Morgan J Freeman: "Anthem Blue Shield Blue Cross -- just denied cancer follow-up MRI to check spread was deeme

[IrishBubbaLiberal]

My insurance -- Anthem Blue Shield Blue Cross -- just informed me that my cancer follow-up MRI to check spread was deemed "not a medical necessity" and therefore not authorized.

— Morgan J Freeman (@mjfree.bsky.social) 2025-02-10T21:19:42.881Z

Morgan J Freeman

My insurance -- Anthem Blue Shield Blue Cross -- just informed me that my cancer follow-up MRI to check spread was deemed "not a medical necessity" and therefore not authorized.

February 10, 2025 at 3:19 PM


=====
My own comments…

GOD DAMN US medical insurance companies are PREDATORY KILLING MACHINES DENYING
NECESSARY MEDICAL TESTS TO STAY ALIVE.

AMERICANS ARE BEING KILLED BY PREDATORS, US CORPORATE PROFITS COME FIRST BEFORE LIFESAVING TESTING

America is a fricken joke.
Americans are getting killed for profiting

[Skittles]

2. psycho killer cowards do NOT need pardons

FUCK that

[IrishBubbaLiberal]

4. Not a pardon,,, a jury nullification

Jury Nullification

[drmeow]

5. Judges remove anyone who

believes in jury nullification (a bullshit practice that the Supreme Court should not have allowed but did) and would probably declare a mistrial if he was found not guilty!

I might find him guilty but insist that his punishment be time served and not a second more.

[Jersey Devil]

18. You cannot appeal a not guilty verdict or declare it a mistrial

Judges can do nothing to prevent jury nullification if jurors do not disclose their beliefs during voir dire.

[Skittles]

55. WTF

THE MAN IS A GUN HUMPING PYSCHO KILLER COWARD

HE FUCKING AMBUSHED SOMEONE AND SHOT THEM IN THE BACK

are you SERIOUSLY saying people should be able to act as judge, jury and executioner? WTF!!!!

[Farmer-Rick]

66. Wellllllllllll

I understand what you're saying. It's just more complicated than that.

Some people who have lost their spouse or children because they couldn't get them the medical attention needed to keep them alive, would say that the dead CEO acted as judge, jury and exectioner. The CEO just did it through paperwork and scams.

So if someone had managed to assassinate Hitler or Stalin, or Jeffrey Dahmer would they be psycho killer cowards too?

I understand 2 wrongs don't make a right but sometimes it does provide real justice when nation's justice system has failed.

In normal times I would be 100% behind you. Now that we have an American dictator, who allows oligarchs to subvert justice for profit, I think there is more to the story than just a psycho murderer hunting down an innocent man.

[Skittles]

82. it doesn't fucking MATTER

we don't do this kind of SHIT in a CIVILIZED SOCIETY

Mangione didn't even CONFRONT the guy - just shot him in the back - what if he had missed and killed someone else? Would that be OK because well he had GOOD INTENTIONS!

JFC

DONE here

[Skittles]

3. just more proof the problem is industry-wide

not just UHC

[B.See]

8. Precisely. I have one insurer and

my wife has another and they're both fucking policy holders, moreso this year than last.

And Donnie "price of eggs Trump" (btw, how's that going for ya?) who just killed Biden's caps on prescription drugs isn't going to do shit about it.

Besides, he's too busy trying to import Afrikaners and GUTTING consumer protections.

[The Madcap]

34. Don't forget saving endangered species like...

plastic straws.

[Ms. Toad]

50. The cap on Medicare prescription drugs (and the insulin cap) were implemented by Congress.

He didn't kill those.

What he killed was Biden's negotiations with drug companies for lower prices on a few drugs a year.

[B.See]

54. Yes this is correct.

I'd read about it, but off the top of me head misstated what really had occurred . Thanks for the clarification.

[bluestarone]

6. I would think he's on Medicare?

[LeftInTX]

11. It's another Morgan Freeman who was born in 1969

[bluestarone]

13. Ah ty

[Ms. Toad]

19. If so, it is probably Medicare Advantage.

MRI is not one of the few things that require a pre-approval on traditional Medicare.

