It Was Even Scarier Than Cancer (For a While)

While I'm driving the Gloom and Doom bus, I'll blog about something else that I have found can be even more scarier than cancer.

My insurance company is trying to prove that I applied for insurance with them under fraudulent terms, and then drop me without paying for any of my coverage.

Here's the back story. It has been my good fortune to become acquainted with several individuals who have the inside "know how" on how insurance companies work (one of whom works for and insurance company herself). When I began to sense trouble on my own insurance front, I consulted the bunch of them and here is what they said:

"Insurance companies are in the business of making money. They are not interested in losing money on any patient for any reason. If you are self-employed (as I am) and you have an individual policy (as I do) and you get cancer (as I did) they will move heaven and earth to drop you. This is because you are a lone little nobody without a group to back you therefore making you easy pickings for the kill. People at the insurance company are specially trained to weed out lone cancer patients like you."

In my case, my insurance company has frozen all payments to any of my doctors pending a five year review. According to my friends in the know, this means that the insurance company will closely examine all of my medical records for the past 5 years, and then try to catch me in a lie from my initial application. Not only will they be looking for evidence that I lied about having cancer, but they'll also be looking for any tiny foothold to prove that I lied about anything and then will drop me.

The stories: One lady was dropped by her company after they discovered she had not disclosed a visit to a psychologist. When she asked them how that could have anything to do with her current cancer, they said "You were probably depressed about having cancer." They promptly dropped her from coverage.

Another woman was dropped when the insurance company learned that she had fudged her weight on the initial application by 10 pounds. They declared this "fraud" and dropped her even though it had nothing to do with her cancer.

An third woman was given consent for a cancer surgery by her insurance company and proceeded with it. Afterwards, the company demanded a 5-year-review at which time they rescinded their approval of the procedure, refused to pay for it, and left her holding the $40K bag. Spiffy!

I have no idea what my own status is. Limbo I guess. I get letters in the mail every day explaining that payment is being held pending examination of the records. Sad stuff, huh? I'll keep you posted as the saga unfolds.

Paix - Jen

Five Weeks In; No Game Plan and None in Sight

Saw another surgeon today. He is associated with the hospital in my town and came recommended by the Oncologist that I saw last week. The visit was just so-so, I'll spare you the details. However, when we went to schedule a possible date for surgery ... surprise! My insurance doesn't cover surgery at that hospital.

So, to recap, my insurance covers surgeons who work at the hospital the insurance company doesn't cover, but the insurance doesn't cover any surgeons at the hospital where I can have surgery. How's that for a pretty good racket?

Ah the hilarity. That literally leaves me with absolutely nowhere to go to get this cancer out of me. Five weeks and still no game plan. I have a call into the Cancer Treatment Centers of America, but I am not hopeful.

So, the options are, do nothing and hope for the best. Treat myself with alternative therapies and hope the cancer goes away or at least doesn't spread. Or pay for the surgery myself at my local hospital. (Sure thing! Let me just run and get my checkbook.)

I told my girls afterward that my work has been hanging in limbo for over a month now and that I have to get back to it. I am a self-employed single mom who runs a busy business and who has agents and clients who depend upon me to show up and work everyday. If I don't work, I don't get paid. So, cancer in tow, that's what I'll do for now.

Here's hoping for a better day tomorrow. Jen