Insurance companies cannot pay for every single medical expense of their members, period.  It's simple math.  You can't subtract 3 from 2 and come up with a positive number no matter how hard you try. 

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Nor did I say they could. However, in my case we had  a specialist fill out numerous requests for my wife to receive the drug, stating it was a medical necessity, and they refused to pay. The drug she needed was NOT an experimental drug. It had been on the market for years. They just said that the cost was too high and they weren't going to pay for it without proof that any damage she had from her condition would be helped by taking the drug. So explain to me how you show a drug works, when you can't afford to get the drug?

Claims like this are turned down all the time. Insurance companies may not be the only problem, but they're a huge part of it. The biggest part of it in my opinion. Having a company who's goal it is to make a profit decide your treatment is asinine.

William, now don't read anything into this other than the question.  I really don't want another spat about asking a question...  How much was the drug your wife needed without insurance?  I know that insurance doesn't always pay all the cost anyway of a drug because of co-pays.  I've had to pay over $10 per pill for some antibiotics, and that's WITH my insurance paying for most of it.  Now for some folks, $10 might not seem a lot, but when you're taking the meds 3x per day for 10 days, it adds up quick.

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Humira was, at that time, $750 per shot. She would need it every 2 weeks. Our copay on it would have been $50 per shot or $100 a month. Was it expensive? Absolutely. And I wouldn't be here complaining about the treatment we got from the insurance company IF her condition wasn't so severe. Her arms and laegs were covered almost completely with psoriasis. She had patches on almost every other part of her body, including her scalp, and it was starting to affect her joints. Most people don't have it that severe.

If it had been a minor case, I could have understood them turning it down. But after a specialist says it's one of the worst cases they've ever seen, you would think that would be enough. Go look up pictures of what it looks like and imagine having your body covered in that. It was horrible for her.

When I met her she would have outbreaks mainly on her elbows and knees, but they would be cleared up with a cream she had. After she had Calleigh though, it ran out of control.

All I know, is the shots cleared it up the completely. Her skin is clear and she has no more pain in her joints. The only problem is Humira lowers her immune system so she can't get flu shots and colds hang on forever. But other than that her life is 100% better. That's what it should be about. Not how much money these companies can save by denying coverage.