Government Insurance Screwing Me- Primary or Secondary - Screamin' Like Charlie Brown and They Don't Give a Royal Flyin' Youknowwhat!

In 2001, when I first became very sick and I mean really sick, I was working for a large international dot-com company and had "over insured" myself, if there is ever such as thing. I had everything you can buy, insurance/protection wise after having had open heart surgery for a cancerous tumor resection (See "Goober" on my page). So when I went out on disability, boy- little did I know that I was embarking on a new full-time career. Enter MY "Office of Healing". Not only was I going to have to worry about trying to get well and manage what was to become a growing myriad of illnesses, the latest of which is can-ser, but no, the never-ending f*ck-me fest of insurance, both private and governmental.

You see, even if you have disability and you have insurance benefits through your employer, after 2 years, they require you to go after the government for SSD benefits...whether you want or need them or not.

The bitch of it is, since the spring of 2002 when the long-term portion of my disability case was filed, I have had to keep a lawyer on retainer, For what? TO PROVE I'M SICK TO PRUDENTIAL! Every year for the first four years, it became routine, long forms, collecting affidavits, medical records, x-rays, MRI, surgical reports, all of the nosy details of every visit, drug, test and what I thought I was capable of doing...and all of my docs had to verify it.

THE HEIGHT OF IRONY...at year two, Prudential had the balls to hire a lawyer FOR ME, to file and/or sue to get me Social Security benefits...(just so they could discount the benefits, ie. my due salary they were having to pay me)..subtracting the disability benefits that the government would pay me.

(Absurd note...No cost of living increase since 2001 from Prudential-Cost of living increase from SS on an avg year $9/mo. Average cost of healthcare increase per year since I went out...35-40%!!!!! F*ck me!)

I feel like Lewis Black here...see my finger waving????

Then the Congress passed a new revision to the health care laws regarding primary vs. secondary health insurance..involving if your spouse insures you, how many employees your company has, etc. But, bottom line, I'm disabled, no spousal insurance on me, I insured my household as the major breadwinner at that time..so it did not apply...but did that matter..NO!

The government and then Cigna said that because I was listed on the rolls as a "non-working" employee, that Cigna was to be primary...so they switched everything and took back payments for years worth of treatments and rebilled. Next year the government changed their tune, repeat process, rinse repeat, rinse repeat...finally now the government is primary, it is finally primary as should be...as I told them so and my lawyer told them so, did they listen these past 3 years, NO!

BUT NOW, TODAY, DUE TO THEIR INTERNAL FREAKIN' MISTAKES...THEY WANT TO FREEZE MY BENEFITS AND LAUNCH AN INTERNAL INVESTIGATION???? WTF?

NOW...HERE I AM, NEW DIAGNOSES OF CAN-SER...MULTIPLE MEDICAL ISSUES, CIGNA WON'T PAY ANYWAY SINCE GOVERNMENT IS PRIMARY...

"DONT WORRY, WE'RE SURE THIS WON'T TAKE LONG TO GET SORTED..." MY BUTT!

THIS IS THE GOVERNMENT EVERYONE IS SO BUBBLY ABOUT GETTING INVOLVED IN YOUR HEALTHCARE...MY FRIENDS, THINK AGAIN...

I'm sorry, I'm so pissed off I'm seeing red and it takes a lot to make this elven one's blood just boil. My established docs are seeing me, my new ones have determined to wait for the most part and I cannot blame them. The United (I used that term frivilously) States government dictates medically who I see, what I do, what I take, what treatment I may have, what hospital I may go to and its not pretty...government insurance may be a good thing, better than no-thing, but by our so-called representative people, who cannot even run an education system or manage this financial crisis...no thank you. They need to get the private health care system right and make it affordable and available and fair for all.

I have insurance and I am sick and I should not have 20 full binders of records and have to stand guard over every step and bill and bureaucratic bullsh*t move made with my life...but I do. I should not have to pay thousands out to protect myself from insurance companies and my government from running roughshod over me! But I do! Like Lewis Black, forgive me but I'm screaming at the top of my elven lungs "F*CK!"

A-U-G-H! When you see Charlie Brown, think of Me!!!!

Tags: government, insurance, rant, screwed

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Replies to This Discussion

Permalink Reply by Bren from Rivendell on October 3, 2008 at 12:38pm: Both the people at Prudential and Social Security say its in the "contract". Thus entitling them to 'manage' my case and keep it up for 'renewal' status at periodic intervals....That even though my docs have signed off repeatedly that I am permanently disabled, blah, blah, blah (the originally reason I went out is severe seizures with no warning, which are completely intractible, won't ever get better and hydrocephalus and my brain eats shunts and rejects them for lunch, so f*ck me)

SO...what and where is this contract??? Can I have a copy? NO! WTF?? (see Lewis again) And my lawyer can't get one either...
The contracts are (is) between Prudential and my employer and Social Security and the individual State paying out the benefit! F*CK!

KEEP THE F*CKING GOVERNMENT AWAY FROM MY HEALTHCARE OTHER THAN TO TELL PRUDENTIAL THAT THEY CANNOT ABUSE LEGIMATE SICK PEOPLE WHO HAVE LONG TERM DISABILITIES AND THE PROOF TO BACK IT UP. (YES I AM SHOUTING!) ONCE YOU PASS THEIR F*CKING LITMUS TEST OF A FEW YEARS, LEAVE US THE F*CK ALONE AND JUST LET US TRY TO HEAL OR LIVE IN PEACE!

