Health Insurance Stories, Pt. 3

Hang onto something while you read this one.

Last summer, while working on my ranch in the Southern Sierra mountains, I was attacked and badly mauled by a predatory black bear. Although my face was ripped off, and I was blinded, I was able to make my way back to my vehicle and drive myself down a rutted mountain road to a fire station for help. From there I was airlifted to UCLA Medical Center where a team of nearly a hundred people put me back together in a grueling seven-hour emergency surgery.

That was the easy part…

Continued after the jump.

Although I’ve maintained a private individual health insurance policy with Blue Cross of California for thirty (30) years, they have, at every turn of my ordeal, tried to waffle, obfuscate, or outright deny me benefits for medical care. Because my injuries were mostly to my eyes, my facial structure (including my nose and most of my teeth,) and obviously, cosmetic appearance, my policy “does not cover services,” for putting me back together, and demands 30% co-pays before they will pay for the hugely expensive ($300,000 and counting,) reconstructive surgeries I need to regain a degree of functionality.I am, not surprisingly, disabled and unable to work. My assets and savings were exhausted long ago, (their deductable and co-pays reset every calendar year and my reassembly is a multi-year project.)I always thought having a “good” insurance policy was not only my civic responsibility, but would cover my medical expenses should I ever face a catastrophic illness. But it turns out that Blue Cross’s $2,500 deductable is actually more in the order of an $11,500 deductable before they kick in for 100% of what they deem “reasonable and customary” care. Even that determination is subjective and skewered in their favor.All this is on top of Blue Cross’s insanely expensive monthly premiums -a difficult proposition for me given that SSI disability only pays me $654-oops, just reduced to $625– a month on which to live.Twice in the last month, Blue Cross denied payment for ophthalmologic consults I had arranged to see if some of my eyesight can be retained. Then there is the $600+ per month Blue Cross doesn’t cover in specialized prescription eyedrops I need to save what is left. My other medications are similarly extortionate and not covered.MediCal, for which I now qualify, does not have any participating ophthalmo-plastic, maxilla-facial, periodontic, or reconstructive surgeons here in Kern Kounty who are qualified to do these surgeries. Nor will they or Blue Cross pay for anesthesia if I DO find someone willing to do them! (There’s nothing like having an acute PTSD episode when you’re trying to lie very still for a delicate bone or tissue graft.)On the plus side, I DID fight off a bear attack and survive to tell the tale.I am also the daughter, sister, mother, sister-in-law, niece, and former wife of physicians–and spent my 20’s working in the medical malpractice insurance industry–so I do know the ins and outs of the system in detail. Medical insurance is a license to print money…by the industry’s own admission.If anyone is interested in using me as a “spokesvictim,” I’ve documented my injuries and recovery in both journalistic and photographic detail and have a complete record of my insurance travails.I am in an unique position to advocate for getting the insurance industry out of the medical care system–and am more than willing to offer up my privacy and dignity in order to do so. I am free to travel and testify, am articulate and funny, and have had highly positive responses to my public appearances thus far. (If you Google me, many of these are posted. I also have DVD’s of most of them.)Allena Hansen

Adding… Allena just wrote back to me to say: “Stephen Colbert has been warning us for years, but did we listen???..”

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