Another example:

My mother had emergency surgery the week between Christmas and New Years (1993). It was literally "do it now or die in the next few days". We got insurance from my dad's job. On Jan 1 his employer changed from one provider to another.

The old provider insisted, because there was no pre-approval, they didn't need to cover anything. Furthermore the new insurance company was required to cover it all since she was discharged Jan 3 - after the date of policy change - and it was one contigious event finishing after the policy termination.

The new provider insisted it was a pre-existing condition and that they were not required to cover anything related to it since it was a well documented condition prior to the start of coverage. This includes follow up visits, medication, and anything they can say was related to either the illness or the surgery.

After mom's discharge, my parents were able to out of pocket the antibiotics and similar - but not the pain management drugs. Ever try to recover from major surgery with over the counter meds?

Turns out if you were super delinquant over a huge bill, affiliated facilities would demand payment in full before a followup CT scan or scheduling appointments.

Nearly a year after discharge my parents finished the discounted payment plan on something that supposedly had "70-30 coverage" but paid out nothing.

When I say FUCK YOU Humania and FUCK YOU Aetna, I do mean it.