Current Events > My mother got denied her oxygen...

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Banjo2553
05/16/18 1:47:43 PM
#1:


So she's had an oxygen concentrator/bipap with her previous health insurance for a while now, as her oxygen gets dangerously low when sleeping. She has sleep apnea, a weak lung due to it having collapsed and underwent surgery to fix it, and she is obese. All three of those combined sounds like she needs that machine right? Hell, her sleep doctor even says she needs it to survive.

So anyway, she recently had to switch to Medicare because of her age, and got Humana. She was told her doctors are in the system, but they've been giving her hassle about the machine, saying that her reasons aren't enough. She took it to the doctors so they could convince them. Well now today they called her and said they denied all her claims because her doctors aren't in the system.

So...what should we do? Does she have a right to sue? They lied to her about her doctors and are essentially killing her by denying her oxygen.
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refmon
05/16/18 1:48:32 PM
#2:


cant you pay for it yourself
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Anarchy_Juiblex
05/16/18 1:49:39 PM
#3:


Banjo2553 posted...
All three of those combined sounds like she needs that machine right?


I suppose, I'm not a medical professional.

she is obese


Sounds like she needs to lose weight.
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Banjo2553
05/16/18 1:49:41 PM
#4:


refmon posted...
cant you pay for it yourself

Can't afford it, we're poverty level.
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IfGodCouldDie
05/16/18 1:51:56 PM
#5:


Fuck America sucks
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Banjo2553
05/16/18 1:52:21 PM
#6:


Anarchy_Juiblex posted...
Sounds like she needs to lose weight.

She wants to, but her lung collapsed because of overexertion. Insurance won't pay for a liposuction either.
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John_Galt
05/16/18 1:53:01 PM
#7:


Banjo2553 posted...
refmon posted...
cant you pay for it yourself

Can't afford it, we're poverty level.

Why? What are you doing?
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WrkHrdPlayHrdr
05/16/18 1:53:12 PM
#8:


I know how much CE loves Reddit, but:

www.reddit.com/r/insurance

They can answer medical questions having to do with insurance.
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Banjo2553
05/16/18 1:55:51 PM
#9:


John_Galt posted...
Banjo2553 posted...
refmon posted...
cant you pay for it yourself

Can't afford it, we're poverty level.

Why? What are you doing?

She's essentially retired, but has to stay at home to take care of my father as he's suffering advanced alzheimers. I'm...working a deli at Walmart but I'm looking towards college to get something better.

WrkHrdPlayHrdr posted...
I know how much CE loves Reddit, but:

www.reddit.com/r/insurance

They can answer medical questions having to do with insurance.

Thanks. I'll end up reposting it there.
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C7D
05/16/18 1:56:31 PM
#10:


Usually, the solution in this case is to go to the ER. They usually have legal professionals on site that can advocate on her behalf. They can probably also help her find a doctor who she can use. If her insurance wont allow for a concentrator, she may have to go on bottle for a while.
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Questionmarktarius
05/16/18 2:00:27 PM
#11:


Banjo2553 posted...
refmon posted...
cant you pay for it yourself

Can't afford it, we're poverty level.

Cancel your internet.
If you're paying $15 a month for the cheap Earthlink plan, that's $180 a year. If you're paying the average of about $50, that's $600.

Then, get some "welding" oxygen.
https://www.avweb.com/news/pelican/182079-1.html
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Sajo
05/16/18 2:06:51 PM
#12:


Questionmarktarius posted...
Banjo2553 posted...
refmon posted...
cant you pay for it yourself

Can't afford it, we're poverty level.

Cancel your internet.
If you're paying $15 a month for the cheap Earthlink plan, that's $180 a year. If you're paying the average of about $50, that's $600.

Then, get some "welding" oxygen.
https://www.avweb.com/news/pelican/182079-1.html

She needs on O2 concentrator for overnight sleeping, not just tanks.
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C7D
05/16/18 2:09:15 PM
#13:


After the insurance pays the Medicare benefit, the cost to the patient is around $500/year for a stationary oxygen concentrator used for overnight. How many LPM is she needing?
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ManBeast462
05/16/18 2:10:06 PM
#14:


Lose the weight and stop smoking
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clearaflagrantj
05/16/18 2:10:29 PM
#15:


This is America
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DragonGirlYuki
05/16/18 2:21:45 PM
#16:


Run up medical debt and let bankruptcy solve it.
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Questionmarktarius
05/16/18 3:03:51 PM
#17:


clearaflagrantj posted...
This is America

When someone else is paying your bills, you're no longer the one making the decisions.
Doesn't matter who that someone else is, be it some faceless corporation, or a government.
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Banjo2553
05/16/18 5:11:58 PM
#18:


Thanks for all the responses so far (except for filing for bankruptcy...that sounds like...a bad idea, though it was probably a joke anyway), but she got it sorted out. She went to their office and got things straightened out. Apparently Humana had already approved for her oxygen concentrator, it's just the equipment provider told her otherwise. They've been having a lot of trouble with that provider lately so they're probably switching.
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Questionmarktarius
05/16/18 9:41:37 PM
#19:


Banjo2553 posted...
Apparently Humana had already approved for her oxygen concentrator, it's just the equipment provider told her otherwise.

Too many middlemen.
Good to know it worked out eventually.
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DoctorVader
05/16/18 9:43:39 PM
#20:


When it comes to healthcare, if you get denied, you have to hit up all the executives. If anyone ever needs help with this, please PM me.
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KiwiTerraRizing
05/16/18 9:47:39 PM
#21:


Stuff like this is almost always denied before its approved. I have a lot of experience fighting insurance companies.
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