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Old 06-02-2006, 09:37 PM   #12
mekasan
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Join Date: Jan 2006
Location: New Jersey / Miami, Fl
Posts: 50
I should add that my primary is Student insurance

I want to add that my primary is student insurance called MEGA Life and Health Insurance and my secondary is Medicaid. Because I was diagnosed right after finals of my second year of school, my coverage was extended for the 12 months I took off on medical leave.

I have every intention of sueing, but before this option is available I must go through all the hoops of the grievance process offered by the insurance company. I must first be denied, then complain, write letters, have doctors write letters, etc... until they give me what I want. They have so far. As soon as they don't then I'll have the "injury" required to sue.

Of course, I could try the psych harm route, but that is hard because it is subjective and the insurance company tends to base their denials on "insufficient information" or a misunderstanding of some sort. This suggests that once I or my doctors provide more info they will pay. I truly feel that insurance companies that behave like mine are abusive to patients who are forced to fight for everything. The scam is to deny everything and wait to see if the patient has the time, energy, or knowledge to complains. Because the law is on my side, they usually reverse the denial.

If this behavior is not illegal, it should be. I began my law clerkship this week and have been assigned to the healthcare division. I will be working closely with an attorney who was a trial attorney in healthcare law (i am not sure of which side he was on before, but now he is working for poor clients). I hope to learn more about my rights as a patient.

Thanks for all your responses. The shadows of this disease cast darkness over so many other areas of our lives. We all need to vent sometimes. It is good to know there is a place to be heard.
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Dx @ 29 years old in 8/05
Stage 1
2 IDC tumors (.7 cm and .5 cm)
4 cm DCIS
0 nodes
ER-/PR-
Her2+ (5.33 FISH)
AC (4 cycles)
Bi-lat mastectomy w/ lat flap recon + cohesive gel implants
1 year (every 3 weeks) Herceptin
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