Aventist Health System Employee Health Care Plan Complaint - Resolved!

Worst Heath Policy Ever - Worst Health Insurance Ever!

3
Helpful Votes
Posted By: Dirtydave on 10/27/2005

Location: Orlando, FL

I work for one of the largest Health Service providers in the state of Florida. One would expect to have World Class Health benefits from such a provider. This is indeed not the case. We have in fact the worse health insurance I have ever had the misfortune to have had to deal with in my life.

It is their policy to deny every claim, no matter how small as a pre-existing condition, until they have completed their “pre-existing condition investigation.” Despite the fact that I provided proof of previous insurance to this provider over a month ago, they continue to deny each and every claim.

For example, a few weeks ago my wife slipped and sprained her shoulder.

Per the “Rocket Scientist” at our insurance company, that is a possible pre-existing condition. I dislocated a finger and tore a tendon, and of course that is a possible pre-existing condition. They even went so far as to deny the co-payment for the pain medication. A total cost to them of about two-dollars, but it might be a possible pre-existing condition. Never mind the facts; the insurance Nazis haven’t finished their “pre-existing condition investigation.” While they drag their feet on this “investigation” they have no problem at all deducting the co-payment from my paycheck.

In the end, I am paying for insurance that covers nothing; I have to pay the Doctors myself, with little to no hope of ever recovering those funds. I cannot afford any follow up visits that had been scheduled as I cannot afford to pay the insurance company and the doctors as well. My finger requires surgery to ever regain full mobility of it again. I will simply have to live with it, as I cannot afford the surgery, and the insurance company refuses to cover it. By the time the insurance Nazis, complete their “investigation” it will be too late to reattach the tendon.


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    User Discussion - Add your 3 cents!


    guchiedad (10/27/2005)      
    if more people sued the insurance companies instead of doctors, they might actually listen to the patients and pay for things preventively before it costs too much to fix a problem that has gone out of control...

    LMH81 (11/20/2005)      
    the pre existing clause on a policy is not set by the insurance company, it is set by your employer when they enroll for the group coverage, it's nice for everyone to blame the insurance companies but they are only doing what your employer is telling them to do.

    SJYY (11/02/2007)      
    Dirty DAVE- I too as well as other employee ofs Florida Hopsital ( all their campus's in florida ) there are MANY feel your pain with their private health insurance. YES theyhave NO problem deducting their FEES bi-monthly for their take, but EACH and every claim is denied....LOW and behold I had one claim that was not denied - shocked me,but guess when they PAID it - 1 1/2 years later - I found it on my credit report ---they took a year and a half to pay the bill? WHY - how can they ruin your credit like this - make us pay them for their insurance and then have NO COVERAGE and when they on the RARE occasion pay something , pay so late that i... more >>

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