Insurance Won’t Pay Story


Just want to let people know I went to the hospital cause hurt back when was at home and I couldn’t get in to the doctor office for 2 weeks.

I hurt my back I pulled something and it hurt like heck I mean it hurt enough to make me cry. I ended up at the ER in alot of pain on 8/1/2014 they did x-rays and said i had a pinched nerve and the muscles in my back was in flamed causing it to pinch the nerve up in to my spine.

To make along story short I got a bill in the mail yesterday 01/21/2015 telling me my insurance denied to pay the bill or even part of my bill. so what good is it if you cant get help paying your bill… i am totally pissed off cause we were paying out 75.00 dollars a month for insurance and we are still got stuck paying a bill that the insurance didn’t even paying a dime on it.

I am low in come i worked at Walmart making 8.45 a hours and was only getting 30 hours a week my gross income for this tax time is 12,300.00. So can anyone tell me why we are to get insurance it they not paying anything……

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My wife and I are disabled senior citizens on medicare with a medicare management plan through United Health Care-Senior Dimensions.
She went into the hospital on approx. November 1, 2014. She has constantly been denied rehabilitation services by Senior Dimensions since she was released to a skilled nursing facility ( El Jen in Las Vegas, Nevada) on January,17 2015. I have tried everything in my power to get her the care she needs to no avail. I have no one left to call or anyone who will help us.
I thought that pre-existing conditions had to be covered under the new Affordable Care Act. Am I wrong? Where can we get some help??

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You have the right to an appeal of insurance companies denying your claim. That is actually one of the things the Affordable Care Act did really right. Just follow the directions on this page https://obamacarefacts.com/appeal-health-insurance-denial/

You have:

(1) A right to information about why a claim or coverage has been denied;

(2) A right to see and respond to all information used in the internal appeal decision; and

(3) A right to an independent review (also called an external appeal).

The above being said, make sure you understand your responsibilities in regard to cost sharing. If you have a high deductible you could end up owing a bill out-of-pocket (even though a claim was approved) as your deductible wasn’t met yet.

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