An unnecessary death

First, sorry about your pain and your friend's loss.  You ask what kind of country do we live in, and is this acceptable? 

It's not acceptable to me although, now on Medicare, I have excellent care, but so many don't--about 50,000,000 at the moment.  But it apparently is acceptable to the rest of the country since we're in the midst of a national election, where the so-called liberal nominee refused to stand up for mandated health care, yet gained the nomination over the candidate who supported universal health care. And this supposedly on the caring side of the house.

On the other side we have a candidate who wants to give a tax credit so people can buy their own health care, a $5,000 credit.  First, you would have had to pay $5,000 in taxes to use the credit, which is not the case for a large number of our citizens.  John McCain is covered under a government plan, as I am, so perhaps he doesn't know that $5,000 will hardly cover a family of four purchasing health care.  In 2001 I was paying $1,000 a month for my husband and me.  For sure it would be closer to $2,000 a month now, or $24,000 a year. i wonder how he stumbled on that number? And for sure he stumbled.

It's an absolute disgrace and I join you in your anger. 

Another example of insurance mess I discovered today: my ps no longer does ins. cases, so no more recons.  He was one of the last in Nashville, a fair size city, to stop taking ins.  I was given the name of ONE ps there, who is of course kinda new, who DOES take ins. 

I am unsure if Vanderbilt plastics refuse ins also.  Ain't that a kick in the head!  The ins. co's are running more and more docs away from patient care.  My pcp's office, with like 13 docs, accepts no new Medicare patients.  Fortunately, I just got it and have been followed there for  6 years, so I get to stay.  (yipppeeee, I now save $2,200 a month in  private ins premiums)

LuAnn, the insurance companies only have to cover recon to the extent of the policy coverage for any other surgery. And ps's don't have to take insurance...that's their option. Many don't bother since it's not usually covered by insurance at all. It's a cash business.

If I can find an in-network ps that does the kind of recon I want, I will still have to pay 20%, as that is what my policy covers for all surgery.

When you have out-of-network coverage in your plan, you can pay the dr up front and get reimbursed to the extent of the policy (usually 50%). Many women go to the best ps they can afford under their insurance, but many more choose to bite the bullet and find the best, cost be damned, even if they are out-of-network.

So the law that says insurance companies have to cover recon is only as good as the policy that covers you and the doctors in that network.