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WillyT

(72,631 posts) Mon Nov 24, 2014, 02:23 PM Nov 2014

My Insurance Company Killed Me, Despite Obamacare - DailyBeast [View all]

My Insurance Company Killed Me, Despite Obamacare
Malcolm MacDougall, a prominent speechwriter and creative director, was diagnosed with prostate cancer earlier this year. Even after the passage of the Affordable Care Act, his insurance company delayed and denied cancer treatments despite MacDougall paying his premiums. This is his story, in his own words, written five days before he died.
Malcolm MacDougall - DailyBeast
11.24.14

<snip>

How far will a health-insurance company go to deny coverage when you are really sick?

How willing are they to risk their customers’ health and possibly their lives? Well let me tell you my experience with Health Republic and its affiliate MagnaCare.

For five months—ever since I was diagnosed with stage-four metastasized prostate cancer—they refused to pay my medical bills. On Oct. 20, a nurse with Health Republic overruled my oncologist and my primary-care physician and declared that a critical test to determine the progress of my cancer was unnecessary.

It seems she was wrong. As a result, I am writing this from Lenox Hill Hospital, where I am undergoing emergency tests and treatments ordered by three prominent New York doctors who didn’t agree with that health-insurance nurse.

This latest fiasco is not at all surprising. I have been fighting to get Health Republic and MagnaCare to explain why they suddenly and inexplicably refused to pay for my doctors and my treatments even though I followed their rules for members, went to their online list of providers, and actually received two form letters stating the treatments the doctors had ordered were legitimate.

It’s a long story, but if you want to know what it’s like dealing with the health-insurance bureaucracy when it’s a matter of life and death, you might want to stick with me.

My health-insurance company has refused to explain why, on every visit, these doctors accepted my Health Republic/MagnaCare card, and assured me I was “in network”… or why the doctors I saw appeared in the insurance company’s website of providers… or why they sent me two letters assuring me that my treatments “meet criteria and have been certified”… or why they waited five long, costly months to tell me that my doctors were not “in network.”

Bottom Line: They won’t pay. Period. So don’t ask.

<snip>

More: http://www.thedailybeast.com/articles/2014/11/24/how-the-health-care-bureaucracy-killed-me.html#

105 replies

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My Insurance Company Killed Me, Despite Obamacare - DailyBeast [View all] WillyT Nov 2014 OP

Very sad Faux pas Nov 2014 #1

It wasn't the ACA that killed him. At his age AND with that condition, he was dying anyway. pnwmom Nov 2014 #2

Often people in hospice live a bit longer SheilaT Nov 2014 #6

His doctors recommended these tests and treatments BrotherIvan Nov 2014 #7

Doctors are loathe to give up no matter what, pnwmom Nov 2014 #12

I agree Mz Pip Nov 2014 #31

Oh for Pete's sake - his age was incidental as they deny deny deny whatever truedelphi Nov 2014 #54

His age combined with his diagnosis of stage 4 cancer is anything but incidental. pnwmom Nov 2014 #61

if hes 85 Isnt he on medicare anyway? elehhhhna Nov 2014 #55

Nope. jeff47 Nov 2014 #57

He should -- but he must have opted for the private version, "Medicare Advantage" pnwmom Nov 2014 #62

Medicare is not remotely single payer. former9thward Nov 2014 #86

Your definition isn't remotely the definition of "single-payer." pnwmom Nov 2014 #87

No what we have now is people on Medicare making payments former9thward Nov 2014 #88

You still don't understand because you're confusing PAYER with PAYEE. pnwmom Nov 2014 #89

The problem is that people on Medicare former9thward Nov 2014 #91

Well, single-payer won't solve that problem. pnwmom Nov 2014 #92

It's mind boggling Dorian Gray Nov 2014 #16

It's mind boggling to me that you think it's okay to blame Obamacare, pnwmom Nov 2014 #35

Obamacare isn't Medicare BrotherIvan Nov 2014 #59

His private "Medicare Advantage" plan is NOT governed by the ACA. pnwmom Nov 2014 #63

I didn't say anything about Obamacare Dorian Gray Nov 2014 #68

It's her job LondonReign2 Nov 2014 #83

+1 eggplant Nov 2014 #18

Here's a weird thought -- Nuclear Unicorn Nov 2014 #20

He was an 85 yr. old on Medicare so this has nothing at all to do with Obamacare. pnwmom Nov 2014 #32

What's his age got to do with anything? Either he has paid ito the coverage pool or he Nuclear Unicorn Nov 2014 #36

His age means he was eligible for Medicare. Standard Medicare pays the bills, pnwmom Nov 2014 #37

Wow... So Just Let 'Em Die ??? WillyT Nov 2014 #64

Hospice provides palliative care, which I strongly prefer to pnwmom Nov 2014 #65

It's Still The DOCTOR'S Call !!! WillyT Nov 2014 #67

Medicare does not necessarily mean single payer. Ms. Toad Nov 2014 #74

Medicare Advantage isn't really Medicare. As you say, it's the private insurance pnwmom Nov 2014 #78

My point is that just because he is 85 doesn't mean he is on single payer. Ms. Toad Nov 2014 #79

But this has nothing to do with Obamacare, as he implies. pnwmom Nov 2014 #81

This is what I was responding to: Ms. Toad Nov 2014 #85

I'll remember to always demand a new car from my car insurance company after any fender bender... Silent3 Nov 2014 #47

Sounds death-panelly Nuclear Unicorn Nov 2014 #51

There isn't a single medical system in the world that isn't a bit "death panelly" Silent3 Nov 2014 #73

