Wednesday, September 26, 2018

The Things You Can Learn About Your Insurance Company -- If You Take the Time!

There were things I learned about today about (my) health insurance that I want to share just in case you ever find yourself in the same position.

A few days ago I shared this post that explains a bit about the health problems I'm experiencing.

After a bit of back and forth with my P.A.'s nurse with regard to next steps, having the procedures done or having a Gastro consult first, I had enough. I let her know that I respectfully wish she would have given me all of the information at once that it took all day to receive so I could be in a much calmer place with my health.

This morning, on my way to work, the M.D. of the practice called me to discuss what happened the day prior. Again I explained my stance and told him I simply want to know what's next should something happen in the three weeks I must wait for my Gastro consult. He stated that perhaps I should come in and see him and we'll talk and re-consult. I kindly told him that seemed like a waste of time as I have all the trust in the world for my P.A., it was only the miscommunication between her, her nurse and myself. In the end, I set up the appointment because the conversation just wouldn't end and I was getting upset.

One thing I did bring up to him was why wasn't a stool sample taken? A person with the issues I'm having for a year and a half would indicate something is wrong. His response was that it could take up to five days to get results. I didn't hold back in my response, which was...Oh so you mean the results would have been in today or tomorrow? And I got crickets.

I'm about to cancel this appointment due to what I've said above in addition to having to take more time off from work and pay another co-pay. Nothing is going to come of it anyway.

Here's what I learned today directly from my health insurance rep. You (I) can't go to the ER simply because you're not feeling well. It must be life or death (in the eyes of the ER staff, not yours) or you will be billed 100% of that bill to the ER. If you're experiencing something such as I am and you're lying on the couch with your upper abdomen in so much pain, you know it will explode at any moment, you can't keep food down, the pain is spreading to your back and lower abdomen, you can't keep from crying, you're freezing even though you know you have a fever, etc....without a doctor saying is't okay to go to the ER or you must go to the ER, do not go to the ER. I was told, go to urgent care first, call your PCP, get online with a doctor via Facetime and get that referral or your insurance (mine -- Humana) will not pay your bill(s) and they will be hefty.

This is MY experience and MY insurance. I share this because you just never know, do you? Stitches, yes. Broken bones, yes. You get the point....

Here's the thing...don't treat me like I don't know what I'm talking about simply because you have a medical degree. I have studied, I have ideas, I have questions and I will question you. I will give you a run for your money for myself and my loved ones because that degree of yours? It doesn't make you a God.

My husband had two dislocated shoulders due to back to back seizures earlier this year, spent two nights in the hospitals with tests upon tests upon tests and these individuals (a team of them) couldn't figure out what was wrong. Give it time, they said. Give it time, over and over again. It will heal itself. That's three ER visits, a PCP visit, a Specialist visit (BINGO!) and a visit to the surgeon (who is a God). Four months later we found competent doctors who performed surgery. It will take a year plus of therapy to get him as close to normal as is possible.

So yeah, your piece of paper means shit to me. And Humana? You love collecting my monthly premium but as far as help is concerned? You're just sitting back waiting to reject, reject, reject. 

No comments:

Post a Comment

Share your thoughts!