My friend is one tough SOB, had his own saw mill, was in the lumber business. Recently a lady plowed through a stop sign and creamed his car. He almost lost his arm, his wife showed me a picture of it, it looked like it went through a meat grinder. His private insurance is making him go through 6 weeks of rehab before they will do a more costly procedure that his doctor was prepared to do. If this guy can't use his arm he isn't faking it.
My friend also has A-fib, he is out of rhythm but before getting a cardioversion to get him back in time his insurer says he must have a stress test. They pay a lot for their private insurance. 
I have Medicare and have never had a problem with my procedures being questioned or denied. The people at the hospitals told me they love to handle claims from Medicare because there is never a problem. It is coming to Medicare. Krasnov wants to morph Medicare into Medicare Advantage and then I will be told what doctor I am allowed to see and my care will need pre-approved. I had one knee replacement and have scheduled my second knee because I can see what's coming. The Big Ugly Death Bill is designed to kill unwashed Americans like me.