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        New Message Board Archives >> 2003 Posts >> INSURANCE = CRIME 
        
(Message started by: das on Mar 28^th, 2003, 12:39pm)

Title: INSURANCE = CRIME
Post by das on Mar 28^th, 2003, 12:39pm

I am royally pissed here people. I got my doctor to submit a form to my insurance (criminals) company about my need for oxygen. They refused me !!!!!! They said according to my doctor, I do not have a condition that requires oxygen !!!!!!!!!! They are right I use it for fun. I go to my neuro at the imaginary clinic, get a prescription for my imaginary disease and wooohoo oxygen for me!!! Wow what joy at having oxygen for nothing.

Am I alone in my belief that insurance companies are the biggest scam artists around?

I am ready to go postal on their motherf&*#$n asses.

Title: Re: INSURANCE = CRIME
Post by Roxy on Mar 28^th, 2003, 12:45pm

das, just go to your nearest welding shop. It will work just as well, and it's not very expensive.

Sorry you're having hell with them,
Tracey

Title: Re: INSURANCE = CRIME
Post by Tim_w on Mar 28^th, 2003, 12:53pm

Das
DO NOT GET ME STARTED >:( :-X !!!!!!
Tim_w

Title: Re: INSURANCE = CRIME
Post by amber on Mar 28^th, 2003, 1:00pm

Das, I'm speechless...

I'm going in to talk to my doc on tuesday about getting some o2 to try as I haven't yet. Where have you been getting it in town? How expensive is it? And about the welding shop...where would we go here in town and where do I get a non-rebreather mask?

das...all i gotta say is..they suck. who is your insurance ...blue cross?

amber

Title: Re: INSURANCE = CRIME
Post by Bob_Johnson on Mar 28^th, 2003, 1:52pm

Suggest that you ASK the insurance company why thery declined. It may be that they do not have information which shows oxygen to be a "standard" treatlment for cluster. If this is the case, then search the OUCH library for MEDICAL journal articles (NOT reports from this message board) which support the use of oxygen; get copies via your library and send to the insurance medical director.

Title: Re: INSURANCE = CRIME
Post by amber on Mar 28^th, 2003, 2:22pm

good idea bob

Das, mah man...here's one:

http://www.ion.ucl.ac.uk/~headache/cluster.html

Title: Re: INSURANCE = CRIME
Post by cootie on Mar 28^th, 2003, 2:26pm

Oxygen doesn't hit me as a party drug.....what gives ? Not to informed Pam

Title: Re: INSURANCE = CRIME
Post by Bob P on Mar 28^th, 2003, 3:00pm

AH, the good old OUCH Library:

http://www.clusterheadaches.org/library/medications/O2.htm

Title: Re: INSURANCE = CRIME
Post by jonny on Mar 28^th, 2003, 3:40pm

on 03/28/03 at 14:26:28, cootie wrote:

Oxygen doesn't hit me as a party drug.....what gives ? Not to informed Pam

Its no party drug but it sure will light up the house if used wrong, just ask Kip.....LOL

.............................jonny

Title: Re: INSURANCE = CRIME
Post by das on Mar 31^st, 2003, 1:51pm

Just spoke to my insurance cmpany (Liberty Health is the name of these crooks) and they refused my demand for oxygen coverage on grounds of it being an "experimental treatment" . What a scam !!!!!

Title: Re: INSURANCE = CRIME
Post by amber on Mar 31^st, 2003, 3:53pm

god they're cheap.

wonder if any other health care would cover it??? maybe we here in the city should look into it.

How much do you pay for it now? I"m looking to get some tomorrow.

Take care das...i'm sorry they're being so miserly.
Amber

Title: Re: INSURANCE = CRIME
Post by das on Mar 31^st, 2003, 4:01pm

I pay 45$ CAND for two tanks (2.5 feet high) don't know their exact volume. Plus 16$ per refill. I can go through a tank in 2-3 days easy during hard times. Do the math. It isn't cheap.

