Letter to The Observer by Linda Granger of La Grande
I usually don’t write letters to the newspaper, but I have an important issue about health insurance coverage that I would like to share.
In August 2013 I attended a very informative program presented by Beth Stewart, a local insurance broker, who clearly outlined the coming changes in Oregon’s health insurance coverage. Thank you, Beth, for pleasantly addressing community questions about Cover Oregon.
Unfortunately my issue with “essential” health insurance coverage will not be resolved by Cover Oregon.
I realize that profitable businesses, including health insurance companies, must operate to increase assets and yearly revenue, but hopefully not do so at the expense of their customers’ or clients’ health and well being. Note I didn’t say patients’ health and well being. Health insurance companies, and also state supported health insurance entities such as OHP, are not licensed to practice medicine in the State of Oregon, are they?
My deepest concern involves health insurance companies and OHP refusing to follow doctors’ orders. How many times has your primary care physician, or a specialist, prescribed an essential and necessary specific drug or treatment, or requested a certain medical test or procedure, that was not covered by your health insurance company or OHP even though that treatment or medical test was considered normal and acceptable by the state licensed medical community? Or perhaps your health insurance company’s underwriter/call center person, who is not a licensed physician, insisted on ‘re-prescribing’ a different drug, medical procedure, treatment or medical device other than that originally prescribed by your own state licensed doctor?
Yes, health insurance clients have options: Don’t comply with your own doctor’s advice and instead agree to follow insurance company orders; don’t get any treatment or prescriptions at all; or pay out of pocket for the treatment or prescription originally prescribed by your own doctor!
I hate to think that health insurance companies bully their clients into not complying with doctors’ orders.…
But beware! If you don’t agree to the health insurance company’s ‘re-prescription’ you may lose specific coverage or protection, or be unable to receive continuing needed medical treatment.