This is a purely personal diary. The topic isn't even trending right now, and I don't care. Hell, I'm not sure I care if anybody reads this. Just typing it made me feel better.
I'm sure someone in the comments will point how how privileged I'm being, and how "lucky" I am, how I could have it worse off, and I'm a whiny adolescent and should probably shut up. So let me say here, this is not a "my problem > your problem" diary. I know there are a lot of people out there less fortunate than me. I am not trying to one-up them.
I'm turning to DK now because I've lost hope that it's going to improve, and maybe sending my frustration into the void of the Internets will help my stress levels a bit. Kindly don't add to them by turning it into a pie fight. If you can't stand me, just leave, it's that easy. Go insult me in yesterday's diary thread instead.
Let's start where it started: December 2010. Our company, for which I am employed full-time as a college-educated engineer, had an all-hands meeting to discuss something we all knew was coming: our employer was changing health insurance plans.
We were told that some accountant at the company had determined that our current insurer was a rip off because 1/3 of what we were paying them (the company self-funds all medical payouts, so they only pay administrative costs to the insurance carrier) went directly to profits.
To which many of us went, aware of how unregulated capitalism works, said, "Duh. And?"
Long story short, the company took bids for a new provider. This provider underbid everyone else considerably, promising to deliver high quality service for a too-good-to-be-true price. Only if the company had actually done any research instead of just buying their tagline, they would have found that this insurance provider was actually ranked very poorly in terms of customer satisfaction and value.
Clue #1 that all that matters is the bottom line.
Unfortunately, they admitted to us with A Very Sad Face, our particular location would probably have some difficulty with the new plan, since the provider had 0 presence in the region. It'll be easy, they told us, just submit your doctor's name and practice and we'll get them on the "approved providers" list lickety-split. Plus, your office will get a special deal where you can even get coverage for providers that never get in-network!
The warning bells in my head were ringing so loud by that point that I couldn't hear myself process a coherant question, let alone listen to the rest of the pitch at the meeting.
And, as does occasionally happen, I was entirely correct to be feeling pessimistic.
After diligently checking to make sure my doctor was on the "in-network" list, to avoid the aggravation of trying to get them ON the list (a 3+ month process which many doctors in the area never did go through with) while hoping my health didn't suddenly fail.
I had my annual physical. I learned that I have worsening hypothyroidism, which explained a lot about why I'd been feeling lethargic, underhydrated and well, let's just say "upset in the digestive system." I had a few blood tests. I was prescribed some daily medication. I assumed my insurance would take care of it.
Well, picking up my prescription was no problem. the $5 co-pay was certainly reasonable.
The $400 in doctor and lab bills wasn't.
Over the course of the last 19 months, not a single bill has been covered under my health insurance plan. Last year I paid almost $800 in medical bills out of my pocket. In my attempts to make my insurance company live up to its promise of, you know, covering my bills I made numerous phone calls and emails. The result was that I got bounced from rep to rep, none of whom could answer my question. Eventually I talked to my HR representative, who "unofficially" handles all the screwed up insurance stuff, only to have her admonish me for not bringing it to her first because our "special deal" meant that the normal insurance reps had no idea what I was talking about when I called. She talked to our "assigned" insurance agent, who, 6 months after I received my bills, finally admitted that they should have been covered. I swear to the FSM that if I hadn't yelled at him about it while he was in a meeting with me and a bunch of other angry customers that it never would have gotten done.
Clue #2.
I did eventually get reimbursed for about $500 directly from the billing departments of my doctors. The other $300 was "balance-billed" which is perfectly legal. I'll never see it again.
And if you'd been paying attention, you'd notice that "out of network" in this case was actually "in network, but we screwed up" with regard to my insurance company.
Clue #3.
This year I had a scare in which, during my exam, my GP saw something suspicious and insisted I see a specialist, who did a painful scoping test and biopsy. I had been informed that the specialist was in-network by their billing office, who was either wrong or had run into the same problem as my GP a year earlier. Not only was I emotionally fraught from the prospect of being 25 and diagnosed with cancer (it was just an infection, thankfully), but soon after I was hit with another $600 in medical bills.
When I have talked to those doctor's billing departments, they are perplexed, because they think they are in-network. My insurance, as usual, says they're not. My HR rep who I took this up has not been able to get results in the last 2 months. She also told me to file for reimbursement with the insurance company, even though last year a rep told me not to do it because it wouldn't process correctly with my company's "special plan."
Clue #4.
I'm now paying these bills out of pocket, too, all because this insurance company, the local doctors, and my employer can't get their goddamn ducks in a row. In my last email to my HR rep, I asked who in the company I could lodge a formal complaint with over our insurance policy. She informed me that we WILL be changing providers....in 2013. So I just have to stop beings sick until then. You hear that, limbic system?
If only.
While I've done my best to keep my temper in check and not blame anyone personally, the sparse communication and the impression that nothing at all is being done is starting to grate on my nerves. I understand why people give up the fight, I really do.
I also said that if I can't get anything resolved here I was going to take this up (again) with the Better Business Bureau, who seemed quite interested in my complaint last year. Though the first complaint got cancelled because I did finally receive coverage, I'm more than willing to do it again if it means I get an agreement from my insurance to stop fucking around and cover my damn bills already.
Short of looking for a job with better benefits and probably surrendering my $8000 homebuyer credit in the process, I really don't know if there's anything else I can do. A few hundred or even thousand dollars in medical bills isn't going to break me financially...but emotionally is another matter.
My deteriorating thyroid makes me prone to depression, which I'm already prone to due to my genetics. (See a doctor, right?) I already hate the desert climate where I live, don't particularly enjoy my job, and get to experience the unbounded joy of being a liberal in a neocon culture and a tea party district. Short of a miracle, this wanker of a health system isn't going to be overhauled in any useful way for me anytime soon. But you know what? In the end, I'd pay more if I could get an agreement that I wouldn't have to worry and stress and call customer service multiple times a week.
And this indignity of being treated as worth no one's time, this hopeless feeling that it will never change... that part's worst of all.
Wed Aug 10, 2011 at 9:36 AM PT: EDIT: I just wanted to say, this is pretty cool and a definitely mood lifter to have two diaries in a row on the rec list. And thanks to everybody for their words of encouragement and advice. I read them all.