If you want healthcare coverage, amputate your arm don't fix it!

Nothing like a little personal experience to understand the true F*&D-upness of the US's healthcare insurance system. I could rant for hours, but to see the hypocrisy and ridulousity of the system, just read the email we had to send to Blue Shield of California (YOU SUCK!) today.

After you read this you will see why we are considering having my wife's left arm amputated even though it works great (BTW, she's a righty, so no big deal, right?:)). Also, if you break a limb you may consider amputation to protect you from future coverage denial. Don't fix it, throw it out. Not your arm, our whole BS system. I hope Blue Shield of Ca get regulated to death! Just abosultely ridiculous

Dear XXXX,
Attached you will find a scan of all the relevant documents on my applications for Balance 2500 coverage. To recap the timeline for you:

On July 14th, 2008 I shattered my elbow in a freak bicycling accident
On July 17th,2008 I had reconstructive surgery, a radial head arthroplasty for a comminuted radial head fracture
On approx August 20th 2008, I completed physical therapy and have been symptom and treatment free since
In April 2009 : I applied for coverage under the Balance2500 plan on your recommendation
On May 5, 2009, we were informed in the enclosed letter from Jenny K medical underwriter that we were declined coverage because:

"The information indicates that you have the following, which exceeds Blue Shield's Underwriting acceptance criteria:

• Fractured elbow requiring reconstructive surgery, radial head replacement within last year"

On June 9, 2009 we requested underwriting reconsideration in writing supported by a letter from Dr. Frank Chen stating that I was complication and symptom free, essentially cured. Both of these items are enclosed.

On June 25th 2009, we were informed in writing that we were declined again, and I quote with CAPITAL BOLD italics emphasis being mine:

"We regret to inform you, based on this review, coverage through our Balance2500 plan must be declined UNTIL YOU HAVE BEEN SYMPTOM AND TREATMENT FREE FOR A MINIMUM OF ONE (1) YEAR"

In August 2009 I reapplied for coverage effective October 1st. PLEASE NOTE, AS OF OCTOBER FIRST I HAVE BEEN SYMPTOM AND TREATMENT FREE FOR 14 MONTHS, WHICH IS CLEARLY MORE THAN A YEAR.

On September 4th I was again declined for coverage with the NEW EXPLANATION:

"This information indicates that you have the following which exceeds Blue Shield's underwriting acceptance criteria:

• History of fractured radial head with replacement"

Now the criteria is changed? I am a year + post treatment, but now the rule changes. What's is going on here. Please reconsider this application and be reasonable. We are at our wits end here. How does the criteria change when it was clearly stated previously. Are you all just trying to waste our time. This is really frustrating. I WANT coverage, and am healthy.

Thank you for your consideration,

Joel' C Rutsky