claim denied

I had a severe Vitamin D deficiency. It was serious.

According to the National Institutes of Health (NIH): "Vitamin D deficiency is a global health problem. With all the medical advances of the century, vitamin D deficiency is still epidemic. Over a billion people worldwide are vitamin D deficient or insufficient. Yet no international health organization or governmental body has declared a health emergency to warn the public about the urgent need of achieving sufficient vitamin D blood levels.

Vitamin D3 deficiency can result in obesity, diabetes, hypertension, depression, fibromyalgia, chronic fatigue syndrome, osteoporosis and neuro-degenerative diseases including Alzheimer’s disease. Vitamin D deficiency may even contribute to the development of cancers, especially breast, prostate, and colon cancers."

Obviously, having a severe vitamin D deficiency is no laughing matter, it's a serious health issue. And I had a SEVERE vitamin D deficiency. My doctor diagnosed me, via a blood test, and put me on a massive dose of vitamin D and follow-up maintenance doses. My vitamin D level improved but was still well below normal. My doctor was monitoring my deficiency and every six months or so he would check my level by including the vitamin D test in with my other blood tests.

Recently, I had another set of blood tests, including the vitamin D test. The results of that test were not as severe but still low, still below the suggested medical minimum level of vitamin D. I am still vitamin D deficient. Today, I got a bill from the lab that did all my recent blood tests. The bill stated that I owed them $91. Understand this: I have excellent insurance. I have a PPO, which covers 80% of my medical procedures, et al, and supplemental health insurance, which covers the remaining 20%. I should never have to pay anything out of pocket for any necessary procedures that are covered by what my numerous doctors want to medically do to me. Suddenly I am being billed for almost $100, from the blood lab,for a needed--and prescribed--blood test.

I phoned the lab and they told me, "Medicare and your supplemental insurance company denied your claim and refuse to pay for the vitamin D test. You owe us $91." I was stunned. I said, "Wait a minute. I had a severe vitamin D deficiency and my doctor has to monitor it regularly. How can my Medicare and Blue Shield refuse to pay for that blood test? It's NECESSARY." The lab rep said, "I guess Medicare and Blue Shield don't think it's necessary." "THEY don't think it's necessary", I shot back. "My doctor--and my body--thinks it necessary!" The lab rep replied, "What can I say, you owe us $91."

To be fair, I do not expect my health insurance to cover the cost of my vitamin D pills but I DO expect them to pay for blood tests which monitor my epidemic deficiency! Needless to say, I was angry. Will I now have to pay nearly $100 every time the doctor needs to see if I'm still deficient in this important vitamin? If so, what's the point of having health insurance if they're not going to cover my necessary health care, especially if my medical issue is a fucking epidemic!

It appears that, now, in modern America, it's the insurance companies that determine the patient's health care--not the doctor. What the hell is that!? There's a worldwide vitamin D epidemic and health insurance companies don't want to pay for periodic blood tests, blood tests that are absolutely necessary in order to monitor the suffering patient who has been medically diagnosed as being part of the epidemic??? What kind of health care is that? Why is my health being determined by insurance companies? Did the health insurance companies go to medical school? Are they licensed to practice medicine? Do the health insurance companies see, and heal, patients in THEIR office? NO. So why are they allowed to decide what doctors can and can't do--with MY body?

Welcome to the new America.