"We're Still Gonna Say No": Inside UnitedHealthcare's Effort to Deny Coverage to Chronically Ill Pat

[Nevilledog]

https://www.propublica.org/article/unitedhealth-healthcare-insurance-denial-ulcerative-colitis

In May 2021, a nurse at UnitedHealthcare called a colleague to share some welcome news about a problem the two had been grappling with for weeks.

United provided the health insurance plan for students at Penn State University. It was a large and potentially lucrative account: lots of young, healthy students paying premiums in, not too many huge medical reimbursements going out.

But one student was costing United a lot of money. Christopher McNaughton suffered from a crippling case of ulcerative colitis — an ailment that caused him to develop severe arthritis, debilitating diarrhea, numbing fatigue and life-threatening blood clots. His medical bills were running nearly $2 million a year.

United had flagged McNaughton’s case as a “high dollar account,” and the company was reviewing whether it needed to keep paying for the expensive cocktail of drugs crafted by a Mayo Clinic specialist that had brought McNaughton’s disease under control after he’d been through years of misery.

*snip*

[SWBTATTReg]

1. This poor kid. Can one imagine the horrible disease he has, and then have to fight his own

insurance company to foot his life-giving treatments? I certainly don't wish this on anyone. I pray and hope for the best, perhaps the exposure of this story will help resolve things.

[LuckyCharms]

2. This is one of the most frightening things I've ever read.

[IbogaProject]

3. "ShareHolder Supremacy"

The health plan owners and the administrators of both the insurance corp and any institutional investors are more important than actually covering one big claim.