Texas mom pays $400/Month for insurance. Then United Healthcare denies her son’s 30-min procedure and allegedly demands a $1K upgrade: ‘it’s a scam’ – We Got This Covered
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Image via TikTok/ @kristin.swanson

Texas mom pays $400/Month for insurance. Then United Healthcare denies her son’s 30-min procedure and allegedly demands a $1K upgrade: ‘it’s a scam’

The ultimate scam: paying for coverage that covers nothing

For parents, a child’s scheduled medical procedure often comes with enough uncertainty on its own. One Texas mother says the biggest obstacle wasn’t the procedure itself but getting her insurer to cover it.

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TikTok creator Kristin Swanson says her nearly four-year-old son was scheduled for what she described as a routine outpatient procedure. According to Swanson, despite paying nearly $400 each month for health insurance through UnitedHealthcare, the company informed her it would not cover the operation. The decision, she says, left her questioning the purpose of maintaining coverage in the first place.

“I just want to come on here and talk about how insurance companies are an absolute scam. Absolute scam,” she says near the beginning of the video before explaining that her son “is going to have to have a procedure, a very minor 30 minute outpatient procedure.”

A denied claim and a costly alternative

According to Swanson, the denial came as a surprise because she believed the family’s monthly premiums should have protected them from exactly this kind of expense. “The insurance company that we pay almost $400 a month to says we’re not gonna cover it,” she says, before asking, “Why, for what reason are we paying you monthly for if you’re not gonna be there for us when you need it?”

Swanson goes on to claim that the company presented another option that only added to her frustration. Recalling what she says was the insurer’s response, she sarcastically says, “We got you girl. We’ll help you out. We’ll let you upgrade his insurance plan for just a quick little thousand thousand dollars and then for his, his deductible to start all over.”

@kristin.swanson

UnitedHealthCare insurance is a SCAM!!! I posted this earlier and somehow the sound of me talking got taken out of my video… well here it is again. #insuranceisascam #unitedhealthcare #fyp #insurance

♬ Mozart/Requiem “Lacrimosa”(1394506) – Mint

The creator does not identify the specific procedure or share documentation explaining why coverage was allegedly denied. Insurance claims can be rejected for reasons including prior authorization, medical necessity reviews, or plan restrictions. Similar insurance complaints have surfaced on TikTok before, including from another creator who said UnitedHealthcare would not approve treatment recommended by her doctors.

Swanson estimates the procedure could cost her family around $10,000 out of pocket, though she says the final total remains uncertain because additional bills could still follow.

“This surgery is gonna cost us probably about 10 grand, if not more, cause we don’t know what the anesthesiologist bill will be,” she says.

Later in the video, Swanson briefly references the fatal shooting of UnitedHealthcare CEO Brian Thompson while making clear she is not endorsing violence.

“It’s such bullshit. And this is why CEOs get, you know. And not that I agree with that,” she says, before saying she found it “ironic” that the reported denial involved “the exact same insurance company that that CEO got.”

Many viewers responded by sharing their own experiences with insurance costs, while others offered suggestions for lowering the bill. One person suggested looking outside the insurance system altogether, writing, “Call the hospital and what the cash pay option is.”

Another commenter wondered whether the issue could be tied to the provider instead of the insurer, asking, “Is it with an out of network provider or facility? What is their reasoning for not covering it.”

Others used the comments to compare their own healthcare expenses. “That sucks girl! But $400 a month?? We pay $1100 a month then have a $3,000 deductible before they pay,” one viewer wrote. 

Some responses reflected broader dissatisfaction with private health insurance. “I want to cancel my insurance,” one person commented, while another wrote, “This is the very reason why I canceled all my insurance. I paid thousands of dollars monthly for all the good it did. Insurance is a scam.” A separate user summed up their reaction in two words, writing, “Complete scam.”

Swanson closes the video by returning to the question that drives her entire account. “But I just think that it’s absolutely insane that we’re paying this insurance company For what? For what? You’re not here for us. You don’t help us, we pay you. For what? It’s a scam.”

Swanson’s claims have not been independently verified, and the exact reason for the reported denial remains unclear based on the information she shared. Even so, her video reflects a broader trend of TikTok users documenting disputes over healthcare costs, from denied procedures to unexpected insurance bills that they say left them questioning the value of their coverage.


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Mrinav Dehingia
Mrinav has been covering entertainment, gaming, celebrity news, and internet culture for a while now. When he is away from the keyboard, you'll usually find him watching movies, playing games, or keeping up with Fred Again.