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WARNING : Long post concerning my health insurance struggles. Don't read if this offends you. It has been healing for me to write about this since I was asked about my now cancelled Knee replacement surgery.

Let me tell you about the saga of my knee surgery. The short end of it is that I am getting it in on both ends by the surgeons office and my health insurance company. My surgery was cancelled. My health insurance denied approval and I first heard this from my surgeon's surgery coordinator telling me my insurance told them that the Doctor hadn't sent adequate proof for need of surgery. This I was told 3 weeks prior to my surgery date. The Surgeon's girl told me they appealed and sent more records and for me not to worry. I never received a letter from the insurance company but I called them checking this and they told me it was in appeals process and the they had until 4/28 to give a decision and my surgery date was the 19th. The surgeons office had been following up every two days having the appeal placed in an expedited condition but having no decision three days before the surgery date the hospital had to cancel my surgery. I figured this is the insurance company's game seeing if someone might give up during the first denial and they would have to approve but it would come by the 28th deadline when I would then get scheduled for surgery. That sucks but not the end of the world. On April 19th ( the date I was to have surgery) I received a notice letter from my insurance company that was mailed a month prior (postal service delays ) giving me notice of the original denial of coverage. It had listed as the reason for denying coverage being that the Surgeon and hospital was not in network with my insurance. I about fell out of my chair , this was the first I had heard about this . The surgeons office thought I was in network as well. I had been told by my insurance and the surgeons office that I was in network when I first started down this road 3 months earlier. After double checking it appears that I am indeed not in network and I have no coverage. I wasn't a happy camper to say the least.

I am not a quitter and have some hope. I found out that because of Covid the health care marketplace enrollment period has remained open instead of being a month in Dec. each year or I would have to wait until next year to get the desperately needed surgery . I was able to contract health insurance through a new provider who absolutely IN NETWORK with my surgeon and hospital. It takes effect May 1st. At that time I plan to get in writing proof that the insurance is in network with my surgeon and the hospital he works out of. I will then start the entire process over placing my surgery date sometime in July at best case. I am self employed and am forced to use the Obama Care system of Health insurance. During this ordeal I spoke with a good friend that works for a large health insurance company. The first thing he said was this: "people are mistaken that health insurance companies care about them or their health, they do not. Health insurance companies care about making a profit only" I guess I always suspected this but now I know for sure. I have had other insane dealings with health insurance in my past. Years ago I was waiting approval for surgery for a herniated disc in my neck. They insurance company who had been taking my premiums and paying all of my covered bills told the surgeons insurance coordinator that they didn't know who I was and that I wasn't insured by their company for over a year.  I asked the insurance company how this can be? They had cashed my premiums and paid my bills, even paid this surgeon's office for my recent visits. I was told that I should feel lucky that they had been paying my medical bills when in fact I had been cancelled over a year ago. I was furious, but I got nowhere, I guess it is true, that you can't fight city hall.  I am all for universal health care. I loved it during my times in the UK. Good luck to all who read this and I pray they have better experiences with their health insurance. Thanks for listening , it is healing to get it out.