Jarrett vs. Health Insurance

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output_0fhCWAGreetings, the internet!

I apologize for my overlong absence from posting here. This here story I’m about to unfold gives some insight into why I’ve neglected this beacon of organized nonsense. Before I get into the reading portion of today’s entry, we’re gonna do some math –

#1. Affordable Care Act + dude with extensive medical needs = grumpy insurance company.

#2. Grumpy insurance company + dude with extensive medical needs = sub-par coverage and service

#3. Dude with extensive medical needs is due for an annual MRI + sub-par coverage and service = dude pays for MRI

#4. Dude keeps records of all the times he tried to contact the insurance company + dude pays the bill anyway = legal action against insurance company.

#5. Legal action against insurance company^2 = 11…

#6. The square root of 11 is 3.31662479 – on a phone, these numbers could spell “DEMOBIPY” or “FENMAGRY”…which kinda rhymes with “gravy”, a delicious substance that clogs arteries, thus leading to more claims for the insurance companies, making them more grumpy.

I digress…

…Listen, part of my ongoing upkeep is a once yearly visit with my neurosurgeon. That annual visit is preceded by an MRI. When I was employed and insured through a PPO, I didn’t need a referral. Having an HMO (stands for Has Many Obstacles) through the Affordable Care Act, I need to get a referral to blow my nose. As if that bureaucratic labyrinth wasn’t enough, math problem #2 takes form in the…uh, form of unreturned messages and “health assistant” buck passing…hmmm, if you are a health assistant that had been passed a buck, you shall henceforth be called a “health passistant”.

Gosh, I’m all over the place, let me summarize – I need an MRI by mid August. I started the referral/prior authorization process for this about a month ago (after already having it approved, then losing coverage, but that’s a horse of a different color). All I’ve gotten in response is “I’ll reach out to your doctor’s office to see where they are in the referral process”. Three things about this –

1. The way they talk about trying to get in touch with my doctor’s office, you’d think they were trying to contact Santa Claus on Christmas eve.

2. The doctor himself told me that the paperwork was sent on June 2nd.

3. Every time I’ve called, I’ve spoken with a real person in the department I intended.

Here’s what I’m getting at – MRIs are expensive. I had one last year before paying my deductible ~ $1800. Call me paranoid, but I believe that when an insurance company is looking at paying that amount of money, there phones stop working, emails get sent to spam more often and the fax machine works maybe half the time. After all, HMO stands for Healthy Monetary Outlook. So I would have you bare witness, interwebs – I’ve done and continue to do my part to ensure that the MRI will be covered.

One more thing – I’m not slamming Obamacare here. I’m grateful that I have insurance, limited though it may be. And if there’s one thing I’ve learned, you are your best advocate. Even the best insurance companies can’t get inside your head, even if they do pay for an MRI of your brain, and decide what’s best for you.

Also, I thought of one more meaning of HMO. For this one you need to use a salty New Yorker accent – HMO = Healthy?!? Meh, Oh well.
FIN

@JarrettLWilson

2 thoughts on “Jarrett vs. Health Insurance

  1. My enemy is our medical spending account….standard practice is to deny all transactions and then claim at least once to not have recieved the proper proof via fax or email….

  2. It was my experience that one that, 1. They’d ask for receipts at the most erratic times. I’d get a prescription with it one month no problem, then the next month they’d ask for documentation and on that note, 2. It seemed like they’d ask for different documents our a different method of submitting it every time. It’d start simple enough, fax a form and the receipt, then next time they’d want the form, the receipt and the manual for the car that you drove to get the prescription, signed by the pharmacist; and you had to mall it from a mailbox of someone with a last name that starts with U…

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