People usually put a lot of thought into choosing the best health or insurance policies to make life easier during difficult times. But sometimes, those very policies can lead to unexpected frustrations and headaches.
A Redditor recently asked, “Americans, what is your insurance horror story?” The responses were a collection of jaw-dropping tales, highlighting the struggles of denied claims, endless paperwork, and customer service nightmares. These stories shed light on how complicated and stressful dealing with insurance can be when things don’t go as planned.
Keep reading to dive into these real-life tales of frustration and find out what you should watch out for when it comes to your own policies!
#1
I got super sick when I was 7, and had an extended hospital stay. Unfortunately, it happened during a brief lapse in my Dad’s employment history, so we were briefly between insurance.
I later found out my parents went bankrupt, and my dad had to take on higher paying jobs he hated in order to pay it off.
He eventually worked himself to death - almost literally; he worked so many hours of overtime he fell asleep at the wheel and drove off the road and crashed into a tree. Worst day of my life.
He should have been enjoying his retirement by now; instead he’s been gone for years, and my mom still struggles with depression and being a widow.
America needs universal healthcare.
I later found out my parents went bankrupt, and my dad had to take on higher paying jobs he hated in order to pay it off.
He eventually worked himself to death - almost literally; he worked so many hours of overtime he fell asleep at the wheel and drove off the road and crashed into a tree. Worst day of my life.
He should have been enjoying his retirement by now; instead he’s been gone for years, and my mom still struggles with depression and being a widow.
America needs universal healthcare.
154points
#2
My dad is an oncologist and he says there has been an uptick in the number of arbitrary denials, by insurance companies, for claims that should absolutely be covered under the patient's plan.
When they're appealed they'll often eventually be approved. But the whole process moves really slow, which can be a death sentence given early treatment is critical when dealing with cancer.
**It almost seems like the insurance companies are delaying s**t on purpose, in the hopes that the patient will die before they have to pay for treatment**.
When they're appealed they'll often eventually be approved. But the whole process moves really slow, which can be a death sentence given early treatment is critical when dealing with cancer.
**It almost seems like the insurance companies are delaying s**t on purpose, in the hopes that the patient will die before they have to pay for treatment**.
117points
#3
Doctors kept trying to switch pain meds for my wife she was on daily doses of morphine and it was building up in her system too much. Insurance kept saying they need more reasons to switch meds. She died last year to toxic affects of morphine.
I felt joy when that ceo was taken down.
I felt joy when that ceo was taken down.
Report
110points
Insurance is supposed to be that comforting safety net we all rely on when life throws unexpected curveballs. Whether it’s a car accident, a health emergency, or damage to your home, it’s meant to help us bounce back with less stress.
But let’s be honest—dealing with insurance isn’t always smooth sailing. From endless paperwork to denied claims, the process can leave you pulling your hair out, wondering if that “safety net” even exists.
#4
My daughter was born with Cystic Fibrosis. We knew she was going to have this due to genetic testing that was done before she was born. She was denied insurance the day she was admitted into the NICU because she had a pre-existing condition since it was known in the womb that she would have CF. I had to fight with insurance literally the day she was born. This was shortly before Obamacare ended that b******t. PS I will never vote for a Republican again in my life for so much as a dogcatcher for how they demonized it because a Democrat passed it.
109points
#5
My brother was murdered by UnitedHealthcare.
They fought him and denied every single test, treatment, and prescription until it was too late and he was terminal.
They fought him and denied every single test, treatment, and prescription until it was too late and he was terminal.
82points
#6
My father was a doctor with a pre-existing condition before Obamacare, which meant the only health insurance he could get was through his state's pool of last resort. It took 30% of his income as he was self-employed and working in a very rural area. He was the only physician in his speciality for 75 miles and when things got desperate for his patients would allow them to "pay" in piano lessons, vegetables, whatever instead of cash if they needed to. He had a stroke and "died" on his bathroom floor but lived on life support for 4 more days. $350,000 later, including a 70k helicopter flight for 30 miles, a man who dedicated his life to medicine and donated all of his organs to science died less than broke because of healthcare costs.
81points
One significant issue is the rise in claim denials. A 2024 report by Experian Health indicates that denials have been increasing year over year, with authorization issues and incorrect information being the primary culprits.
The impact of these denials is substantial. Patients often face delays in receiving necessary treatments, leading to deteriorating health conditions. Additionally, the administrative burden of appealing denied claims can be overwhelming, both emotionally and financially.
