Health insurers can use this loophole to push pricy medical bills onto you, the patient
Insurance companies often require patients to have medical procedures preapproved to ensure the insurers are willing to cover the costs. But that doesn’t guarantee they’ll end up paying.
Lauren Weber
Kaiser Health News
2/6/2020
The more than $34,000 in medical bills that contributed to Darla and Andy Markley’s bankruptcy and loss of their home in Beloit, Wisconsin, grew out of what felt like a broken promise.
Darla Markley, 53, said her insurer had sent her a letter preapproving her to have a battery of tests at the Mayo Clinic in neighboring Minnesota after she came down with transverse myelitis, a rare, paralyzing illness that had kept her hospitalized for over a month. But after the tests found she also had beriberi, a vitamin deficiency, Anthem Blue Cross and Blue Shield judged that the tests weren’t needed after all and refused to pay – although Markley said she and Mayo had gotten approval.
Darla Markley and her husband, Andy Markley, pose for a portrait at home in Winter Park, Florida, on Jan. 27, 2020.
While Darla learned to walk again, the Markleys tried to pay off the bills. Even after Mayo wrote off some of what they owed, her disability and Social Security checks barely covered her insurance premiums. By 2014, five years after her initial hospitalization, they had no choice but to declare bankruptcy.
Anthem Blue Cross and Blue Shield spokesperson Leslie Porras said company “records do not indicate that Ms. Markley had tests authorized that were later denied.”
https://www.usatoday.com/story/news/health/2020/02/06/retrospective-denial-how-health-insurance-practice-works/4671935002/
Medicare for All
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