Friday, January 19, 2018

When the Patient Is the Loser

A major insurer takes a 20-year, first-line standard treatment off its preferred list in one market. But where will it end?


PUBLISHED January 19, 2018

Martha lives in Illinois and was diagnosed with metastatic breast cancer in January 2015. She has a husband and three children, ranging in age from 12 to 18, a dog and a lizard.
My health insurance has made it possible for my family to remain financially "OK.” It has covered my ongoing treatment for just over three years now, with manageable co-payments and various other charges. There have been runarounds with some services, mostly to do with my children and not the big-ticket item (me).

Even with the overall positive experience, I dread having to call the insurance company. Will they comment on the expense of my care? Will that expense be determined to be too high? Should I plan to do nothing all day except speak to the insurer once I dial those numbers? I know I'm fortunate to have good insurance and that the insurance company's representatives are mostly helpful, polite and kind. But, really, I am at the mercy of my insurer.




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