#7
As a Brit staring down the scope in horror at the US, I genuinely wonder how any of you survive after things like this. Not only my condolences for lost loved ones, irreplaceable property lost, etc ... but my most profound respect for enduring it all. My country is on what feels like the brink of a different form of collapse; our politicans are too busy arguing over f*****g sandwiches to realise the writing on the wall. Collectively something needs to change and its not going to come from government. I wish you all the best, honestly. .
78points
#8
2008 went into hospital for ruptured intestine due to crohns.
Airlifted to Mayo clinic high on fentanyl for the pain.
Spent a month in hospital, came out with no colon and looking like a h*******t survivor.
Wife felt like something was wrong, went into obgyn to check on baby. No heart beat at 8 months. they induced labor.
Buried son.
Received a bill for $110k for Mayo Clinic which the insurance company denied.
Received a bill for $20k for abortion which the insurance company denied.
Spent 4 months of daily calls with hospital and insurance company fighting charges all the way down to $12k.
Airlifted to Mayo clinic high on fentanyl for the pain.
Spent a month in hospital, came out with no colon and looking like a h*******t survivor.
Wife felt like something was wrong, went into obgyn to check on baby. No heart beat at 8 months. they induced labor.
Buried son.
Received a bill for $110k for Mayo Clinic which the insurance company denied.
Received a bill for $20k for abortion which the insurance company denied.
Spent 4 months of daily calls with hospital and insurance company fighting charges all the way down to $12k.
71points
#9
My migraine meds were denied. They allowed me 9 pills per month. On an average day I need two pills. AFter over 6 months of fighting them they finally approved my meds. But only 18 pills per month. I had no choice. I go to fill the prescription. My responsibility was $5. The insurance companies responsibility $0. Fighting me over nothing. The pre-authorizations are out of control. Why do you need to pre-auth. a $5 d**g? That use to be used on expensive and experimental stuff. Not the everyday needs. My buddy had neck surgery 3 months ago. Left surgery with all of his scrips, gets to the pharmacy and his pain meds were denied. He needed a prior-auth. Bullsh*t. The man went 6 days with no pain meds after a fairly complicated rebuild of several of his vertebra. I hated to see the CEO get shot. But also wondered what took so long. I don't like feeling like this. This isn't who we are, or were. But I think we are headed for new territory. Stay safe.
68points
Automation in claims processing, while streamlining operations for insurers, has introduced new challenges. A 2020 study estimated that automated processing saves U.S. insurers over $11 billion annually. However, for patients, challenging a denial can consume significant time and resources.
#10
My father got hospitalized for a week from heart failure. Literally guaranteed death without getting medical help, lungs were filled with fluid and he was effectively drowning.
Insurance decided that the entire stay was completely unwarranted because, according to them, it didn't seem like he was sick enough. They didn't want to cover _anything_ relating to it.
While we were eventually successful, it took years to fight. Bill was in the six figures.
Insurance decided that the entire stay was completely unwarranted because, according to them, it didn't seem like he was sick enough. They didn't want to cover _anything_ relating to it.
While we were eventually successful, it took years to fight. Bill was in the six figures.
67points
#11
My wife just got her third denial for authorization (from UHC) for an MRI on her hip that her doctor has been trying to get her for over a year.
The first reason: she didn’t submit X-rays. Submitted X-rays, reapplied.
The second reason: she hadn’t done PT before the request. Submitted evidence that she has done PT on and off for seven years, to no improvement, reapplied.
The third reason: she needs to have X-rays done first.
This AI auto rejection cruelty is par for the course.
The first reason: she didn’t submit X-rays. Submitted X-rays, reapplied.
The second reason: she hadn’t done PT before the request. Submitted evidence that she has done PT on and off for seven years, to no improvement, reapplied.
The third reason: she needs to have X-rays done first.
This AI auto rejection cruelty is par for the course.
65points
#12
My mom killed herself because she was afraid her condition was going to get our family kicked off our insurance.
63points
Common reasons for claim denials include missing or inaccurate data, lack of prior authorization, and discrepancies in documentation. Policyholders are advised to meticulously review their claims and ensure all information is accurate to mitigate these issues.
#13
I thank my stars for living somewhere with universal healthcare. My socialist brain cannot simply comprehend the daily trauma you all must go through.