[LeftInTX]

21. It's not the same Morgan Freeman. This one was born in 1969.

[Ms. Toad]

25. Well that explains it. I should have checked.

[Meowmee]

7. This has been going on for a long time, many, many years

They have escaped accountability for poor care, denied care and what amounts to murder etc. It will only get worse.

[LeftInTX]

9. He needs a larger platform this. This will get traction!

Oops. I thought this was the Morgan Freeman. But apparently there is another one.

But it's this guy:

[Marcuse]

60. Now I'm depressed. The other Morgan would have no problem but this guy could die.

Though I’m sure he gets the wait staff excited after making a dinner reservation.

[LeftInTX]

63. He's another Hollywood guy. Just not a household name.

https://en.wikipedia.org/wiki/Morgan_J._Freeman

Freeman produced the MTV reality TV show Laguna Beach: The Real Orange County. In 2007, he created and executive produced the television series Maui Fever, another MTV reality series. He also produced the MTV reality shows 16 and Pregnant, Teen Mom and Teen Mom 2.[7]

[Marcuse]

65. Thanks, I feel better for him, but there are others who suffer.

[unblock]

10. He'll probably get it approved after his doctor jumps through a few more hoops

Most of their game is to delay treatment.

Find an excuse to deny it, drag hells, but eventually approve.

They profit because the patient might give up or die(!) before disputed test or procedure and even if they do eventually get it, they earn interest on the money just because of the delay.

Insurance companies have a freeroll to deny and delay. It costs them nothing and they might save money.



Of course sometimes they do deny, not just delay. They have little incentive to be decent human beings.

[Tickle]

24. Make me sick 🤢 bastards NT

[aeromanKC]

12. GOP health care plan: Hurry up and die

[lastlib]

49. It's called "GOPeeDon'tCare"....... n/t

[LiberalArkie]

14. Must have been that damn Doctor of Homeopathic Medicine that denied it.

[Evolve Dammit]

15. Always were. Getting worse and more blatant. They are the "death panels." Morgan is right. n/t

[Blue Full Moon]

16. They can cause death by denial but spend money on frivolous lawsuits

https://news.bloomberglaw.com/business-and-practice/unitedhealth-hires-defamation-firm-to-counter-social-media-posts

[Farmer-Rick]

68. Death by denial

Yup, they are murdering people by preventing access to healthcare in a timely manner. But it's legal murder. The government has deligated it's authority to execute citizens to the health insurance corporations.

[Blue Full Moon]

75. The death panels the republicans wanted

[Farmer-Rick]

81. Oh yeah...they did talk a lot about death panels

Sarah Palin would be proud....if she's still alive.

[dlk]

17. There are statutory time frames for medical claim appeals

The entire apeals process has legal timelines for responses and an attorney isn’t required. although in certain circumstances, one may be called for.

Appeal every single claim denial for reconsideration, as many times is allowed.

Insurance companies play a numbers game.

[KewlKat]

20. Death by denial

[dlk]

33. The true death panels...

[KPN]

42. Good advice. Not sure most folks pay attention to the

notices about claim disputes or specific medical care denials. It’s important to appeal timely and per specifics required in appeal.

[Skittles]

48. sick people should not have to spend their time begging for health care

the American for profit system is DISGUSTING

[KPN]

71. Agreed 1000%.

Last edited Tue Feb 11, 2025, 02:03 PM - Edit history (1)

My opinion: we could use a few more Luigi's.

Callous and, some would say, irresponsible on my part -- I know, but I feel quite certain we won't see meaningful relief from our the current health care system and, more generally, the parasitic capitalism we currently endure through entirely peaceful means. It would be wonderful and thrilling if we could, but I just don't see it -- not in our lifetimes at least.

In fact, it is obviously getting worse, not better. When the instigator and principle preparer behind Project 2025 (Vought) is head of the OMB, and the Secretary of Defense (Hegseth) hold and have openly expressed opinions that "political violence is inevitable", "a struggle of good versus evil", and the left poses an “existential” threat, it's hard for me to see a happy peaceful ending.

