (1 children)

I remember the phone call with the insurance clearly. I asked the lady on the phone, "I don't understand - my doctor says this is crucial but you're saying I can't have it?" And she said, verbatim, "I'm not saying you don't need it or can't have it. I'm saying we're not going to pay for it." And when I told her "Then you're giving me a death sentence." she went silent. I ended up stretching my one month doses over 3 months so it was "only" $200/mo.

[–] SouthEndSunset@lemm.ee 13 points 1 week ago (2 children)

That’s inhumane. I wonder if the person on the other end of the phone just didn’t give a shit or what…

[–] Kit@lemmy.blahaj.zone 14 points 1 week ago (1 children)

I think she did. I could hear pain in her voice.

[–] SouthEndSunset@lemm.ee 6 points 1 week ago

Then I feel for her…end of the day we all only go to work cause we have to.

My GF used to work for a company that provided in home care and facilities for the elderly, there were people whose job it was to phone up families and basically say “I know died last week but you owe us this money/equipment…”. That mustn’t have been fun.

[–] theneverfox@pawb.social 7 points 1 week ago

She probably had no authority to do anything about it. Delay, deny, defend…she’s part of deny/defend. She’s there to tell you that you were rejected, not to explain why or appeal. If a doctor calls, they’ll go into “you didn’t submit X step of paperwork declaring the patient has Y, and so even though you noted it elsewhere we’re denying”

Going off script risks her job, and for what? By design, she can do nothing to actually help

[–] Postmortal_Pop@lemmy.world 12 points 1 week ago (1 children)

It's actually an easy translation. "Nah" means "we don't anticipate you being capable of paying us more than what we'd have to spend to give this to you, so if you can't find cheaper the more lucrative option is letting you die."

[–] SouthEndSunset@lemm.ee 9 points 1 week ago

Yeah, they’re in it to make money, not to provide a health service. I forgot that bit.