Here is my "recovered" post from this past weekend...
Let's say a telephone company charges you $90 a week for a complete service package. Local, Long Distance, High Speed Internet, Wi-Fi, the whole ball of proverbial wax.
Now let's say that you paid said $90 a week for four months without once using the service. Kinda stupid, but maybe you just didn't need to make a call during that period. Besides this is obviously an allegory for, oh, something.
Then one day, after that four months passes, you really, really need to make a phone call.
Huh, no dial tone? Service denied? Huh, there must be some mistake! They've been paid their $90 a week and only now am I trying to make one measly little call.
I'd better find out why. I know, I'll call customer service for an explanation of what it is I've been paying for.
You see, my wife went for her annual OB-GYN checkup. She complained about a pain. The doctor had an ultrasound taken. There was "something" attached to an ovary. It looked like a cyst, but the Doctor felt an MRI was in order to better define what its is. She scheduled my wife for the MRI at 8:30 the following morning at Hospital A.
Then the Insurance Company called and told her that they won't allow an MRI, it has to be a CAT Scan! The appointment was then changed to 2:30 at Hospital B. My wife had to drink 3 pints of foul, gag-inducing contrast prior to the procedure.
Now here's the punchline: While my wife was at Hospital B having her scan, the Insurance company called the Doctor's office to say that they weren't going to allow payment for the CAT Scan because my wife's diagnosis is considered (by them) to be a pre-existing condition!
In fact, they have refused to pay for any of my wife's OB-GYN stuff on these same grounds! And, folks, she's looking at surgery to remove an 8.5 cm diameter cyst this Thursday.
The OB-GYN had us come by her office on Friday to fork over $1,500 in cash as a deposit toward the surgery. Which we did.
It's rough enough to have to consider the possible ramifications of a hideously large "something" growing inside of your wife (rhymes with "prancer") without being guaranteed that her convalescence will be in a dumpster outside of the county homeless shelter.
And not only am I paying $90 a week out of my own pocket to these crooks, but my employer is also paying hundreds of dollars a month to them on my behalf. With the exception of you, gentle blog reader, I hate all of humanity at this point.
I'll post any updates as I can, as they happen. At the very least, I'll let you know how the wife comes through the operation.
Let's say a telephone company charges you $90 a week for a complete service package. Local, Long Distance, High Speed Internet, Wi-Fi, the whole ball of proverbial wax.
Now let's say that you paid said $90 a week for four months without once using the service. Kinda stupid, but maybe you just didn't need to make a call during that period. Besides this is obviously an allegory for, oh, something.
Then one day, after that four months passes, you really, really need to make a phone call.
Huh, no dial tone? Service denied? Huh, there must be some mistake! They've been paid their $90 a week and only now am I trying to make one measly little call.
I'd better find out why. I know, I'll call customer service for an explanation of what it is I've been paying for.
"Hello, sucker! This is Ms. Screwyou and I'll be happy to explain it to you. You see, prior to signing up with our service you did not have an existing telecommunications service agreement. Therefore, even though you have been paying $90 a week for our service, we don't actually have to provide you any service until you've paid into the plan for a full year. This is because we say so."Now, if you substitute "Healthcare Plan" for "Telecommunications Service Plan" you'll have a snapshot of the hell that is my life at this moment.
"Oh, what a sweet deal! What do I do in the meantime?"
"Well, that's really not our problem, Mr. Loser. Might I suggest you use pay phones or buy some calling cards?"
"Can I terminate my contract and get a refund for all the money I have paid you for all the services I have been denied?"
"Oh, most certainly not! But, if you want to opt out on the one year anniversary date, you may. That way, you'll have paid us for a full year and we wouldn't ever have had to provide a single service. I hope you find this information is helpful."
You see, my wife went for her annual OB-GYN checkup. She complained about a pain. The doctor had an ultrasound taken. There was "something" attached to an ovary. It looked like a cyst, but the Doctor felt an MRI was in order to better define what its is. She scheduled my wife for the MRI at 8:30 the following morning at Hospital A.
Then the Insurance Company called and told her that they won't allow an MRI, it has to be a CAT Scan! The appointment was then changed to 2:30 at Hospital B. My wife had to drink 3 pints of foul, gag-inducing contrast prior to the procedure.