[Skittles]

84. no, we do NOT need any more gun humping psycho killer COWARDS

JFC

[Ms. Toad]

51. Most of the time it doesn't even require a formal appeal.

I refuse to be shunted off to the appeal process until all direct avenues of informal appeal is exhausted. I just keep asking for supervisor after supervisor after supervisor until I get the straight story about the denial. Normally, it is something stupid that is easily fixed. A step therapy medication - where they lost the documentation that the first line meds had already been tried; coding errors - where an out-of-network care that had received in-network authorization was still being coded as out-of-network, etc. Those kinds of errors aren't really suited for appeal, since it takes actual conversations with real people to sort out what actually happened and resolve it. If it gets sent to appeal, without a conversation to sort it out, it just gets denied on the same basis as the original.

As to the coding error - it took 200 hours of my time, because every new claim on the approval number required calls to two corporate entities and convincing one of them to call the third to get the bill re-coded, the payment sucked back, and a new payment sent. I got to the point where I could walk the customer assistance agent through a computer system I had never seen - because in my prior conversations I learned exactly what was happening and why it was repeatedly mis-coded (the initial authorization or out-of-network care was for a second opinion only; it was converted to authorization for care - but instead of assigning a new number, they just tacked the new authorization pages into a long .pdf document under the original number, so the people doing the coding saw treatment - and only authorization for a second opinion because they didn't bother to scroll down in the .pdf). Ultimately, I insisted that they open a new number for the third go-round (multiple surgeries), and that solved the problem. Had I just appealed, that would never have happened. I probably would have gotten each bill resolved - at the cost of a ton of paperwork each and every time, and I never would have know that I needed to insist on a new case number being assigned. I have also successfully had an insurance company rewrite their nationwide software system because their software didn't match a kind of policy they sold.

If working informally doesn't work, then I appeal - I've probably done it only once or twice, and I'm far less successful at winning appeals than I am at working through customer service. By the time I file a formal appeal, it requires a doctor's cooperation (and the few who don't cooperate quickly become my ex-doctor).
Working through customer service, I've won every appeal I've chosen to fight. There were two out of perhaps 50 that I chose not to fight (small dollar amounts, not likely to be repeated).

But - yes - they count on us not challenging them, whether informally (as I do most of the time) or formally. Virtually no one challenges the system, so they win on those, and others give up too soon - so they win those by attrition.

[dlk]

64. Excellent advice -- always follow up

Insurance companies count on their customers being passive and just accepting poor service.

[Farmer-Rick]

69. That's good info

But you got to wonder why our supposed democratic government put statutes of limitations, so to speak, on murder by denial?

[LittleGirl]

22. I've been on Medicare for 4.5 months

and I've been denied multiple things including an ultrasound for my dense breasts. It took me 4 months to get the insurance, Medicare! to pay for an ultrasound last week and I was told, I'll probably have to pay for it. God damn it. I've paid into Medicare since 1976. I want my healthcare!

[wryter2000]

29. You're not on Medicare Advantage are you?

That’s not Medicare

[LittleGirl]

45. Nope. Just Medicare. nt

[RicROC]

59. Medicare vs. Medicare Advantage

When I first turned age 65, I went to a local insurance broker who sold me a BC/BS Medicare plan. A couple years later I went to a 2nd broker, friend of the family, who recommended Anthem Medicare. I'm never sick so really didn't have many claims. After listening to Thom Hartmann radio on authentic Medicare, I called the 1st broker to tell her I would like to go back on the original Medicare plan. Her response, "you've never been on traditional Medicare, you've always been on Advantage"

What an eye-opener! These brokers will steer clients into Advantage and never explain the difference. Fortunately, I live in NY State so as one of 3 states where one can switch easily back and forth, I am now on traditional Medicare.

===> If I lived in other 47 states, (after 1 year on Advantage) Medicare is allowed to audit and decide whether to accept the potential patient. They have the option to bar one from Medicare.

