[gricardo99]

That's exactly right.

Their coverage is not based on the insurance policy they sold you. It's based on what they can get away with and make the most profit.

I don't think it's a coincidence that the largest medical bill I had to pay for a hospitalization was likewise initially denied and then caught-up in bureaucratic hell for several months before they finally paid. I honestly thought I was going to have to hire a lawyer to fight them. But somehow, probably based on my push-back, their calculation eventually favored paying-up.

They make things difficult and confusing for people on purpose. They deny perfectly legitimate procedures on purpose.