THIS GOVERNMENT COULDN'T WIPE THEIR RESPECTIVE COLLECTIVE ASSES IF I HELD THEIR HAND TO DO IT...WHICH I DO EVERY TIME I WALK THEM THROUGH THEIR OWN PROCESSES....F*CK! AND DOUBLE F*CK...WITH ALL DUE RESPECT...NO THANK YOU MICHAEL MOORE...BLESS YOUR HEART, BUT IF THIS PART IS SO EASY TO F*CK UP FOR SO "FEW" IMAGINE WHEN THEY HAVE TO MANAGE ALL OF US...; ▶ Reply to This

Permalink Reply by Lea on October 5, 2008 at 2:23pm: Can your employer get you a copy of the contract??? I am sorry you are having to deal with all of this. You are in my thoughts and prayers. Take a deep breath..............now, release...................love ya, lea; ▶ Reply to This

Permalink Reply by Bren from Rivendell on October 5, 2008 at 8:20pm: No, it is not my "right" to have a copy of it...not even my lawyer can get it unless we sue and go before a federal judge to overturn some protective bullsh*t clause written to protect THEIR consumer rights...WTF?

so, they have received notice both sides...5 days or we will proceed to federal court...end of frickin' story...I will not play...Mordor, will f*cking fall! Play with this elf? Watch and see...Erin Brockovich has nothing on me...I will go all the way to Washington and get in Kennedy's, Obama's and McCain's respectives faces and watch that on TV, it'll be pretty I promise you. I am an independant, so I don't play along party lines...all asses are game on...; ▶ Reply to This

Permalink Reply by Bren from Rivendell on October 5, 2008 at 8:29pm: ▶ Reply to This

Permalink Reply by althea on October 5, 2008 at 8:46pm: You go girl! I can at least give moral support. You'd think since you're so profoundly affected by whatever is in this mysterious contract that it would be available under the Freedom of Information Act. F-ing unbelievable. To my mind, it should be illegal to manage a contract to the point that it is tanatmount to denial of care.; ▶ Reply to This

Permalink Reply by Jenny on October 5, 2008 at 10:38pm: Bren, I'm so sorry that you are having to go through this. I wish there a way to fix everything so that you didn't have to deal with it. As my GP says, "when you are dealing with things like canser, you shouldn't have to deal with other stresses". I agree with him 100%. I will keep you and your situation in my thoughts.; ▶ Reply to This

Permalink Reply by granola on October 5, 2008 at 10:52pm: This just makes my blood boil. You need to share this story with more people. Try here http://www.healthcareproblems.org/; ▶ Reply to This

Permalink Reply by granola on October 5, 2008 at 11:15pm: I just looked back--I knew I posted about this topic.
http://my.crazysexylife.com/forum/topic/show?id=2001521%3ATopic%3A1...
I have a link so you can even send a video of your story. It is American Cancer Society's Action Network & they are sharing their info with both candidates!; ▶ Reply to This

Permalink Reply by Sharon632 on October 6, 2008 at 6:32pm: Okay, I actually broke down and cried in the accountant's office at my oncologist's office. Our insurance coverage at work keeps changing and I bought the "buy up" program which is more expensive. It is still the same health insurance co. but they raised the rates through the roof and added a $500 deductible. My CAT scans had been $200. and I got a bill for $609. Okay. I get that I have that deductible so I used a credit card check to pay that, they went to the oncologist's office to address a $550 bill. I had been paying a copay of $30.00 and the insurance says we can still do that. The accountant called the insurance co. while I was there and instead of my normal copay, they are charging me for the chemo!!! I never paid for that before and am flat broke. I am a single mother with two kids in college and now this?? WTF am I going to do? The accountant was very nice and said we will never make a collection on this so just pay what you can? I can pay nothing since I already pay top rate for insurance. Is there any relief in sight? I am so angry and I don't get angry very often.; ▶ Reply to This

Permalink Reply by Bren from Rivendell on October 8, 2008 at 8:34pm: A VICTORY...WHILE IN THE HOSPITAL MY LAWYER FILED A WRIT WITH THE FEDERAL MAGISTRATE AGAINST BOTH CIGNA AND THE FEDS REGARDING MY INSURANCE BENNIES BEING FROZEN. MY DOCTORS CONTRIBUTED A DEPOSITION STATING THAT THE WITHDRAWAL AND STRESS HAD CONTRIBUTED TO MY DECLINE AND ENDANGERMENT.

LONG STORY SHORT, ALL BENEFITS ARE RESTORED. 1/2 HOUR PRIOR TO HEARING BOTH CONTACTED MY ATTORNEY SAYING NO NEED TO SUE, BUT WE HAVE NOT CONCEDED THAT POINT. JUDGE/MAGISTRATE IS ON A TEAR...(HIS WIFE IS SICK) HE IS LAUNCHING A PERSONAL INVESTIGATION INTO MY CASE???YEAH! SO WE WILL SEE WHAT JUDGE FRANK COX AND DONALD PHILIPS WILL DO...BUT LOOK OUT...THE COURTS ARE UPSET NOW....

YEHAW...; ▶ Reply to This

Permalink Reply by Jenny on October 8, 2008 at 8:38pm: What wonderful news!!!; ▶ Reply to This

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