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Ms. Toad

(38,055 posts)
15. You put too much faith in insurance companies to look beyond the immediate decision.
Mon Sep 8, 2025, 10:28 PM
Sep 2025

My insurance company denied a $500 (IIRC) treatment because although it was proven (and routinely approved) effective outpatient treatment for clot prevention post-surgery, it wasn't yet a standard outpatient outside of the surgical context. They ultimately relented, when my doctors pointed out that denying it meant a minimum of 2 weeks of hospitalization. But their initial response was to deny it. (Within a year or so, it was routinely approved for out-patient clot prevention - the ridiculous denial which I experienced was one of two medical conditions I've had which were featured as ridiculous on TV medical dramas.)

That's not the only personal example of penny-wise, pound-foolish behavior by insurance companies. Generally, unless it is an immediate cost (as mine was), they don't relent. In other words the long-term costly illnesses aren't necessarily going to fall on their pockets - the person they deny a vaccination to may be someone else's problem by the time they have a costly illness.

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