GRAND JUNCTION, Colo. (KREX) —

Many have felt like they’re getting the runaround from insurance companies before,
but some are questioning if health insurance carriers are intentionally keeping.
people from getting needed treatment. We spoke with Kris Melnikoff a western
slope resident who was already dealing with her cancer diagnosis when she had
to find new insurance in November of last year, she said she went for the gold
standard. She told us, “I knew I was gonna need to carry that kind of plan and
here I am with nothing.”

Kris feels left behind because of numerous roadblocks in her treatment. She says she wasn’t notified her insurance company, united healthcare, pushed in-network providers she was already using– to out of network, “when I purchased my policy to make sure that all the doctors that I needed were in network and they were listed in the network then come January first, now they’re not.

She’s also faced problems with “prior authorization” which allows insurance companies to approve or deny treatments from doctors based on whether they determine the treatment is “necessary.” when Kris’s oncologist recommended a new treatment she says united health told her she needed approval from her primary care physician over her cancer specialist— she got that
recommendation– only to have united health tell her they determined the treatment two doctors recommended was “not necessary.” She told us she doesn’t think “that they should be telling my oncologist how to treat people.”

Chris tells me that at a time in her life when every moment matters all the roadblocks United Health has thrown in her path are devastating, but beyond just herself, she worries about how many other people face similar life-threatening problems and hopes that lawmakers will step in, bring new oversite and extra competition and change the current system.

A May 31st Denver Post article reports the Colorado medical society is trying to convince state lawmakers to set up a gold card program to streamline prior authorization with more oversite– the report says a congressional committee and the Department of Labor are also looking into complaints like Kris Melnikoff’s.

We’ve reached out to united healthcare and have not yet heard back but will explore why in-network providers change and how customers can address concerns as soon as they get back to us.