I have worked in USA health/prescription insurance industry for 25 years. First, there’s no such thing as a death panel. Second, there is a difference between health INSURANCE and health CARE. You should consider health insurance the way you consider car insurance, it helps defray the cost of covered items, ti does not cover every single thing that happens to your car or is needed by your car. Health insurance functions the same way. Third, everything has to be coded correctly as a type of checks-and-balances, it’s not just about the money, it’s about quality, effectiveness, and safety of care.
The medical/health field is incredibly complicated and, unfortunately, someone had to be last in their medical class. Your doctor could be the one who got his license to practice with a C- minus grade average.The billing practices and coverage practices are there partially to protect you from your own doctor.
As an example: I had a doctor’s office send in prior authorizations to begin treating type one diabetes with growth hormones. There is no study on record to substantiate this care, not even experimental, and no care record of what would happen if growth hormones were injected into a child who was developing normally, so coverage was denied. I had another doctor routinely prescribing viagra for sinus infections. I’m pretty sure we’ve all seen the commercials and we all know what the “little blue pill” is for, which would be nothing whatsoever to do with your sinuses, or anything about the waist for that matter. Coverage denied.
Before you complain about your insurance be sure you look at the whole picture. In your case egoiste, why was a dermatologist diagnosing TN in the first place? That’s not remotely his field, which kinda makes my point about someone having to be last in the medical class.
Overall the insurance company wants you to be healthy. The healthier you are the less they have to spend on you, more profit for them, less expense for you. Health and prescription insurance is going to prefer preventative care over acute care every time and they’re going to be leery of experimental treatments because they don’t want to make you worse experimenting on you when you’re already having issues. You can always appeal care and insurance tends to be very reasonable about customizing a plan for you but is has to be reasonable, too, with some medical foundation.