One Health Insurance Company Says You Are Responsible For Botched Surgeries

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Posted: 8:01 AM Apr 3, 2008
Last Updated: 6:05 PM Jul 31, 2008

6 comments

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A major health insurer won't pay for botched surgeries.

Starting next year, Wellpoint will no longer pay for certain medical mistakes, like surgery on the wrong patient or body part, or a mismatched blood transfusion.

The company's 35 million customers won't have to foot the bill either, even if another surgery is needed to correct the problem.

Wellpoint is working its new policy into hospital contracts.

It's hard to track how many major medical mistakes occur every year, and a few states now require hospitals to report them.

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Posted by: J Location: NC on Apr 4, 2008 at 02:38 PM
If a hospital makes a mistake that big, then they should be the ones paying for it, not the patient or the insurance company. I mean it is unbelievable that mistakes like that occur to begin with, and boy somebody could get big dollars for mistakes like that.

Posted by: Mike Location: Edenton on Apr 4, 2008 at 05:29 AM
Health insurance companies shouldn't have to pay for botched surgery. Those who made the error should pay, many times over. Lawsuits from malpractice is one thing that made John Edwards rich.

Posted by: Insurance Specialist Location: NC on Apr 3, 2008 at 10:20 PM
You can visit this websote for more information: http://www.wellpoint.com/business/about_family.asp I'm not quite sure the difference, but it is not the NC BCBS or State of NC insurance - Wellpoint covers Empire BCBS and others like Anthem. They do not pay like NC BCBS or State of NC insurance (through BCBS). That was my point.

Posted by: mjb on Apr 3, 2008 at 06:32 PM
Why should insurance companies pay for botched surgeries? Who usually botches the surgery?

Posted by: Douglas Location: Hubert on Apr 3, 2008 at 03:45 PM
This article is so brief it is misleading. Read a more detailed account of this and you'll learn that this policy is similar one adopted by Medicare and it's simply requiring that the hospital pay for it's own mistakes and not charge the patient or health insurance provider for egregious mistakes or remedial treatment that resulted from one of those mistakes.

Posted by: COB Analyst Location: KY on Apr 3, 2008 at 02:08 PM
This "off the wall insurance company" Wellpoint *is* Blue Cross / Blue Shield. It's the parent company. But the rest of your comment is correct - ALWAYS talk to the hospital/medical facility about what happens in a case like this. Forewarned is forearmed...

Posted by: Insurance Specialist Location: NC on Apr 3, 2008 at 11:18 AM
QUOTE "The company's 35 million customers won't have to foot the bill either, even if another surgery is needed to correct the problem." That makes it sound good to those of you who do not know how medical insurance works.... However, what this means is that if the hospital (where the surgery was performed) is not in a contract with (or does not "accept") this off the wall insurance company (which I have never heard of) - this means that the patient will have to foot the ENTIRE bill. Make sure to do your homework! Even though you may have to pay an arm and a leg per month for Blue Cross Blue Shield at least you know that MOST places ACCEPT/PARTICIPATE with the insurance company ... and that is the BIGGEST issue when choosing an insurance company.

Posted by: jay Location: rocky mount on Apr 3, 2008 at 09:27 AM
im laid off my unemployment check is 300.00 a week i have to pay 80.00 a week for blue cross. it seems un fair.

Posted by: Mr. Bob on Apr 3, 2008 at 09:10 AM
Health insurance companys are cowards.

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