Pages


Thursday, December 19, 2024

‘Not medically necessary’

BOUNTIFUL, Utah (KUTV) - A Utah family is battling an insurance company because it won’t pay for a child’s prosthetic arm.

Nine-year-old Remy Bateman has outgrown her current prosthetic, but Select Health has twice denied her from getting an updated appendage.
MORE

22 comments:

  1. They should try again. After the UHC incident, the attitude at the insurance company might have changed.

    ReplyDelete
    Replies
    1. They should insist and keep insisting. Get a consumer advocate involved. Get the nightly news involved. They'll come around, it's the standard insurance company procedure (Deny, Delay, Defend).

      Delete
  2. Call some democrats, tell them you want your child's gender changed.
    That will get attention.
    Then use the money for the prosthetics.

    ReplyDelete
  3. So, technically, they're not wrong.
    She will survive as a human being w/o both appendages. It won't cause her to die.
    Quality of life and other issues ARE an issue, which begs the question - what is medical insurance for?
    Listen, I'm not taking the side of the insurance company, truly, they're vile, evil creatures. But this gets to the crux of the issue. What do you have/buy medical insurance for? Is it to get reduced co-pays, or catastrophic insurance. Different people want it for different reasons. If you use Doctors and such regularly, it's in your interest to pay the Vig to get the discounted rates (think Costco Wholesale Club membership ROI). If you rarely use one, but don't want to lose your house b/c you have a heart-attack, you want catastrophic insurance. The premiums and coverage are far far lower on catastrophic insurance, rightly higher the other way.
    UNFORTUNATELY, the skidmark from Kenya made it so the entire country has to pay for the same services for everyone, but the insurance companies slice and dice it different ways to make you think you're not subsidizing the other people. Check your math folks, either way YOU pay 20k/year, regardless. So the people who never use the facilities end up subsidizing the folks that do use them frequently. That's what insurance pools are designed to do. Spread the risk around. The fact that it's been enacted nationally is the problem. IF it were free-market, the people making heavy use of the medical establishment wouldn't be able to pay for their insurance premiums, because it would be adjusted to reflect the cost of their use.
    AKA - for the slow folks - IT'S SOCIALISM!!!!!

    ReplyDelete
    Replies
    1. Yeah, it really pissed me off when I realized that it was illegal to get limited catastrophe only health insurance. I wanted to not cover cancer, diabetes, or heart attacks, since I know damned well the "health care" system doesn't have clue what to actually do about those anyway, and they're all hideously expensive as a result. (I have a family history - and family culture that created that history - of all three. But they're all easily treatable and preventable if you don't buy the 'doctors' lies.)

      Fuckin' feds anyway. If anyone wonders why medical care is so expensive? That's it, right there.

      John G.

      Delete
    2. People can't tell the difference between insurance and a maintenance plan for health issues, only for cars. To be consistent they should demand State Farm pay for their oil changes and tire rotations.

      Delete
    3. "That's what insurance pools are designed to do. Spread the risk around."
      And oh-by-the-way, make money for their stockholders.
      Sometimes, these ideas collide.

      Delete
  4. And one wonders why WTF happened in NYC???

    ReplyDelete
    Replies
    1. And if the victim had just been another Joe Anybody in the street, nobody would have said a word.

      Delete
  5. Well, surprise, surprise...
    "SelectHealth covers gender affirming care, including surgeries, hormone therapy, and primary care."
    - WDS

    ReplyDelete
    Replies
    1. Every health insurance company will cover that crap due to government intervention.

      Delete
  6. Has anyone called the most senior management? Maybe t(he)y might override their current stance.

    ReplyDelete
    Replies
    1. Ask them if they're planning to attend a conference in NYFC any time soon? Asking for a friend....

      Delete
  7. And we wonder why ordinary people are doing unordinary things. This is just one example among many others that banning corporate shyster lawyers might be an answer to some of society’s problems.

    ReplyDelete
  8. I deal with this all the time for some of the cancer patients I treat. Missing half a jaw and the the insurance company will declare that it is cosmetic because the prosthesis replaces the teeth…
    As well as half the upper jaw, without which the person cannot speak, chew or swallow liquids or solids. The teeth went along with the affected bone.

    But it’s just cosmetic

    Coelacanth

    ReplyDelete
  9. I have a question. If you have a child with a birth defect, does insurance actually cover a deformity you were born with?

    ReplyDelete
    Replies
    1. One of my kids born with cleft palate, insurance paid for repair surgery.

      Delete
  10. This is why the assassination of the CEO garners no sympathy from the general public. It's not often the left and the right agree in things, however this is one.

    ReplyDelete
  11. A nine year old girl will need at least three more prosthetics in the 10 years. They want the insurance ( all of us paying premiums) to cover the cost of the most advanced prosthetic available. Have we asked what they will cover? Not standing up for the Insurance Company but. lots of missing information here

    ReplyDelete
  12. I saw an article a few years back about a man whose son needed a new lower leg. Since the kid was growing and actually needed a new one almost every 6 months, dad learned about how they were made, got a 3-D printer, and began making them at home. After a stretch, he started making them for other folks in similar situations. Granted, they weren't bionic with micro-processors and such, but sometimes it may be necessary to take extraordinary measures

    ReplyDelete
  13. Insurance is the lowest scum legal businesses, well credit card companies are not any better, and there's no movement to change that, well except for the little incident in new yawk.. Multi-million dollar bonuses for the CEOs but crumbles and denials for those paying for coverage.. Fuck those POS
    JD

    ReplyDelete
  14. Maybe a bionic arm is not needed at her stage in life. My friend had a mechanical arm since he was 9. He could do most anything with his pinch arm. He would have been 62 this year.
    The bionic part may be why the insurance company is saying no. That isn't medically necessary for quality of life.


    The bionic part would be

    ReplyDelete

All comments are moderated due to spam, drunks and trolls. Keep 'em civil, coherent, short, and on topic.
Posted comments are the opinions of the commenters, not the site administrator.