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This March I was diagnosed with breast cancer. It was caught early and small and I am insured through my employment with a staffing agency. I would have surgery and radiation and be done with it. I continued working while waiting for the treatment to be pre-approved and scheduled. Then the woman who handles those tasks for my surgeon called to tell me my insurance carrier told her I was only covered in the one mid-western state where the insurance company and staffing agency are located. About the same time I started receiveing judgements from the insurance company on my earlier medical bills and they were all coming back as out-of-network. I had been very carefull to locate providers who were on the approved list linked from my employer's website. Worries. I called the Plan Administrator who is also an HR administrator with the staffing agency. She admitted she did not understand the very complicated coverage and network system. She pointed me to the insurance company who were also unable to discern the problem. After several calls over several days the Plan Administrator raised her voice so loud I had to hold the phone away from my ear. She told me it was MY problem, she had spent too much of her time trying to help me and she would not spend any more. I was trying to get surgery for breast cancer! I finally got help from the woman who does the scheduling for my surgery. She was able to locate a network specialist deep within the insurance company. The Plan Administrator at my previous place of employment also did not understand the duties of her task and was unable to provide me with a certificate of credible coverage. Employer based health care is not working well. The Plan Administrators do not understand their duties. I was also faced with the threat of loosing the insurance if I did not maintain a certain number of hours per week, difficult to do when your are experienceing illness. This is not a good way to provide health care.
posted 3 years, 10 months ago
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