The Pittsburgh Tribune-Review Luis Fábregas column
It was a nasty break.
The 82-year-old retired teacher and
Four months later, he hasn't been able to go back home. Young has had a rough time learning to walk again and even getting in and out of bed. His life has been turned upside down.
"I have trouble with pain, more so than anything else," Young told me sitting in a wheelchair in his room at the nursing home.
His injury was so complex that his rehabilitation had to be suspended because he couldn't bear to put weight on his leg.
That's when things got tricky.
His insurer, the
It did not cover treatment at its long-term care unit, which is where he wound up when his therapy stopped. Federal
As a result, Young and his wife received a hefty
"That's not fair for them to do that," Young's wife, Dorothy, 72, told me through tears in her living room. "I am so frustrated."
A spokesman for Highmark's Freedom Blue, which contracts with the federal
"We value the Youngs as our members, and we will continue to work to assist them as they navigate the health care process," he said.
"I don't understand what they base my coverage on," said
The Youngs aren't trying to get out of paying their bill. They offered
It's not productive to point fingers. Any of us or our relatives could experience this plight. You think you have insurance coverage, then you don't. You think you understand what's covered, then you don't.
The case proves sometimes you're on your own when it comes to the black hole that health care insurance can become. Instead of focusing on wellness and recovery, patients and their families are forced to become experts in the bewildering subject of insurance.
The bottom line: Make sure you understand your coverage. But be warned. It's more difficult than learning a foreign language.
Luis Fábregas is Trib Total Media's medical editor. He can be reached at 412-320-7998 or [email protected].
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