Marc’s girlfriend found some lumps in her breasts, the mammogram and ultrasound came back ok, but BCBS is denying coverage for the biopsy, saying it’s a “pre-existing condition.” The out-of-pocket cost is over $2,000. We’re confused, BCBS. What pre-existing condition? That she has breasts? That she might not have cancer?
The additional biopsy was recommended by the doctor because of Marc’s girlfriend’s family history of breast cancer.
Some helpful information for Marc: an insider once walked us through how to appeal an insurance company’s denial of care. Consumer Reports has a good appeal guide too.
Our health insurance system truly is sick.
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The reason the government can provide healthcare more efficiently is that under a single-payer system, administrative fees are drastically reduced. The amount of money spent by physicians and insurance companies who have to submit mounds of paperwork for approval of each procedure, research into a patients medical history, etc. is astounding.
The other proven effective cost reducer under a government health system is the ability for EVERYONE to receive preventative care at no cost. Many conditions can be treated cheaply and effectively if caught early, but if you can’t afford the preventative care, you end up paying many times more in the long run. Government sponsored healthcare is the ONLY way to go.
@Murph1908: U.S. health care best in the world? Hahahahaha.
No doctors in Canada because the eeevil People’s Republic of Canuckistan pay doctors a few bucks more than a Tim Horton’s or Canadian Tire clerk? Well, guess what – there’s a shortage of primary care/general practice physicians in the United States, although not in doctors shooting people full of Botox.
So instead of denying a pre-existing condition, they denied the condition pre-existence?
Our insurance company initially denied the claim for my daughter’s birth, claiming her birth was a pre-existing condition.
The health care insurance in the USA is beyond the pale. BCBS refused to cover the anaesthesia for me during a major operation… what was i suppose to do??! bring a bottle of Jack and and some bullets???? And people are fighting against having a public option?