"I had the insurance company deny my claim for my hospital stay when I had a stroke because they said it wasn’t 'medically necessary.' A STROKE!"
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After UnitedHealthcare CEO Brian Thompson was shot and killed by a masked gunman in Midtown Manhattan, the internet was flooded with stories of health insurance claims being denied (while these corporations rake in billions in profit).
Last week, we shared some of those heartbreaking stories. But thanks to our hellish American healthcare system, over 300 people in the BuzzFeed Community added their own experiences in the comments, and we just had to share those, too:
Note: BuzzFeed cannot confirm the validity of any of these stories as they're just comments on the internet.
1. "My partner of 34 years had liver cancer. After we found out that the latest round of chemotherapy wasn’t working, he was referred for a clinical trial. He went for the initial appointment and found out he was a good candidate. They'd had success in treating this type of cancer, he qualified for the program, and all they had to do was get insurance approval. Insurance started dragging their feet asking impossible questions. During the approval wait, which began to get lengthy, he got sicker."
"We went to the hospital only to find out the cancer had spread to his chest, lungs, and lower stomach. The emergency room doctor said he sees this all the time. The insurance companies start dragging their feet so the person will get sicker and no longer qualify for the clinical trial. He passed away within a couple of weeks. This is a person’s life that the insurance company played with. How can they get away with this? I just don’t understand, and it breaks my heart."
—Anonymous
2. "I am diabetic, and at the height of COVID-19, my doctor said we had no other options; I needed to start insulin. It made a massive difference in my health and life. Fast-forward a year later, I tried to pick up my prescription from the pharmacy, and they said my insurance had denied it. When I called to find out what was wrong, they told me it was not medically necessary. I proceeded to pay $800 per month out of pocket for my medication while my doctor's office fought with them for the following year. I was never reimbursed."
—Anonymous
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3. "I was pregnant with twins and had to deliver them at 34 weeks via C-section. My doctor was in-network, the hospital I delivered at was in-network, but the NICU in the same hospital was NOT in-network. Our babies spent a week in the NICU, and we got a bill for $100,000 for their one-week stay. Fought the insurance for almost a year to get it covered."
—Anonymous
4. "When my daughter was 20 and seriously addicted to opioids at the height of the pill crisis in Staten Island, I was denied when I tried to place her in an in-patient facility. We had what I thought was wonderful coverage through an NYC union. This was after they had already denied a prescription for Suboxone to try to handle her addiction (which I had been forced to pay out of pocket). Insurance said they would only pay for 30 days of outpatient treatment. I explained the very people who sold drugs waited outside of outpatient therapy to make sales. I was in tears and told the agent if she didn’t get into the right treatment, I didn’t think she would make it to 21."
"The agent then said, 'Well if she does, you can kick her off your coverage, she can go on Medicaid, and they can pay.' I took the last bit of money I had received from my mother's death (which was also hastened by insurance denials) and spent $60,000 to help my daughter. Thankfully, my daughter is now doing wonderful thanks to her therapy, but there is a special place in hell for insurance agents."
—Anonymous
5. "My daughter with autism is on a non-stimulant ADHD medication. It took six months to find the right 'fit.' During that time, you have to stay on each medication for four to six weeks before you can say, 'This did not work.' We went through hell. Sometimes, she couldn’t eat. Sometimes, she would become physically violent to us and her teachers. Sometimes, she would cry, and I would have to rock her because she was so amped up. After all that time, two years ago, we found a medication that our insurance covered and worked amazing. Last week, we found out that at the start of next year, her medication will no longer be covered."
"I cannot believe they can legally do this!! We cannot go through the testing phase of medications for her again and will now have to pay out of pocket for her meds."
—awfulknight45
6. "An $8,600 ambulance charge was denied because the ambulance was out of network. I guess when you are having a life-threatening emergency, you should call your insurance company to make sure that the ambulance is in network."
—Anonymous
7. "My mother’s cancer meds cost her $6k/month out of pocket. Insurance is paying about $30k, but the fact that she’s bearing a $72k/year cost for lifesaving meds is absolutely fucking wild. And, yes, my parents are really fucking fortunate in that they can afford it. But my father-in-law’s cancer meds that are covered are beginning to stop working. The next best meds carry a $10k/month out-of-pocket cost. He can’t pay that, and we can’t afford it either. So he’s just supposed to die because insurance, big pharma, and the federal government don’t give a shit."
—bird_dont_sing
8. "I had the insurance company deny my claim for my hospital stay when I had a stroke because they said it wasn’t 'medically necessary.' A FUCKING STROKE!"
