Back Pain Isn't Covered???

hi dear alaskanray, I dont believe everything these so called Gods in White say. My father was a doctor and I work for Workers Comp now so I got to work with medical reports and the like. but I cant imagine that back pain isnt covered by your insurance. I would investigate on that too if I were in your shoes. My former doctor also told me things which arent true. He said I got to enroll in that special program for diabetics or my health insurance would not pay for the diabetes meds any more. Sure that somewhere along the line I asked the insurance people and they said noooooo taking part in that program is totally voluntary.

Ages ago I went to one doc who told me dismissively that he didn't do "cosmetic surgery," which I suspected I might need. I had new mole, & it looked really weird & itched constantly. The next doctor I checked had it tested. Melanoma... Fortunately, he got it all before it had spread too far. ALWAYS get more than one opinion! MP

Frankly, I wouldn't be angry at the doctor because they're not the ones who make the rules of insurances, the HMO company does. I have come across the same with you. My aunt was required to have a huge cyst on her back removed, it was as big as a golf ball and it was really disturbing her in her sleep. Mind you, her HMO includes these sorts of things - excision of mass/cysts, the doctor said that she should make sure that they're going to cover the full amount because it was a difficult operation, when she asked them to be safe, they said they will. After the operation, the bill was around $500.00 but the insurance would only pay $25.00. Now the doctor and her were friends and have been friends for a long time now but it would have been highway robbery if the company would only pay $25.00 for something that is $500.00. Regardless the reports and photos showing that the mass was not the 'usual' mass, they wouldn't budge. She ended up paying for the remaining herself. You see, these companies are not run by medical professionals nor doctors. They're run with people who obviously don't have much experience in the real world of medicine. Therefore, their pricing scheme is general and not custom. They're good at selling their products but once the patient avails, there are fine prints. You should be glad that you were told by that doctor that xrays were not included in your HMO, they probably aren't and he's just saving you for additional costs. You should have confirmed this first with you HMO rather than taking sides. Have a great MyLot experience ahead!

Hi Alaskanray, It does seem that the insurance companies are getting worse and worse on what they will and will not cover. A few years back, I had cervical cancer and when I needed to go to a specialist for treatment, they tried to deny me. It infuriated me as I had to travel to get to this specialist and I found out about the denial on the day of my appointment. In order for them to treat me, they wanted like 200.00 downpayment which I didn't have so I wasted my time and gas for now good reason. I had to argue with the insurance company and eventually won and they did cover it and they did catch the cancer before it spread. Now at this point, I don't have insurance. I could not afford to continue it because at my work, it was going to nearly double. I do have it on my daughter and I have noticed that in the past couple of years, they are denying more and more tests and things for her. The last one was an MRI and I did not find out until AFTER the procedure. The doctor had already known it was denied, said nothing to me and went ahead with it. MRIs are costly. A little bit of questioning with the insurance company and I found that it was denied due to the way the doctor wrote it up. If I were you, I would call the insurance company. I have never heard that they don't recognize back pain. It is usually the result of an injury some on-going health issue. My mother was on medicare and had chronic back pain due to an old injury and also osteopherosis. All of her treatments and meds were covered as well as physical therapy.

This happens quite a bit actually. And it happens more with independent doctors rather than medical groups because the money is coming out of the drs pocket rather than a covered plan for many dr.s in the group. Does your HMO cover urgent care or er. If so, go here to het your needs taken care of. One of my family members is having a similar problem with stomach problems. His insurance doesn't cover ct scans unless the blood work is messed up. Crazy.