Subject: Re: Re: Re: Re: Re: Re: UNITED CHEAPSKATES

Comments:
: : : : : : My spouse and I pay over $300.00 in monthly premium, only to have United Healthcare disallow $1,400 on a nationally-recommended, routine diagnostic colonoscopy! Now that I know they are in the business of micro-management insanity I will wait until I'm dying from colon cancer so the tab to United Healthcare will make the $1400 seem like chump change to the micromanagement chumps who make these penny-wise, pound-foolish denials of prudent, preventive health activities by those of us who are really paying the tab in ridiculously high premiums - the damn consumers! : : : : : Was this test ordered by a physican as ROUTINE, or did he have a reason to have the test done?? : : : : : In other words, was the test "medically necessary?" : : : : The test was "medically necessary". I complained of symptoms. That's not the issue! The media makes a point of telling EVERYONE to have a ROUTINE colonoscopy! They better tell them to dig deep into their pockets to pay for it since insurance companies would rather have covered individuals to wait until they have to have major surgery costing MUCH, MUCH more than this important screening. : : : That is the point!!! An insurance contract specifies what it will pay and what it will not pay. You can't just go to the doctor to have what ever test you want when ever you want them. What if a person wanted to have a physical every six months, should the ins. co. pay?? Do you have any idea what that would do to your premiums?? : : : Most test should be medically necessary in order to be paid. In order to maintain an affortable premium, un-medically test can't be paid. : : : Everyone wants to go to heaven but no one wants to die. If the tests are not medically necessary, pay for them yourself. That is just the way it is. : : #1 - Heaven is not a place. It's a state of mind and one doesn't have to die to "go there." : : #2 - Who should determine "medical necessity" - surely you don't believe the insurance company should. If a physician orders a test, isn't it UNDERSTOOD that the almighty physician has deemed it "medically necessary"? If the insurer questions that, then the insurer should also question having such a physician in its "family of physicians" - or is THAT decision based solely on the BOTTOM LINE. That's rhetorical. I know the answer. : : #3 You obviously are a part of the insurance industry and therefore biased, lessening rationality of PREVENTIVE MAINTENANCE (MUCH CHEAPER THAN CRISIS MANAGEMENT AND REHABILITATIVE MAINTENANCE). : Why did the MD order the test? Did he suscept anything or was it routine?? : If the insurance is going to have to be the one to pay out the money, they get to be the one who determines whether it is necessary or not. : You didn't address the issue if a person wanted to have a complete physical done every six months, should it be paid by the insurance co.? : How would that impact your premium?

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