I recently applied to receive health insurance through Pacific Source Health Plans based on glowing reviews from not only doctors but patients and insurance agents as well. Everything I’ve heard about them has been good. It was refreshing to hear such good things, considering how many people (including me) hated a company I used before, Lifewise. So I was excited when I applied.
However, I knew, based on previous back, leg, and other problems, I had this gut feeling I wouldn’t get covered. I made it quite clear on the application what was going on and treatment. I was just hoping, I guess. Even if my back problems weren’t covered, it would be nice to have the insurance for other stuff.
Word came today: Application denied. For me, at least. My wife and two babies are covered (for the same premium price, which is annoying, but they charge a flat rate for 3+ people), but I’m out in the dark now, and still paying out of pocket.
Since I was denied, I’m eligible to apply for the Oregon Medical Insurance Pool (OMIP). It’s basically a state-subsidized program for people like me who are screwed. But I’ll still have to pay for it, and affording two seperate premiums is something I know I can’t afford right now. I might have to apply for FHIAP as well.
Why am I needing this so bad? Because my back and leg is still killing me. I did good stretching and exercise for three weeks, and it hurt it even more. I’m in too much pain to work out any more, and everything hurts to bad to even stretch anymore. I can barely move, and certainly can’t do the extra work I’ve got on my plate to make the extra money I need (I have five web sites lined up, but I’m so damn tired and sore all the time that I can’t do them).
I took the day off today (Sunday — I usually work today) as my leg was hurting pretty bad. Damn nerve pinch. I’m skipping out on work tomorrow, too, to see if I can rest my back some more and (possibly) get into a specialist, as yesterday was an awful day. I spent about 4 hours in my parents hot tub (not in succession) and could barely walk because of the pain. I’m pretty doped up right now, and I’m feeling good if I don’t have to walk.
We’ll just see what happens. Anybody know a bone/joint doctor who needs some Web/computer work done? 😉
Comments
Dude, you might want to try a chiropracter. They’re pretty affordable, and they may be able to help you.
I’d recommend someone, but I’m in Portland.
I’ve already seen three chiros, finally found one that I think knows what he’s doing, and even he’s skeptical if he can help me.
It’s been three days since I’ve been able to walk, and I’ve had to miss work (been working from my couch, so not entirely out of it). I’m seeing a specialist in a couple days.
damn. its too bad you’re in Bend, cos there’s an extremely excellent spine specialist out here in Coos Bay named Dara Parvin.
Isn’t it weird that North Bend is waaay south of Bend?
Damn, being in pain sucks, and not having coverage for yourself sucks just as bad. is Unicare insurance available in Oregon? i don’t know if they’re any good or not, but when i was unemployed last year i considered applying with them for coverage. i think it was all those television commercials, since i spent a lot of time with my friend the TV back then.
I too have been suffering for many years with three protruding disks in my back and spinal stenosis. In 1998, I couldn’t walk a 100 yards without a wheelchair, nor could I stand for more than a few minutes. Since then I have been getting Rolfing treatments. See http://www.rolf.org/ if you want an explanation. I can now walk as far as I want. I still get tired, but I’m no spring chicken any more. Good luck
I was involved in an automobile accident where I was broadsided by an uninsured motorist that did not have a driver license and did not own the car. Luckily, I had great uninsured motorist insurance. The problem was that United Healthcare would not approve the only procedures that would solve my problem, even though they would be totally reimbursed for the procedure.
I am in need of a disc replacement surgery which UHC has covered before for other patients, but, they send me denials saying that they do cover because they say it is an unproven procedure. This is the only procedure that will solve my condition. I am unable to work because the pain of driving for more than 20 minutes or sitting in a chair for 20 minutes is too severe. I get no sleep because the pain wakes me up every 30 minutes.
They provide phone numbers in their letters that are disconnected. They provide no way to contact them by email although doctors have a way to email them. They provide no address to contact them. If you call their 1 800 numbers it will put you into loops and disconnect you countless times. The customer service reps regularly give me phone numbers that do not work or that have a message box that is constantly full. They will not let you speak to anyone that can assist you. I think they are instructed to give you the run around until you give up. If you press them on anything they tell you another department handles that and they switch you to a number that tells you to call the 1 800 number then disconnects. It is genius if you think about it. Deny, confuse, point in the wrong direction, and make communication impossible. That way they can say they did not do anything wrong — because they did not do anything at all – thereby it could not be wrong. It is a racket. When I ask them to tell me any other procedure that might solve my condition, they say they do not have one but will deny the only option that I do have. I am stuck in insurance hell and my life is being ruined because of it. I can not work, I can not fufill my obligations to my family, I can not sleep, I can not have sex, I can not drive distances and I have had to stop three times during my typing of this message because of pain.
One operation will solve this but they will not approve it. Or they are waiting as long as they can to approve it. My life is ruined right now. I am at the end of my rope. I am getting despondent and do not know what to do. If anyone knows how to get things approved, have had similar experiences or know about the appeals process, please email me. I am just about to contact the Attorney General, the Insurance Commissioner and a private attorney. Any supporting information would help. Sincerely in distress and pain,
Kevin maris