The place I get it from is called Oxymed 514.389.8245

Title: Re: INSURANCE = CRIME
Post by achinghead on Mar 31^st, 2003, 4:27pm

Dont feel bad.. I just found out the same thing a few minutes.. Ins co says I have to have a level of 88.... in order for them to consider it a medical necessity. One place told me I can come in and do a self pay.. gonna cost me about 120-160 initially.. then 15 to refill.. dont forget.. you also have to have a prescription to get off of it too or else the medical supply will NOT accept it and will keep billing you your monthly rental.. I just found all this out today.. SUCKS.. HATE EM!!. may not be cheap but still hell of alot cheaper than the imitrex injections.. Ive about maxed my credit cards out on em and now am into writing checks.. 4 alone this past week at 140 a pop.. do the math.. WHERES JUSTICE FOR OUR "WORST PAIN HUMANLY IMMAGINABLE" Why dont we go picket in DC!... IM READY.. lets just make sure were all in the middle of our cycles and the beast shows his face at the time!

Title: Re: INSURANCE = CRIME
Post by amber on Mar 31^st, 2003, 11:22pm

das..that's so fricking lame. And totally expensive...
keep in mind we're talking about air.

Isn't this in some book from the 50's..the day when we'd have to pay to breathe fresh air? ;)
it's the man..he's trying to bring us down. Just who exactly decided that OXYGEN was a controlled substance.

Title: Re: INSURANCE = CRIME
Post by Frank on Mar 31^st, 2003, 11:40pm

I talked with my doctor about this subject the last time O2 was denied. Although I received a denial letter from the INSURANCE CO... my doctor told me that the decision is actually made by the local primary care physician group (mine is an HMO) without the insurance company's involvement. The letter from the insurance company is just a legal formality that occurs after the fact.

I told my doctor that the denial was based on a blood oxymeter test showing my blood oxygen level was above 95%, therefore the review board decided that my medical condition did not required supplemental oxygen.

My doctor was so pissed after I told him that... O2 showed up at my house the next day after my visit this cycle.

Title: Re: INSURANCE = CRIME
Post by Frank on Mar 31^st, 2003, 11:54pm

on 03/31/03 at 16:27:55, achinghead wrote:

Dont feel bad.. I just found out the same thing a few minutes.. Ins co says I have to have a level of 88.... in order for them to consider it a medical necessity.

I just saw your post. Bingo! They're doing the same thing to you that they did to me last cycle. They're assuming that since your blood O2 is above 88 (mine was over 95) you must not have a coronary or pulmonary disease that requires O2 treatment.

Your doctor needs to plainly state on the request that it is for the acute treatment of cluster headache attacks... and maybe cite a couple of relevant medical journal articles stating that O2 therapy is an accepted treatment. Good luck.

Title: Re: INSURANCE = CRIME
Post by amber on Apr 1^st, 2003, 8:36am

thanks frank
that's what I'm going to do today *crosses fingers*
this is so frickin lame.

Title: Re: INSURANCE = CRIME
Post by hdbngr on Apr 1^st, 2003, 11:28am

Das:

Insurance companies are all about time and money, so hit them where it hurts until they see you as a person, not a number that pays a premium.

Keep calling them, every day at the same time. Try and talk to the same person, and be disgustingly polite. Keep notes. Date, time, name. Reference them frequently, to their annoyance.

Have your Doctor call on your behalf, explaining why O2 is important for pain relief. It is less expensive than the triptans. Have him send medical documentation on your behalf. Insurance companies also have to send a disputed treatment to medical review board.

Obviously, you don't have Chronic pulmonary disease, so them saying you aren't below 88 is irrelevant and silly. A pulse ox reading isn't needed, a patient file reading is. You aren't asking for O2 for a heart or lung condition, but a pain condition.

If you call them every day for two weeks, they will likely give it to you just to save there staff the time of having to deal with you on a daily basis. This has actually worked for me. ;)