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What can I do?
I’m 50 and male. The last 10 years I have been dealing with back problems/pain and had 3 surgeries over 10 years ago. About 3 years ago, I was having more severe problems with it and went to a surgeon. I had all the tests with MRI, X-ray and other things. I was scheduled for surgery then the day before, my insurer denied it and I could not get the surgery. We appealed and was still denied. Then, just over a year ago, I got worse where the disc was now pinching nerves and I have some severe pain in the lower back and runs into my left leg and now my upper left leg. The skin is numb along with most of my right foot. Now, with a different insurance company, I went to the same surgeon and got an updated MRI and X-rays. I was again scheduled for surgery twice last month. I emphasized how I needed it done then because my new insurance has a $6,800 deductible/co-pay which I met and I could no way afford that again come this month (the beginning of the new year). Well he still canceled the surgeries stating some scheduling conflict. Bottom line, I still did not get the surgery I need and am in pain continuously but not able to afford the deductible/co-pay in order to have it.
Asked on January 3, 2017 under Insurance Law, Wisconsin
SJZ, Member, New York Bar / FreeAdvice Contributing Attorney
Answered 4 years ago | Contributor
There is nothing you can do: there is no inherent legal right to be able to use up a year's deducitible or get surgery done before a change in plan, etc., and your desire to pay in a certain way or while under a certain plan does not obligate the surgeon to do it along your schedule. Making things work under your insurance plan(s) is your responsibility only--no one else has to make this work for you. As such, there is no legal action you can take in this regard.
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