Now here's the punchline: While my wife was at Hospital B having her scan, the Insurance company called the Doctor's office to say that they weren't going to allow payment for the CAT Scan because my wife's diagnosis is considered (by them) to be a pre-existing condition!
In fact, they have refused to pay for any of my wife's OB-GYN stuff on these same grounds! And, folks, she's looking at surgery to remove an 8.5 cm diameter cyst this Thursday.
The OB-GYN had us come by her office on Friday to fork over $1,500 in cash as a deposit toward the surgery. Which we did.
It's rough enough to have to consider the possible ramifications of a hideously large "something" growing inside of your wife (rhymes with "prancer") without being guaranteed that her convalescence will be in a dumpster outside of the county homeless shelter.
And not only am I paying $90 a week out of my own pocket to these crooks, but my employer is also paying hundreds of dollars a month to them on my behalf. With the exception of you, gentle blog reader, I hate all of humanity at this point.
I'll post any updates as I can, as they happen. At the very least, I'll let you know how the wife comes through the operation.
posted by Craig D at 6:00 AM
9 Comments:
Who are these assholes? I want to be sure that no one I know ever gives them any money.
I am so sorry Craig. You and your wife will be in my thoughts and prayers.
Oh, Craig, this is awful. Awful first and foremost for your wife, who must be feeling the full range of emotions from fear to guilt. (I hope the fear is soon replaced by relief).
As for the guilt... by what lovely-sounding healthcare provider name are these bastards going? Haliburton Healthcare? A call to your elected representative and senators could do no harm and might help. Can your employer be of any help in pressuring these creeps?
I'm very sorry to read about your troubles, and I hope for all the best for your wife as well as your wallet. Good luck, friend.
Craig, I am so sorry you and your wife are going through this! She is in my thoughts and prayers. I truly wish we had some power over these stupid insurance companies!
Thanks for the well-wishes, folks!
My employer put me in touch with our agent, who got us hooked up with a claims worker. Nothing definite yet, but it helps to have people screaming from all sides, I suppose.
Michelle picks up her prep kit this morning and her sister arrives this afternoon. (I trust you all know what the prep kit is for. What a way to spend the evening!)
Surgery is tomorrow at 8:30am...
Wow, that's frustrating. My neighbor just told me that the hospice where his mother-in-law was being treated was recommending an "alternative form of care." No, she wasn't getting better. Apparently, thanks to the wonders of Medicare, there is now an additional step in between hospice and death. Fortunately (?) she died before they had to move her to another facility.
Wait ... you get insurance from your workplace. Did you just recently switch jobs? Have you been continuously insured? Because I thought that federal law kept them from doing that.
Anyway, sorry to hear about that. The insurance industry really blows. It's awful.
Oh, I'm so sorry that you and your wife are going through the scariness of the surgery/diagnosis just by itself. The insurance company part - I shouldn't even get started on that. But I will. At 2 1/2, my son was dianosed by MRI with a malformation that had caused part of his brain to herniate into his spinal column. The MRI was only of the skull, so the surgeon ordered a second one of the spine so he'd know how far down he needed to cut. Afterwards, the insurance company ruled the second one "not medically necessary." I would challenge anyone of those shitheads at blue cross to let someone slice into their baby's brain without an MRI to guide the way. Eight years later I still feel sickened by their penny-pinching callousness.
diesel: Thanks for dropping by. I'll try to get over to your blog soon.
dorky dad: The tragedy is that I had an interruption in coverage. Short version is I was unemployed for 9 months and could not afford the $1200/mo it would've taken under the idiot COBRA act to maintain my coverage.
csl: So you've been to Hellen Back as well. The latest Health Care proposal I heard is:
If you want bariatric surgery, the HC provider wants to insist you first follow a YEAR LONG weight-loss program to PROVE you're a hopeless fatty that can't loose weight. Otherwise they will not approve this very expensive procedure.
Update in next blog entry.
Thanks, again, everybody!
Last February, I had a huge cyst rmoved from my ovary. Thank goodness it turned out not to be cancer. I already had my fun with cancer the year before that. I see from reading more current posts that your wife is healing well. Did they take out the ovary? Just the cyst? Hysterectomy? I can't find where you wrote what it turned out to be. I'll be thinking of you! I know how hard it is to recover from all of that!
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