Insurance Help...

[Pembo]

I have a question on behalf of a friend.  She had her AN surgery a year ago and the insurance company won't pay her huge bill because they are saying it was a pre-exisiting condition. Before she worked there she had been to the dr for dizziness, no diagnosis was made for several years.

She has consulted with one lawyer who doesn't think she has a case. She is considering bankruptcy due to all the massive medical bills. The hospital wanted her to pay $1000 a month. 

Does anyone have any other ideas she could try to get these bills paid?  She is mid-30's, single. She has read her some but not posted. I asked if she'd like me to post on her behalf and she was thrilled.

My An internet friend has had a rough year. She is still dealing with facial paraylsis (they cut the nerve) and all of the other nasty side effects we all talk about. Any help, suggestions, etc are welcome. 

[Battyp]

I'm no expert but I've always been told as long as you are sending them something they can't turn you into collection.  If she can't afford to pay she just can't.  5.00 a month.  How can it be pre existing if she wan't diagnosed?  I know there are a few on here who have worked or work for an insurance company.  Maybe they'll have an answer for you.  How awful!  Too much stress!

[Raydean]

Boy, this is a tough situation.  Pre existing can be pretty tricky.  Alot depends on the doctors paperwork.  If there is a mention of a possible AN it can cloud the issues.  Also if treatment was done during the pre existing clause timeframe of no coverage that's pretty hard to beat. 

Consider calling the treating hospital and ask to speak to the patient advocate.  Most hospitals have a charitable division that will help to cover medical bills if a person qualifies.  Be sure and come prepared with current checking/saving account statements and a list of all bills including what's owed and monthly payment amount.  This includes everything from house, utilities, daycare, medical, car, insurances, cell phone, credit card, everything that you owe.   The downside to this is any medical bills incurred outside the hospital such as surgeon, and office calls are not covered. The patient advocate may have additional ideas that maybe of help to you.

You might want to consider contacting DSHS for emergency medical coverage.  Being it has been a year post treatment I don't know if this is an option.  My state will go back 3 months retro.  But it's worth a try.

Lastly there is no shame in filing bankrupcy due to medical bills.  My attorney friends have told me that the majority of filings are due to unexpected medical bills.  Many attornies will offer a free consult to explore this option.

Please let your friend know that she's in our thoughts and prayers.
Raydean

[HeadCase2]

Pembo,
  I hope your friend is able to work this out to get the insurance comapany to pay the bills.  But if not, have your friend negoiate with the various entities (hospital, DRs, etc.).  One of the unfair things about our health system is that Hospitals and Doctors can charge higher rates for individuals paying their own bills than they charge an insurance company.  Insurance companies get to negoiate lower rates, with the idea that they are negoiating for a larger volume of business.  The unfair part, to me, is that the very folks who are least able to pay are charged higher rates.  Your friend should be able to negoiate lower bills.
Regards,
 Rob