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Diagnosis of Migraine & Headache Types

First Migraine Ever- Insurance Denies Claim

  • By MigraineWoes

    Hello everyone,
    Hoping I can get some help. A few months ago, my comprehensive medical insurance denied my claim for an ER visit due to my first ever migraine.

    A brief background on me: I am female and in my late 20’s. I have (had) never had a migraine, never had problem headaches and no chronic health issues.

    A few months ago, I woke up to start my shift at the hospital like I would any other day. I had what felt like an oncoming tension headache- very mild, maybe a pain level of 2/10. I took 400mg of Ibuprofen and kept it moving. As my commute to work continued (about 21 minutes; by now it’s around 0635). I developed strange symptoms and started feeling terrible- I was dizzy, nauseous, and vision in one of my eyes was going blurry. By the time I got to work, this headache had landed on me like a ton of bricks! Much of the pain centered on one side of my face and pounding behind my eye. It felt like it intensified out of nowhere. I was in tears, weak and nearly collapsed walking in, save a kind employee who scooped me up and took me to the RN supervisor’s office (I’m a nurse).

    The RN supervisor recommended I go to the Emergency Room to get checked out and to get some relief. With the help of another coworker, I got to the ER and was scared by a doctor basically telling me that it was odd to have my first ever migraine at my age and that it could be a multitude of other things (such as TIA; Tumor; etc). He wanted to do some imaging, but I wanted relief first. I had never felt a pain like that! He opted to give me medication via IV and orally to see if it subsided. He said if it didn’t, we’d immediately need to begin a workup for other possible causes. Luckily what he gave me worked almost instantly!

    I thought all was well until insurance denied the claim and left me with a $2,000 bill!

    Sorry for the long post, but I’m just trying to see if anyone else has experience in writing an appeal letter, and if so, what they included?
    Thanks in advance and have a nice evening.

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  • By Nancy Harris Bonk Moderator

    Hi MIgraineWoes,

    I’m so sorry you went through that – I bet you were scared! Any time we have the worst head pain in our life, it’s always a good idea to have it checked out immediately.

    That’s ridiculous that the insurance company denied your claim. Appeal, appeal, appeal. Usually insurance companies have paperwork to be filled out so that would be a good place to start. It’s been a long time since I wrote an insurance appeal, but I would encourage you to do so. We have information in this article that should help; https://migraine.com/blog/preparing-a-written-appeal-letter-for-insurance-company/ and https://migraine.com/migraine-health-insurance/insurance-denials-migraine-medications/.

    Let us know how you make out and best of luck!
    Nancy

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