—Anonymous
9. "My daughter has cerebral palsy. She was denied a wheelchair because she can walk (sort of). She wears leg orthotics and can’t walk long distances. She tires easily and then falls. This means we can’t go anywhere with lots of walking, like museums or the zoo, without renting a wheelchair from the venue."
—Anonymous
10. "My husband had to have hernia surgery. He went through the steps and even had pre-approval from the insurance company because we had no money to cover this. Then, we received a bill for the entire procedure and a notice the claim was denied. He called and was told to resubmit. The person on the phone said that it was a usual practice to deny every third or fourth claim for no reason, and the company kept the money. He was able to resubmit and get this done. Imagine being too sick or unable to do this! The second claim was paid in full. They’re just interested in big profits."
—Anonymous
11. "I have MS, which is where your immune system basically takes nibbles out of your brain and spinal cord. After an MRI, my neurologist said I needed to switch medications because I had concerning levels of brain atrophy. Basically, I have less brain than before. I switched to a better drug, and the insurance denied it because the reason to switch wasn’t deemed bad enough because there were no new lesions (scars left by the nibbles)."
—Anonymous
12. "My health insurance denied a PET scan for my husband. He had been diagnosed with a very rare cancer with possible metastatic spread. The first denial claimed it was because he hadn’t had a liver biopsy yet, which he had. The second denial claimed it was because PET scans hadn’t proven their efficacy (they were the 'gold standard' test for a decade at that time). The cancer metastasized, and he died six months after diagnosis. He was 51."
—Anonymous
13. "I was denied a prophylactic mastectomy and reconstruction. I had thyroid cancer, my mom had breast cancer, and I have a genetic mutation also putting me at higher risk (that my mom doesn’t even carry). My oncologist estimated my risk factor to be over 70% for developing breast cancer. Insurance said it wasn’t medically necessary. My sister carries the same mutation and had not had any personal cancer. Her insurance approved her for the surgery, and she had two different types of precancerous cells. I’m older than her and had cancer, so that worries me."
—Anonymous
14. "My husband is a below-knee amputee. He needed a new prosthetic due to changes in his stump, a normal change, especially early on. He was denied as the insurance company said it was not medically necessary. Apparently, they thought he should hop everywhere?"
—Anonymous
15. "When I was 17, I had surgical complications that almost killed me. In the hospital, over the course of several months, my doctors stabilized me on Lyrica for pain management. On discharge day, they got the call that my insurance wouldn't cover it. What *do* they cover, you ask? The cheap medication (narcotics). I developed a dependency and became an addict as a high schooler. I stood no chance, in part because they would refuse to cover anything other than narcotics for the next six years until the opioid crisis took off in the news."
—Anonymous
16. "I had five heart attacks years ago and needed an open heart surgery. After the surgery, insurance dropped me like a hot potato. I had to wait a couple of years without having any insurance because I had a pre-existing condition, and no insurance company would extend health insurance to me. Luckily, I was able to be insured again once former president Obama came up with Obamacare and the insurance companies couldn’t deny insurance to people with pre-existing conditions."
"For all those who voted for Trump again, they should know that he wanted to get rid of Obamacare. If he is ever successful at it, that would mean that I and millions of other patients with pre-existing conditions could be left to die with no insurance to cover our health issues."
—Anonymous
17. "I was in residential treatment for an eating disorder. I had to go home after nine days because my coverage was denied, and my parents couldn’t afford it. The deductible ate their extremely limited savings, and I carried the medical debt for years to come. Eat. The. Rich."
—PinkPrincess88
18. And finally, "When my sister had breast cancer, it eventually metastasized to her brain. Her doctor recommended gamma knife surgery, which at the time was still a little new but was an accepted treatment. The insurance dicked around for months until her doctor was finally successful in getting it approved. After the procedure, they did another MRI — all the lesions that were identified in the previous MRI were gone, but in the time it took for insurance to agree to cover it, new ones had appeared. That's when I knew it was over for her. She died less than three months later."
"It's been 20 years now, and my mom still won't tell me who her insurer was as I would still rip them a new one. I work in oncology and know that brain cancer/mets are a death sentence almost all the time, but she still could've had a bit longer if they weren't such fuckers. Her reaction to learning the news when it was time for hospice still breaks my heart: 'I thought I had more time.' She was only 43 — she should've had more."
—sisterhavoc
Have you ever been denied an insurance claim? Share your story in the comments below.
Note: Some responses have been edited for length and/or clarity.