Even the healthiest of people must live in fear. One day you can have it all, the next, through no fault of your own, a stray strand of DNA corrupts and bang, you have cancer and not only do you have to face the fact you could die, but also become bankrupt and end up on the streets losing everything. Just because some faceless corporation says no, our shareholders prefer the money.
On a side note. If you did get cancer and your life saving treatment was denied. And you then decide to take out your frustration on a CEO of a particular faceless corporation, could you theoretically use self-defence as a legal defence? They’re the ‘head’ of the entity that decides you should die, and taking out that frustration is you trying to defend your life.
Even the healthiest of people must live in fear. One day you can have it all, the next, through no fault of your own, a stray strand of DNA corrupts and bang, you have cancer and not only do you have to face the fact you could die, but also become bankrupt and end up on the streets losing everything. Just because some faceless corporation says no, our shareholders prefer the money.
On a side note. If you did get cancer and your life saving treatment was denied. And you then decide to take out your frustration on a CEO of a particular faceless corporation, could you theoretically use self-defence as a legal defence? They’re the ‘head’ of the entity that decides you should die, and taking out that frustration is you trying to defend your life.
63points
#14
So, I am a diabetic. My doctor wanted Lantus insulin, but insurance wanted another, cheaper insulin that's not as effective (Basaglar**)**. So my doctor doubled the dosage. So my insurance decided to make the dosage two times 14 days worth (2 weeks a month) instead of 30 days worth so I had to pay the copay twice a month. That meant 28 days a month, and most months except February have more than 28 days. I ended up having to ration my insulin, and the copay went from $25 for 14 days to $65 for 14 days in less than 2 years. That meant I had to go to the pharmacy, stand in line, and get refills, every 14 days. And the pharmacy ran out a lot, so I had to come back. I can't drive, so I had to walk a mile to CVS down the road for this (and other medicines). I just started "buffering" a week at a time just so I could deal with this inconsistency.
"How come your blood sugar never goes down?" the doctor asked. I told him, and he shook his head, saying this was so common. He tried swapping insulin types, or increasing the dosages, but insurance said no. My A1C was like 10.
Then I ended up on Tricare, because I married someone in the military. I got Lantus, Trulicity, and BOOM, my A1C dropped to 6 in less than a year. I know the military has efficiency issues, but I pay nothing out of pocket in Tricare: no copay, no prescriptions, and no fees. It's like $58/month from my wife's pension for the both of us. I mean, socialized medicine WILL work in this country, The companies just don't want it to.
When my first wife died (the military officer was my second marriage), her insurance dropped her because she was dead. Then they sent her a $230,000 hospital bill for her last week of life because she was on a ventilator in critical care. No, I don't live in a communal property state, but they sent her to collections, and heavily implied (illegally) that I had to pay. I didn't.
Let me repeat this: they sent my dead wife to collections. Then lied that I had to pay because she was dead. Bill collectors called me, called me at work, called our son, and even MY sister. Not her sister, MY sister. I had legal notices and bills for her, in her name, coming as late as 8 years after her death. In fact, twice, she had a summons to go to court. Then a summons for arrest for failure to appear in court, however THAT sheriff had common sense and took her death certificate. He even said he was sorry for bothering me.
F*****g crazy.
"How come your blood sugar never goes down?" the doctor asked. I told him, and he shook his head, saying this was so common. He tried swapping insulin types, or increasing the dosages, but insurance said no. My A1C was like 10.
Then I ended up on Tricare, because I married someone in the military. I got Lantus, Trulicity, and BOOM, my A1C dropped to 6 in less than a year. I know the military has efficiency issues, but I pay nothing out of pocket in Tricare: no copay, no prescriptions, and no fees. It's like $58/month from my wife's pension for the both of us. I mean, socialized medicine WILL work in this country, The companies just don't want it to.
When my first wife died (the military officer was my second marriage), her insurance dropped her because she was dead. Then they sent her a $230,000 hospital bill for her last week of life because she was on a ventilator in critical care. No, I don't live in a communal property state, but they sent her to collections, and heavily implied (illegally) that I had to pay. I didn't.
Let me repeat this: they sent my dead wife to collections. Then lied that I had to pay because she was dead. Bill collectors called me, called me at work, called our son, and even MY sister. Not her sister, MY sister. I had legal notices and bills for her, in her name, coming as late as 8 years after her death. In fact, twice, she had a summons to go to court. Then a summons for arrest for failure to appear in court, however THAT sheriff had common sense and took her death certificate. He even said he was sorry for bothering me.