[wryter2000]

72. They need to take Medicare out of the name

The ads are so deceptive.

[dlk]

37. There is a Medicare Advantage special enrollment period from Jan 1st through March 31st every year

Last edited Mon Feb 10, 2025, 09:34 PM - Edit history (1)

If you are already enrolled in an Advantage plan, you can change to different Advantage Plan or return to original Medicare

All of the Medicare Advantage plans in your zip code are s listed on Medicare.gov. They will all have star ratings. I would recommend checking out the 5-star plans, if they’re available in your zip code.

You also have the option of returning to original Medicare. If you want to enroll in. Supplement, you will be subject to medical underwriting, unless your state has special rules, like the birthday rule, or year round guaranteed issue, such as NY or CT.

Also please note, whatever you decide to do, Medicare requires you to have creditable prescription drug coverage (Part D), either with an Advantage Plan or a standalone Part D plan.

Otherwise, Socisl Security will assess a lifetime penalty of 1% per month of an average national premium established.by CMS.

I noticed for 2025, Advantage plans greatly reduced benefits, as well as greatly increased premiums, copays and coinsurance.

Good luck!

[LittleGirl]

44. I'm on Medicare A and B only. nt

[dlk]

62. If you're not enrolled in Part D, there's a lifetime penalty

You may want to follow up on that.

[LittleGirl]

67. You mean a drug plan? Yes, I have that

but I had to appeal the first denial of coverage for my thyroid drugs already. They have a 500+ deductible and raised the premium from 40 cents (yes, cents) to 17.40. Can you believe that? Ugh.

[dlk]

77. That's really great

n/t

[HereForTheParty]

58. One thing - it's not always possible to get out of Medicare Advantage once you're in

You can switch between MA plans, but to get a medigap policy to go with original Medicare you have to pass a screening process. If you have cancer, for example, forget it. You're stuck with MA.

[dlk]

61. You can change an Advantage plan at Advantage Open Enrollment or Medicare Annual Election Period

You can also change an Advantage plan:

1. If it’s during your trial right (12 months) you can return to original Medicare and either return to or enroll in a
Medigap (supplement) plan with guaranteed issue or return to your previous Medigap plan.

2. If your Advantage plan ends or makes significant changes, you can return to original Medicare and have guaranteed issue if you decide to enroll in a Medigap plan.

If you move out of your service area and your Advantage plan isn’t offered in your new area, you can enroll in a Medigap plan in your new area with guaranteed issue.

Just be sure to have Part D coverage to avoid the lifetime penalty.

[HereForTheParty]

80. Those exceptions exist, yes

I just wanted to emphasize once you are in MA, most often you can't switch to traditional Medicare with a medigap plan without underwriting. Original Medicare without a medigap policy is untenable.

[dlk]

86. It's not easy, to be sure

There are exceptions, depending on where you live.

New York and Connecticut have guaranteed issue year-round.

Some states have adopted a birthday rule, where someone can enroll in a Medigap policy, with guaranteed issue (no medical underwriting) within in a specific time frame around their birthday.

Also 5-star Advantage plans are an option, if they’re offered in a person’s zip code.

More seniors could lobby.for a birthday rule in their state. It offers the best workaround at this point.

[RobinA]

70. Wait A Darn Minute!

That is impossible. Advantage haters on here keep telling me Medicare doesn't deny anything.

[pandr32]

23. Holy sheepdip!

[Tree Lady]

26. I just started getting medical bills

I never got before with medicare. I have Blueshield as my supplement bluecross was no longer a option. We have never paid a cent for going to the doctor, getting regular labs test and xrays.

Hubby was super sick with virus of some kind and bad chest cough. Went to doctor he gave him flu and covid test, they charged $200 a piece for those! Then chest xray to see if he had pneumonia. He had viral bronchitis.

After medicare and supplement they want almost $400 from us. I will be fighting this bill, scares me now to even go to doctor, what used to be covered is not now. And by a lot!

[Auggie]

32. Are you on Medicare Advantage?

[Tree Lady]

47. No regular medicare

and supplement. My husband drove Bart in SF for 30 years so we have always had good medical. This is first time a regular doctor visit with tests not covered.

