United Health Care can suck my pre-approval

We live in a town where there is one healthcare facility, and every doctor in town is employed by that facility.

This is not hyperbole, the way I might say, "Everyone is driving a Mercedes but me!"

Literally, EVERY physician is employed by this single hospital. And by "literally," I do not mean "figuratively."

In order to find another doctor, we would have to drive 40 minutes in one direction 45 minutes in another direction and 50 minutes in a third direction. (There are only 3 directions and a lake, so don't question me about the fourth direction)

By why would we go anywhere else when our local hospital is not only the premiere facility in our county, but also a regional cancer center and a teaching hospital for an Ivy League medical school?

Maybe because the entire facility and all its providers are outside of United Health Care's network of providers. Every one of them.

And, as a new patient, would you like to know when you're informed that every cent of every charge you incur will come out of your pocket?

When you get the bill and call to ask why insurance hasn't been filed. Insurance has been filed, they tell you, and you're not covered.

The good news is that none of us has required extensive care. We've just tallied up charges for four new-patient visits - one to a specialist - two visits for bloodwork (includes charges for the kid who draws the blood and whatever tests were run on that blood), and a pap screen. With a little luck, the total bill won't exceed $3,000.

Then again, does anyone out there know the street value of a pap smear and a CA-125, because I haven't yet seen the charges for those.

And would you like to know how much I have paid out-of-pocket to United Health Care for insurance coverage since moving to this networkless netherworld?

$2,448, which does not include July's premium, which I was not going to pay until I could confirm that I could actually receive care in the FUCKING CITY WHERE I LIVE.

I have spent two weeks talking to the insurance company, where every employee is expertly trained to use the word They as often as possible.

"They're saying that your doctor isn't in network."
"You could file and appeal and maybe they will cover the visits you've already had."
"No, you can't speak to any of my supervisors because they're all in Moncaco lighting their hashpipes with $1000 bills and performing unspeakable sex acts on your elected officials."

They're also well-schooled in the art of deferring to another department, which may or may not actually exist.

"I'm sorry Ms. Bookish, I can't suck your dick. You'll have to call our legislative blowjobs department. Maybe they can help you. Would you like me to transfer you?"

Anger is not my strength. Some people get angry and powerful. I get angry and ridiculous. My voice - already at the upper tier of tones audible to the human ear - skyrockets into the dogs-only territory. My anger does not harvest results. It garners sympathy.

And that sympathy turns my anger into white-hot, ear-stabbing, molar-cracking rage.

At which point I just start crying.

The biggest holyfuck of it all is that none of us was even sick, and I'm in several thousand dollars' debt to the hospital.

If you want to get really upset, visit Moreena and find out what you can do for a 5-year old who is awaiting her third liver transplant while her parents are dealing with insurance coverage questions.

Then visit Michael Moore.

But for goodness' sake, triple check your coverage before you visit the doctor.

Comments

[raehan]

That's terrible. I'm so sorry.

Another sad thing about our health insurance is that many older people can't retire becuse their pensions were fine on their own, but not covering health insurance.

Not to mention people without jobs or pensions.

[Lila]

Ok, Bettie, lend me a hand and I think we can shove this whole HMO in The Cooker.

http://etb.typepad.com/bettiebookish/2005/11/in_the_cooker.html

[An' Beppe]

Girl, you just need to come back home to the South and get you some SALVE. Cures everything.

[moreena]

I'm so sorry to read of your insurance woes. There is just something so very wrong; I can't believe that it's not more of a political issue. Maybe the Michael Moore movie will get people talking even more.

And, of course, thanks for thinking of us, even while messing about with your own mess.

[Bettie Bookish]

My guess is that it is not a huge political issue (despite the Clintons' best efforts) (sorry my legions of pro-Bush fans) because the people who are the most affected have the very smallest political voices.

And the people who profit from the healthcare status quo are either in political offices or in bed with those who are.

If you're poor and sick, you get poorer. And often sicker. Then you qualify for the glorious government-sponsored healthcare system that is designed to make every transaction so flippin' difficult that dying from your illness is preferable to trying to make one more appointment.

And I actually have mixed feelings about Michael Moore's upcoming project. I hope it shines a light on the darkest aspects of a system that we all expect to be kind and noble.

But MM is so easily positioned as a nut by the people whose stock options he threatens, that I hope it doesn't actually cause a backlash against reform.

Meanwhile, I'm told by several good sources that, in my case, the hospital dropped the ball by allowing me to sample the buffet of their luxurious pelvic exams and blood draws without telling me I was footing the entire bill.

It's like I took a CA-125 from the minifridge thinking it was free.

[Amanda]

This just sucks..I am sorry that you are dealing with it.

My mom has been in and out of the hospital for the past three months (simple issues that was compounded by crappy medical care....sigh...), and to see this behemoth that is managed care in motion has been frightening, to say the least.

Long time reader, first time commenter....I love your site and appreciate your honesty and humor.

Take care.

[StepBlog]

F*cking f*cked up f*ckers!!

[Carolyn C.]

UNBELIEVABLE? Unfortunately no, it happens all the time, even to us doctors. imagine working at a hospital getting chest pain similar to a heart attack and being sent to the emergency...waiting for a bed in the cardiac unit of intensive care. having a echogram and blood work to make sure you haven't had a heart attack. being admitted to the hospital b/c the test or inconclusive. to finally being sent home 2 days later with we don't know what was wrong. imagine all that and then getting a hugh bill from one, the er b/c you took up a bed beyond standard time (not you fault, like you could just walk and take any room you wanted). two, from the Xray department for the person that took the films and the person who interpeted the pictures. third, a whooping bill for taking up a bed in the intensive care unit and having constant monitoring of your heart. don't forget four, for the one to the other person interpeting the readings. all this money for chest pain that no one could explain. and why wasn't it covered by the hospital i was working at? the er docs were outside contracted workers for the hospital so they really weren't employees of the hospital and since they were not in network providers and they started the whole processive of addmission....none of the bill was covered. so what was i to do, how would i have known that kind of information? so i fought it out, not with the insurance co, but with the hospital and got them to drop their charges. this didn't work for the other charges. so i pulled my physcian courtesy tatic and got it written off. this would not have happen if i wasn't a dr. so i know exactly what you are talking about. sorry for the long post. sometimes i just get going.

[The Mumbler]

I'll bet that hotshot husband of your could charm his way out of those charges. He's such a hotshot.