Medical Insurance Denials for Womens Health Isssues Someone Please Help!
Hi,
My name is April I am 40 years old. I am so dissappointed with how the insurance company deny many medical needs for women. Let me tell you my story. Four years ago I was diagnosed with Fibroid tumors and Low Iron Anemia. I went into surgery and had the fibroids removed and was put on chromagen for the iron problems. This was covered from my group insurance company at work. Shortly after the surgery I started a new job that did not provide health insurance. I had bought an individual plan from BCBS (Blue Cross Blue Shield of AZ). They made me sign a two year waiver stating they would not cover any problems that had to do fibroid tumors for two years. Last July the two year waiver was up and I had wrote them to take off the waiver since i had no problems with fibroids in that two year period. I had not heard back from them. I paid my premiums on time. Then October 2007 I started to have severe bleeding issues again and went to my doctor. The Doctor sent me in for an ultrasound which came back that my uterus walls were thickening and the uterus was enlarge due to probable fibroid tumors. Then I had a biopsy done on the thickening which was begnin. Meanwhile, BCBS wrote my doctor in October 2007 and decided to make it a permanent waiver on my medical insurance. I feel these waivers are misleading to the public. It was a two year waiver. Since then I am having severe bleeding three weeks out of the month, also discoved PCOS from a blood test, Then I was sent in for and MRI and the fibroids are back. My docter told me I need to have a complete histerectomy. Now BCBS will not cover it.I have appealed the 1 st discision which they had denied and they denied the second appeal. What do I need to do?I am in the process of trying a third appeal. However my iron is being maintained with the Chromagen but hard on my digestive system. The bleeding is out of control and heavy 3 weeks out of the month and the birth control does not work. My hormones are out of wack due to the bleeding an PCOS. I am having a hard time functions due to all of these problems. Work has been difficult. I need to be focused at work. What do I have to do bleed to death before I can get help from the insurance company. They should not be dictating my health. I pay my premuims on time monthly. They should not be allowed to do this to people. Its a way for them to get money from people for premiums and then they will put permanent waiver of coverage on them this is not right and misleading to the public. Does anyone know how I can get help? Does anyone know alternative treatments or a way to get my surgery covered. I want to feel better!!Please Help!! Thank you, April.
Comments
I'm sorry to hear you're going through so much with your health as well as the insurance headaches. When you doctor said you needed a hysterectomy, did he or she provide you any other alternatives? We will also do some research on insurance options and get back to you in the next day or so.
April, I'm sorry to read all this and can't believe (well, the cynical side of me can) that your insurance company is refusing treatment that they previously had claimed they would, once a waiver was finished.
I will also do some research for you and please don't forget that you have congress representatives that may help and they always have local offices.
If this gets any worse, and you are comfortable being public about it, there are many consumer advocacy groups that would be willing to listen to your story.
As Tina already asked - what has your doctor said about your prognosis if you do not receive a hysterectomy?
Dear Tina & Susanc,
They both said I definitely will need a total histerectomy. I did discuss uterine embolization. However, because the cervix has fibroids too they do not recommend it. I also discussed Luprin with both Dr.'s they said it was terrible hormone and would not give it to me. I guess it is causing clotting issues in a lot of women. Both Dr.'s prognosis was that it would not get better in fact, that it may get worse. Thats all I discussed so far. If you have heard of any other treatment alternatives please let me know.
Susan, I would love to know someone I can contact as far as congress, or a state representative, and consumer advocacy. I am willing to let these people know how corrupt insurace companies are and how they are dictating people health and it is not right! Thank you both so much for your responses. I look forward from hearing from you both:) Sincerely, April.
Where in Arizona are you? If you prefer not to say, send a PM.
Thanks!
Hi Susanc,
I am in Flagstaff, Arizona. Thanks again for responding!! Sincerely, APRIL:)
We are trying to find you some help. Please bare with us. We've actually reached out to people that hopefully can help you.
Thanks for sharing your story with us. I'm so sorry that you've had to go through this. It's hard enough to be sick and try to advocate for yourself. Not alone, having to battle with the insurance company.
We will get back in touch with you as soon as we receive a reply. Assuming we get one.
Best in health,
Michelle
Hi April
I have been looking into areas that may help you with your insurance problems. The Arizona Department of Insurance has a department dedicated to assisting consumers with issues just like yours. I am giving you this information, rather than researching options within Blue Cross Blue Shield of Arizona because you seem to be running into brick walls with them and it may be time to take your issues to the State.
Here is your link to make a formal complaint and request for help:
http://www.id.state.az.us/forms/Request_For_Assistance_12-07.pdf
If you'd like to write to them, here is the address:
Consumers Affairs Division
2910 North 44th Street
Suite 210
Phoenix, Arizona 85018-7269
If you would prefer to call, here is more information
Phoenix Area:
Phone: (602) 364-2499
Fax: (602) 364-2505
Tucson Area :
Phone: (520) 628-6370
Fax: (520) 628-6633
Statewide :
Phone: (800) 325-2548
And if you feel better emailing -
consumers@id.state.az.us
I hope this starts the ball rolling in a different and more positive direction and please keep us updated. If I can help you further, just pop back in to Empowher and ask.
Susan
Hi April,
Have you made any progress with your insurance company? I was just thinking about you and wondering how you are doing--please let me know if there is something more I can do. We did contact your insurance company and they indicated that they would be in contact with you, or we may have given you a different number to call. Please please let me know how you are doing and if you were able to make any progress. Best in health, Michelle
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