[Auggie]

57. That's crazy. I wonder if the supplement plan changed?

Or was it part of the yearly deductible? I have a Plan G with a minimum yearly deductible of $257, so I do receive an invoice for up to that amount every year.

[Fullduplexxx]

27. legalized murder

[riversedge]

28. Fight it any way can.

[Bluethroughu]

30. Here is your Republican death panels!

[Cf402]

31. Familiar personal story

During my wife's final cancer, BCBS deemed the follow-up MRIs as unnecessary and uncovered, although they were required to gauge treatment effectiveness against the cancer's spread. After months of playing the idiotic game of appeal, they were finally approved, only to have the final hope treatment denied two weeks prior to her passing, but gleefully informing us that we could appeal -- a process that would take up to two months. Yes, I know this is just another story, but goddamn American insurance.

[waterwatcher123]

35. Insurance companies are not a medical necessity either.

[IronLionZion]

36. They are finding efficiencies the same way as Melon Husk

they make more profit if we die faster. Don't like it? What are we going to do about it?

[JoseBalow]

38. There can be only one

The judges have chosen

[ALBliberal]

39. My son has stage one testicular cancer has this

same insurance! Age 28. He is under “supervision” scans blood tests for five years.

Dear god! Now he has to worry about this!

Works at HP. For three years now.

No one is safe from these sick predators.

I hope this guy takes it to the streets!!!!

[OMGWTF]

40. Death by Spreadsheet. A-I will decide who lives and who dies. Soylent green anyone?

[Racygrandma]

41. It is important to see if the cancer has spread

So I have a pet scan in May. I have Medicare and never had any problems. When I was on bamacare I signed onto to united. So they never took my premium out of bank account. I called and they said three times well we have your payment. Uh no, well then they dropped me because didn’t pay premium . No kidding. I am a cancer survivor so insurance is a big deal. Yeah I had to call the insurance commissioner herein KS to get it straightened out. Yep they want us dead. We cost to much.

[DFW]

43. This is why I tell people I have Blue Cross, so practically no medical insurance

My employer in the USA provides Blue Cross plus some Dental with an immense deductible. In practical terms, that means nothing. Fortunately, you can deduct unreimbursed medical expenses from taxable German income, so it really only costs me half.

[NGeorgian]

46. Medicare DIS Advantage..................

https://www.wsj.com/health/healthcare/medicare-private-plans-insurers-389af1a0?st=rQyJRV&reflink=desktopwebshare_permalink

The Sickest Patients Are Fleeing Private Medicare Plans—Costing Taxpayers Billions

[Skittles]

56. THAT is the "Advantage" con

works great when you don't need it - then when you do, it's a crap shoot and the taxpayers end up spending even more money

[madamesilverspurs]

53. We need to remember

that insurance companies exist to make money for their investors. Period.

It's still a painful memory: We attended all those contentious healthcare town halls, we were heartened by the busloads and planeloads of medical professionals going to DC to testify to congress, we watched the discussions in congress as though our lives depended on the outcome (yes, that was a bit of sarcasm), and we were jolted when the congressional conversations changed from healthCARE reform to health INSURANCE reform. We did get the Affordable Care Act, which the GOP stupidly dubbed Obamacare; and for his manipulations on behalf of the insurance industry, Max Baucus was assigned to a diplomatic post in the ass end of China. Short version: Medical provision is the come-on, but money is the purpose.


.

[4catsmom]

73. it's their way of culling the less fortunate

'cause no country for poor men

[Maeve]

74. As i responded..Always, always ALWAYS challenge

A refused service and get your doctor involved. Insurance companies back down at a much higher rate than expected.

[calimary]

79. Kicking this.

ESPECIALLY this.

[SheltieLover]

76. Kicking

[Kablooie]

78. I'm with Kaiser Permanente in California...

And I’ve never had them refuse anything a doctor wanted. They are a non profit and the doctors don’t make more if a patient gets more tests.

[spanone]

83. JFC