10 1 / 2014

A reply to http://tmblr.co/ZBIeox13mVHeA

Hi Carrie,

Thank you for your reply.

On the healthcare.gov website, it lists 10 coverage requirements specified by the Affordable Care Act, including:

5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy

6. Your prescription drugs

I know you represent the state and not the federal government. But I’ve found no other recourse. Poor people can’t afford access to the judiciary. Insurance companies bank on this, in fact, they make their decisions as to whether or not to break the law based on the probability that they will get caught. As a member of their lowest tier of support, they can count on the fact that I can’t afford representation and can safely deny coverage as they please.

We’ve all said at some point, in response to this kind of injustice, “I’ll sue those ***ers.” But have you ever seen it happen? I haven’t. Actually, I have once: after a friend of mine got diagnosed with cancer her insurance company dropped her. She didn’t win her lawsuit until after she died.

Coventry lied throughout their reply. The phone conversation they discussed took place much later than the one I discussed, and had nothing to due with this issue. During the one I discussed, they lied, got caught lying, and did some pretty pathetic maneuvering to get out of it. Check this out: after I filed my complaint, we called them again to ask about the issue. They’re explanation went like this: “According to our records, you also had coverage under Blue Cross Blue Shield at the time, and we quoted you their price instead of our own.” Does that make any sense? Absurd, right? We called Blue Cross Blue Sheild. They had no idea what we were talking about, and confirmed the absurdity of this explanation. I tell you this story to illustrate that these people don’t even try to lie well, apparently they don’t need to.

Again, I have no other recourse, that I know of, other than you. I beg you to exercise your power as a government agency. Or, at the very least, I assume a human sits on the other side of the computer screen and if so then I beg that person to exercise their power as a human to do something /helpful/. Anything.

Government represents the people, right? Thank you for your time,
Tristan.

09 1 / 2014

among the ten things required by the ACA:

5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy

6. Your prescription drugs

Okay, corporations get sued, it happens, and they get sued for blatant bullshit like this. Does anyone know anyone who knows anyone who knows someone attorney enough, someone with the ovaries to stick up for me. no, /my class/?

December 26, 2013
Tristan D. Lear
16808 Landings Pointe Ln. #101
Tampa, FL 33624

Re: Service Request Number: 1-797636601

Company Name: Coventry Health & Life Insurance Company

Dear Tristan D. Lear:

We have received a response from your insurance company in regard to the request for service you filed, relative to your prescription coverage provided by Coventry.

Coventry stated the policy you are enrolled in does not cover drugs for the treatment of mental health care or substance abuse and that information is located in the “Exclusions and Limitations” area of the Pharmacy Rider #15268. They stated that on 12/10/13, Mr. Lawrence Lear called regarding ID cards not being received for the children. Also on 12/11/13, a call was made by Mr. Lawrence Lear discussing the PCN and BIN# to get prescriptions filled by Walgreen’s Pharmacy. It was a bad connection and he stated he would call back. No specific pharmacy benefits were given during the call. Coventry advised that in order for you to have coverage for Vyvanse, you would need to contact the Health Plan’s Enrollment

Department to change your current policy. As an administrative agency, the Department does not have the jurisdiction to adjudicate disputes of fact or law.

Insurers and Health Maintenance Organizations (HMO) must make available to a group policyholder (usually the employer), as part of the application and for an additional premium, coverage for mental and nervous disorders. However, this Florida Statute does not apply to individual health insurance policies.

We realize this letter does not resolve your specific problem, but we hope these comments help you better understand the handling of your concerns. For additional information on insurance or financial matters, please visit us on the web at www.myfloridacfo.com/Division/Consumers. If you would prefer, you can speak to one of our Insurance Specialists by calling our Consumer Helpline at 1-877-693-5236 between

8:00 am and 5:00 pm EST.

Sincerely,

Carrie Appell

FLORIDA DEPARTMENT OF FINANCIAL SERVICES • DIVISION OF CONSUMER SERVICES


15 12 / 2013

america-wakiewakie:

…The kind of literacy I possess is not one you value; my voice is not one you can hear…

america-wakiewakie:

…The kind of literacy I possess is not one you value; my voice is not one you can hear…

(Source: america-wakiewakie, via activistronnie)

29 4 / 2013

Pam from Harbor

10 2 / 2013

29 12 / 2012

Unlearning Sexism and Other Oppressions | People Of Color Organize! - http://www.peopleofcolororganize.com/analysis/theory/unlearning-sexism-other-oppressions/

original post

29 12 / 2012

beep boop bop b’beep — transmission from outer interspace — diaspora has surpassed facebook in prettiness

original post

21 6 / 2012

cake-and-revolution:

wearethe99percent:

We are all the 99%. Don’t shame yourself about your circumstances, that keeps us divided and diverts the blame from the people who deserve it. Take pride in your poverty.

I know this guy, he’s an amazing human being.

cake-and-revolution:

wearethe99percent:

We are all the 99%. Don’t shame yourself about your circumstances, that keeps us divided and diverts the blame from the people who deserve it. Take pride in your poverty.

I know this guy, he’s an amazing human being.

(via cakeandrevolution)

27 3 / 2012

tumblrbot said: WHAT IS YOUR EARLIEST HUMAN MEMORY?

laying in crib, surrounded by flies