It makes zero sense. United Healthcare profits are billions of dollars per year. We pay premium premiums for the best health care plan that's offered. I had to go in for a second X-ray, wasting time, money, and some extra radiation, to satisfy them. I have had bone on bone knees for years now, and the pain in the right knee has been killer, as I've said so many times. As of yesterday, United Healthcare is deciding not to cover the surgery.
I've had five pre-surgical appointments, and have been cleared by all doctors. I've got my supplies stocked up here, and am getting mentally ready for this. So pray they are just being big jerks! Insurance companies and pharmaceutical companies rule the world. Oh, United Healthcare also specifically mentioned that the robotic surgery is not deemed necessary, as it "doesn't have good outcomes", based on their research. My research says different, the physician's assistant I spoke to today said it is very specific and precision, cutting what needs to be cut, resulting in quicker and better healing.
Never a dull moment, right? The doctor's office called me yesterday and said they are making a "last ditch effort" to get the coverage, but if U. H. doesn't consent, I do not get the surgery. I do feel like I'm going to cry, but it won't do any good.
Right now we are 95% packed to go on our camping trip, and it's hitting us hard that we're taking only one dog. Sunny seems so low these days. I hope she cheers up at the lake, and doesn't miss Suri severely, as it'll be so strange for her to go chase that stick all alone.
Aww, I did not mean to write a woeful post, I'm actually quite happy. Life has it's challenges. God is good, no matter the circumstances, and it's always hopeful, as it is written: "All things work together for the good for those who love God..." Romans 8:28
It doesn't mean that we automatically are just dumb and happy, but we work hard to be at rest, and fight against the thoughts of anxiety and worry and doom and gloom. It's called a fight of faith for a reason!
You all have a good day, off we go camping...(yay!!!! that alone = happy!!!!). I'll keep you posted!
14 comments:
So glad that I live in a country with universal health care!
Grrrrr! As a nurse, I'm so sick of insurance companies trying to be doctors. They control procedures, medications, who you can see, I'm so sorry you are dealing with this.
I'm so sorry - saying prayers that your health care issues are worked out. Insurance companies = well - grrrrrrr!!!!! I feel terrible for you because I know you have worked so hard to mentally prepare for the challenges of surgery. I truly hope that you have a restful and relaxing camping trip!
Praying for you!
My husband had robotic hip surgery 7 weeks ago he was walking and going up steps in the recovery room. He used a walker less than a week and within 2 weeks was doing 5000 steps. He is now doing laps in the pool at age 76! Robotic surgery is the best as you mentioned less cutting thru muscles. I will keep you in prayer that the insurance will arrive this and if they do your recovery will be easier.
Enjoy your camping trip I have fond memories of Westcott beach, lake Eaton and nicks lake camping trips when we lived up there. Great memories
Prayers lifted that you will get the surgery. (I had/have UHC) I didn't have robotic and my surgeon did a great job so if you need to switch, don't worry. Enjoy your camping trip and prayers lifted for your pup to get through the grief, too. xo
Oh dear……that isn’t good news at all! How can that happen? 🤷♀️ I’m just so sorry to read this. Fingers crossed for better news.
I hope you have a wonderful weekend camping and the weather is good. This smoke is awful though 😬😬😬 Hopefully Sunny perks up camping. It’s hard on them though. They don’t understand what’s going on. 🥺
Enjoy ☺️
Marilyn from Canada 🇨🇦
I.m sorry your surgery was denied. I hope the appeal works.if the appeal is denied ask for your case to be reviewed at a higher level. Your state insurance commission or attorney generals office should also be able to help you. Insurance companies should not be able to deny a procedure you have seen 5 doctors for,The pain and lack of mobility you are dealing with is hard.
Mary
I wonder if they will change their minds as you get older. I thought in one of your first posts, you said the doctor said you were too young to have a replacement. I also wonder if you should try not taking the robotic approach, and do the full open knee surgery, since they are specifically saying that is the reason for the denial. It might take longer to heal, but it would get you the same relief in the end, wouldn't it?
Oh no on the denial...so sorry. Camping sounds fun my friend.
Oh yes... the power of the insurance companies! How did we get to this point!??? I know a nurse who went to work for one of the big insurance guys (U). The nurses manning the phones and insurance claims get bonuses based on how they can save the company money. I bring this up because she "ok'd" a 5 year old getting treatment for cancer when the company wanted a denial. She got in huge trouble for approving it but she said her moral compass was stronger than her supervisors. (We also had my husbands back surgery denied... the DAY BEFORE SURGERY. :) Our surgeon (who had had similar happen with his own father a few years ago) said "Oh no they don't don't! That's on US - we will take care of it. I'm going to make sure they have all the scans and paperwork and things they need and will personally write statements. Don't worry... I'll get on my staff today and we'll get this done." And he did.
Have your Dr keep submitting appeals, have them request a "peer to peer" call, but don't let your Dr give up. I worked with UHC and saw this a lot, do not give up!!
What the heck??? I am so sorry, my friend!!! Prayers! Keep fighting!
I’m so sorry. The state of healthcare & insurance is horrible these days. We don’t even have insurance anymore (self employed and it’s too expensive). We have a healthshare and never know if it will actually cover anything, but it is cheaper than regular insurance & deductibles. It sounds like you have a very painful condition. I hope you are able to get the surgery covered.
Post a Comment