16 November, 2011

And the headache continues

I hate medical insurance.

I know, I know. "Hate" is a very strong word. It's not often I use that word and truly mean it. But in this case, I feel absolutely justified in my use of it. Medical insurance has caused nothing but trouble in my life. When dealing with cancer several years ago, the insurance carrier who my employer was using refused to pay any of my bills, claiming it was a "pre-existing condition." They stuck me with around $60,000 in medical bills. Needless to say, this has caused some problems in my life. Now today, cancer is once again being... well... cancerous.

After getting all treated and "cured" of all that nasty cancer business, I still have to go in for yearly checkups. I have to get my blood drawn to make sure that my T3, T4 and thyroglobulin levels are good. I have to get an ultrasound on my neck to make sure nothing's regrown. And I have to shake my doctor's hand and say "Thanks for not letting me die!" It's a pretty simple set of procedures, really, but it's costly nonetheless. For that trouble, the doctor's office charges $641. Ouch. Not to fear, medical insurance to the rescue! ...or maybe not. While they were kind enough to get the charges reduced to $221.91 due to "preferred rates" (umm...what?), they didn't actually pay any of it. Not a single penny. Nada. But wait, my work has planned for just such a problem! We have a second bit of coverage titled "Hospital Confinement Indemnity (GAP) Insurance." Yes, that does say "Hospital." No, I did not get this work done at a hospital. Don't worry, I'll come back to that. So now, a few phone calls, emails and hours later, I've got a GAP (is this supposed to be an acronym for something? Because I sure don't see it...) claim form to fill out and send along to this OTHER insurance company. As I am informed by our insurance carrier however, they will not cover the office visit. They will only cover the procedures performed there. So this leaves me with $61.37 (their cute little preferred rate) to pay of an original $641 bill. Not bad; I can handle that. After filling out the form, gathering up my doctor's bill, my original insurance explanation of benefits (in which they explained that they are going to do absolutely jack,) I faxed off all 9(!) pages to the GAP insurance company. Done deal! I should have a check in my hand within 10 days; fantastic!

But wait, you say, what about that "Hospital" business? This is where I get confused. I did not have my procedures performed at a hospital. I have not even been to a hospital in some time (knock on wood) and that is perfectly okay with me. This GAP coverage is specifically worded to be for hospital confinement resulting from sickness or injury. Granted, there is an "outpatient" section under which I may theoretically be covered, but I'm not holding my breath. Our insurance broker is absolutely certain this will be covered. After all, that's exactly why we got this silly second bit of coverage. Why wouldn't it cover it?

I'm just waiting to cringe and bend over at this point.

I hate medical insurance.

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