Saturday, April 28, 2018

Getting sick from your medical bill is not a covered illness

Here we go again. Hieroglyphics courtesy of your insurance carrier.

My son definitely should be awarded an honorary PHD in interpreting medical bills and health insurance policies. When my wife came to him with yet another unexpected charge for a medical procedure it was like a Yogi Berra truism: "deja vu all over again."  But one more head scratching  episode of "who's on first."

The latest fiasco apparently involves the physical location where a certain procedure was done. We are mandated to read through the manual of dos and don'ts, filled with dotting i's and crossing t's, so that the cough we can't kick or the finger that got caught in the door doesn't get exacerbated until it becomes a full blown case of financial disaster.

I am sick and tired of worrying about whether being sick and tired will burn a hole in my pocket and my stomach . I am now of Medicare age and, for me,  the deciphering of documents has largely disappeared. But, oh by the way, the cost of my premium has not. Between the alphabet soup of different items requiring their own monthly payment, and an annual review of my income to determine next year's costs for protection relating to hospital, doctor, pharmaceutical and air breathing , it seems that the concept of paying into the system for a lifetime in exchange for truly free medical coverage in one's advancing years is more than a smidge of a shell game. And please make sure your doctor does not treat Medicare like a disease.

But my real beef is not with the dollars and little sense wake up call on turning 65 but the perpetual hold my breath, cross my fingers and pray to the gods that tomorrow's mail will not inform me that the procedure performed on my wife was actually a shove it up our collective backsides out of network, wrong facility, not that doctor, unnecessary, experimental, never heard of it, didn't say pretty please, we are no longer in business, hold for the operator, we don't have that code, what date were you born, can I speak with your supervisor, are you standing on one leg, moment.

Seeing yet another claim denied is more than likely to give me a heart attack. Which of course would be uncovered since I had not requested pre-authorization before clutching my chest.

"I don't know - third base."


Anonymous said...



Anonymous said...

the medical/insurance establishment does appear to be based on the word no. i cannot tell you all of the fights that i have fought trying to get payment for procedures that i have had. it takes a lot of perseverance to get to the correct person, then have them do what they said they were going to do. it is so much easier, and expensive, to just accept the first no. good luck and keep fighting.


Anonymous said...

You got this soooo right! Medicare is on my speed dial, together with Social Security - equally and relatedly terrifying to encounter!!