Appealing to the error of others is not justification for committing new errors. Nuclear Unicorn Dec 2014 #93

Where did I say anything about "the error of others"? Silent3 Dec 2014 #94

The scarcity, as far as the OP is concerned, is artificial and bureaucratic. nt Nuclear Unicorn Dec 2014 #96

There isn't an unlimited amount of funds available for healthcare in any system. n/t pnwmom Dec 2014 #98

Maybe some scarcity, not anywhere near all of it. Silent3 Dec 2014 #99

Science should be used to determine which people have the greatest likelihood pnwmom Dec 2014 #97

Eugenics sucks. nt Nuclear Unicorn Dec 2014 #101

You might want to look up what eugenics is before you post incorrectly about it. HERVEPA Dec 2014 #103

This has nothing to do with eugenics. Hint: pnwmom Dec 2014 #105

Doctors often call for tests, not because they will extend your life or rhett o rick Nov 2014 #72

Think how much money could be saved if they stated at age 50. JEB Nov 2014 #76

He said "despite Obamacare", not *because* of it. moriah Dec 2014 #95

The 99% are a natural resource to be exploited; mined, processed, packaged, sold and consumed Fumesucker Nov 2014 #3

And so the dance on this thread begins BrotherIvan Nov 2014 #4

The ACA's best achievement is that it made sure that more uninsured people Maedhros Nov 2014 #14

The Medicaid expansion was the best part BrotherIvan Nov 2014 #29

The real test will be whether the ACA reduces medical bankruptcies. Maedhros Nov 2014 #38

He was 86. Medicare should have paid for everything. jeff47 Nov 2014 #22

True, Medicare would have been better BrotherIvan Nov 2014 #24

Yes, it would. But sometimes you gotta climb a hill before you climb a mountain. (nt) jeff47 Nov 2014 #25

Ok BrotherIvan Nov 2014 #27

Then you don't shut up. You yell at the right people. jeff47 Nov 2014 #30

This message was self-deleted by its author Corruption Inc Dec 2014 #102

Reading. Try it. jeff47 Dec 2014 #104

Did he have one of those policies that "they liked and wanted to keep"? In other words did his jwirr Nov 2014 #5

You do know that the ACA is not an insurance company right? BrotherIvan Nov 2014 #8

Of course but they set up a market with policies that fit their criteria. When this first started jwirr Nov 2014 #10

I wondered that, too. Obamacare doesn't cover every policy. n/t pnwmom Nov 2014 #13

He was 85 years old. He should have been on Medicare. ACA is for those under 65 years old. Fla Dem Nov 2014 #15

I also wondered about the Medicare ctaylors6 Nov 2014 #17

Part of a pension? jwirr Nov 2014 #50

If he were self employeed and didn't pay into Medicare, going through an ACA csziggy Dec 2014 #100

It sounds like he had a Medicare Advantage plan. jeff47 Nov 2014 #21

That is really sad but it's insurance not healthcare. dilby Nov 2014 #9

LOL good plan. jwirr Nov 2014 #11

Yep, a bottle of hydrocodone a bottle of valium, and a liter of the good Crown. LiberalArkie Nov 2014 #23

Don't be daft. Take it from me: A hospice setting eases one out, if you know what I mean. WinkyDink Nov 2014 #82

Single, no family, no kids. Just a dog and cats. LiberalArkie Nov 2014 #84

Me too. bravenak Nov 2014 #28

He was 86. "Obamacare" isn't the issue. jeff47 Nov 2014 #19

BINGO! I knew there B Calm Nov 2014 #26

And "Medicare Advantage" was put into place well before the ACA, and subsequent pnwmom Nov 2014 #33

No, you don't understand Medicare -- it doesn't pay 100 percent nichomachus Nov 2014 #40

You're talking about Medicare Part B. jeff47 Nov 2014 #41

Not quite nichomachus Nov 2014 #43

It's nice you finally googled the program, and found that your $20,000 bill is now $1200. (nt) jeff47 Nov 2014 #44

Thanks for the unwarranted snark nichomachus Nov 2014 #46

The snark is because of your large errors. jeff47 Nov 2014 #56

This 85 yr. old CHOSE a private plan instead of single-payer Medicare. He made the wrong choice, pnwmom Nov 2014 #34

I don't know what you mean by this. nichomachus Nov 2014 #39

Exactly. DURHAM D Nov 2014 #42

"Regular Medicare" does not pay all your medical costs. nichomachus Nov 2014 #45

Where did I state that regular medicare pays all medical costs? DURHAM D Nov 2014 #49

30% of Medicare beneficiaries have made the Medicare Advantage choice, mostly to save money. Plus, Hoyt Nov 2014 #48

Except Medicare wouldn't block a doctor's order. jeff47 Nov 2014 #60

If they go too high, you move to a more competitive plan or traditional Medicare with Hoyt Nov 2014 #66

When I had cancer, (ha ha , good title) hollysmom Nov 2014 #52

Yet another reason why we need universal healthcare, not 'insurance'. nt Erich Bloodaxe BSN Nov 2014 #53

Yep... The 'Death Panels' Are The Insurance Companies... WillyT Nov 2014 #58

Beat me to it.. SomethingFishy Nov 2014 #69

:) WillyT Nov 2014 #70

I never heard of Malcolm MacDougall so I Googled him - LiberalElite Nov 2014 #71

In 2001 I had a goround with NYLCare. hobbit709 Nov 2014 #75

It's not unusual for private health insurance companies to kill people for profit. Zorra Nov 2014 #77

As several others have pointed out, Ms. Toad Nov 2014 #80

The nurse should be prosecuted for practicing medicine without an M.D. closeupready Nov 2014 #90