[mitchntx]

The wife has a breathing problem where as she sleeps her esophagus relaxes too much and collapses when she exhales. It doesn't close completely, but it slows her breathing to a point where her blood/Ox level was down to around 80!

The short term fix is an Oxygen concentrator so that what air she does get is more pure.

Insurance company would pay 80% of a rental after our $1000 deductible was met. After the deductible, our 20% liability was almost $30. They wouldn't cover the cost of a purchase. WTF!

So, I found several sources of these units, both new and used. Purchase price is anywhere from $250 (used with a 1 year warranty) to new at $850. I bought a 6 month old unit for $300 with 3.5 years of the manufacturer's warranty still in place.

I argued with supervisors and managers about them covering the cost of purchase and even submitted an appeal which was denied. They said that they don't cover purchase of major equipment, only rental. I don't understand the thought process.

[BigEnos]

It's all fun and games with the insurance company until there's a big payout requested. Then they start playing rough. My wife was leaving a job where the insurance covered her pump supplies at 100% so she wanted to get everything she was entitled to per the plan guidelines before she left. About a week before the insurance ran out she ordered about $700 worth of supplies and about a month later we started getting the "denied" letters. She'd call and they'd "resubmit" her claim and it would magically come back denied again. After going around with them a few times about how she was, indeed, covered at the time they asked her to prove it. She faxed them a letter they had sent to her showing proof of coverage. (She was smart enough to request it before she ordered supplies) Magically, the problem went away.

Punchline is, the insurance company knew full-well she was covered but denied the claim because they didn't think she could prove it. It's done as a matter of policy and it's borderline criminal in my mind.