F*****g crazy.
59points
#15
My surgery to remove ovarian cancer surgically was deemed, ELECTIVE. The type I had wouldn't respond to chemo or radiation therapies, but since it wasn't going to immediately k**l me it was just cause I wanted it apparently. Had to pay 6k out of pocket.
53points
The human toll of claim denials is profound. Patients report increased stress, delayed medical interventions, and financial strain. In some cases, individuals have been forced to forgo necessary treatments due to insurance hurdles.
#16
My wife had an emergency surgery for a spontaneous retinal detachment. Literally minutes away from going blind. Insurance tried not to pay because she had not gotten pre-authorization, and then after that, claimed a SPONTANEOUS event was a pre-existing condition.
51points
#17
Not me, but someone I know was diagnosed with cancer in her early thirties. Her oncologist found cancer cells in her lymph nodes, indicating that it had metastasized, so he ordered a full body MRI to assess where it had spread to. Her insurance denied it because they said she was too young to be considered at risk, despite her actively having cancer. They did eventually approve it, but not without a lot of pressure from her doctor.
49points
#18
My girlfriend had kidney failure as a child and had been in dialysis for over 15 years. She graduated college and was working as a teacher. She had to stop due to complications with her condition and go on disability. This was prior to Obamacare so we tried to get coverage from all the insurance companies since it’s impossible for anyone to afford dialysis without insurance. Every single company decline to cover her due to her pre-existing condition. They essentially told her that she was too expensive to live.
47points
Healthcare providers are also feeling the strain. A survey commissioned by AKASA revealed that nearly 50% of providers have seen an overall increase in their denials rate compared to the previous year, adding pressure to an already burdened system.
To navigate these challenges, it’s crucial for policyholders to be proactive. Understanding the specifics of one’s insurance policy, maintaining thorough records, and promptly addressing any issues can make a significant difference in the claims process.
#19
Had to call every few days to beg and cry for them to approve a specific pill for chemo-induced nausea. I was supposed to take it the morning of treatment and they would only allow one pill dispensed from the pharmacy at a time, so every few days I’d deal with the anxiety of calling them and begging for approval so I’d be able to tolerate the poison being pumped into me (which…they approved of) I would be on the phone for hours just crying and hoping they’d push it through. My doctors and local pharmacist would call too.
They wanted me to f****n raw dog chemo.
They wanted me to f****n raw dog chemo.
46points
#20
When I was a young teen (early 80s) I was injured in an accident.
Face injury, muscle damage, possible orbital bone break, possible eye injury, etc.
When I got to the hospital, I sat in the ER for over two hours because there had just been a bad multi car accident.
THEN, they didn't want to treat me because they weren't sure the insurance would cover it.
My mom worked FOR THE HOSPITAL (Admin, not medical), it was THEIR OWN insurance .
They wanted her to pay cash to cover a certain percentage, can't remember what exactly, but it was over $2000.
They didn't want a check, they wanted cash. She went across the street to the bank and got the cash.
I got treated, spent a couple days in the hospital, got out and recovered, no orbital break, no eye injury, just a bunch of stitches.
Once the insurance was filed and paid, my mom asked for her money back. They said, "you'll get a check in the mail."
NOPE. She went and literally sat on the administrator's desk until they brought her cash.
They made her pay cash before they would treat me, when I was covered by THEIR OWN INSURANCE, then they would by god pay her back in cash.
Needless to say, she quit that day.
Face injury, muscle damage, possible orbital bone break, possible eye injury, etc.
When I got to the hospital, I sat in the ER for over two hours because there had just been a bad multi car accident.
THEN, they didn't want to treat me because they weren't sure the insurance would cover it.
My mom worked FOR THE HOSPITAL (Admin, not medical), it was THEIR OWN insurance .
They wanted her to pay cash to cover a certain percentage, can't remember what exactly, but it was over $2000.
They didn't want a check, they wanted cash. She went across the street to the bank and got the cash.
I got treated, spent a couple days in the hospital, got out and recovered, no orbital break, no eye injury, just a bunch of stitches.
Once the insurance was filed and paid, my mom asked for her money back. They said, "you'll get a check in the mail."
NOPE. She went and literally sat on the administrator's desk until they brought her cash.
They made her pay cash before they would treat me, when I was covered by THEIR OWN INSURANCE, then they would by god pay her back in cash.
Needless to say, she quit that day.
45points