21 September 2009

Health Care Reform, or "Why I Hate Blue Cross Blue Shield"

I think I may be having some circulation issues. My carpal tunnel appears to be acting up and every time I stand up today, I damn near pass out (and I haven't even been tweaking). Under normal circumstances, I might consider consulting a physician, or at least someone who works in the same office building as someone in a white lab coat with a stethoscope around his/her neck.

But these are not "normal" circumstances, friends. It's a scary, scary world out there, and I would advise you all to think twice (or five or six times) before you make any casual appointments with any medical personnel to have something "checked out."

I say this because of my recent health insurance shopping experience. Sit back, relax, ask a loved one to bring you a cold drink, 'cuz this is going to take a while.

Since we've been married, my husband has proven himself to be the more stable of our partnership--mentally and employment-wise, at least. I have the attention span of a gnat and therefore tend to float from shit job to shit job, and the shit job I held before this one didn't offer group medical coverage. (My then-bosshole graciously offered to either procure health coverage for me and mines or offer me a higher salary. I opted for the cash.) When I started my current shit job, we were well-covered under my husband's stellar group coverage, so I turned up my nose at the subpar (and brutally expensive) coverage offered me by my employer.

Then, as you are likely aware, THE ECONOMY fell into the shitter and my husband's company had to make some adjustments. Starting with a salary and hiring freeze. Then came the mass layoffs. Finally, they decided anyone left would be just so happy to still have a job they wouldn't necessarily mind having their health insurance benefits hacked to shit and taking a 20% paycut.

So when my husband was offered a position at another company with a substantially higher salary, he jumped on it. After all, the insurance benefits couldn't possibly be that bad, right?

Go ahead. Laugh.

They weren't that bad, they were fucking awful. And they were fucking expensive, eating up nearly half the increase in his take-home pay. But because my darling firstborn has some serious ailments that make him virtually uninsurable under anything but a group plan, we had to take it. Beggars can't be choosers, and beggars who are on maintenance medications can just bend over and take it like a trooper.

Upon starting his new job, however, my ever-resourceful husband discovered a way to save us substantial bank on the "employee contribution" for the premiums--select the "employee + children" option as opposed to "family." By simply cutting one of us off, we were able to save almost $400 a month. (Little does Humana know, they still have the most expensive member of our little family on their plate. Ha ha, fuckers!)

This, of course, meant I was left to my own devices for medical coverage. I consulted with my employer's benefits coordinator and discovered I could have a crappy Blue Cross Blue Shield policy for a mere $215 a month.

While I was picking up my jaw off the floor, I did a little research and discovered I could get damn near the same crappy Blue Cross Blue Shield policy for $105 a month. Because I am frugal (read: cheap), this seemed like the better option. (Actually, taking my chances as an uninsured American seemed like the better option, but my husband is convinced I would at that point develop something horrific that wouldn't actually kill me for several years, and he'd rather I bankrupt us now than later.)

I filled out the online application form, which is, by the way, full of bugs and other glitches that make it anything but possible to give full disclosure. I figured I'd be getting a call from an underwriter anyway, so I did my best and hit "send."

Sure enough, within a few hours, I got an automated email stating a representative would contact me shortly because more information was needed concerning my application. I waited patiently.

Two days later I got an email.

The underwriter has some additional questions regarding your application and it in need of medical records. Can I email that information to you?

By all means, please do, I replied. And I waited for the questions to come.

And I waited. And I waited. And I waited.

Two days later, I sent another email asking if the questions were forthcoming or not.

I got this in response:

I apologize I thought I emailed you this information already. Please see below: 1 Have you been convicted of a DUI in the last five years?2. Are you a tobacco user? If so please provide dates of use and when you stopped if applicable?3. Are you on birth control is yes what is the name of it?4. The underwriter would like for you to send medical records from Dr. Doofus from November 2006 to include the nerve conduction study done in November 2006. Medical records can be faxed to my attention at 816-xxx-xxxx. Feel free to contact me if you have any questions.

At first I wasn't sure what the hell she was talking about. Then I remembered. In October of 2006, I lived in a house with hardwood floors in every room, including the kitchen. On one lovely weekend morning, I was walking through said kitchen in aptly-named slipper socks and promptly slipped and fell on my ass. Well, not so much my ass as my outstretched left arm and my ass. It hurt, and continued to hurt. Since I had insurance, I figured it couldn't hurt to have it checked out to make sure I hadn't seriously jacked anything up, and I made an appointment with Dr. Doofus, orthopedist. He sent me for an EMG, which was negative. Knowing what I know about bone and joint injuries and how often treatment measures generally end up making things worse, I canceled my scheduled follow-up appointment after obtaining the EMG results, and what do you know, eventually the problem resolved on its own.

And here I was, nearly three years later, after I'd almost entirely forgotten the whole thing, being grilled about it by an insurance underwriter for a shitty policy that wouldn't even cover pre-existing conditions.

I responded:

1. No 2. No 3. N/A 4. I do not have copies of said medical records. I saw Dr. Doofus twice (two visits) for arm/shoulder pain following a slip and fall in my home. The nerve conduction study was within normal limits. Dr. Doofus advised he had nothing further to offer and recommended exercise. The arm/shoulder pain resolved on its own and I have not seen or contacted Dr. Doofus since that time. I am happy to sign a release for those records should the underwriter wish to obtain them; however, as stated above, I do not have copies.

I received another email stating tough titty, kitty, you're going to have to get copies of those records so suck it.

I muttered several choice words and typed up a very brief and cryptic letter requesting my records, filled out a release form and had it notarized (I work in a law firm, this is easy for me to get done) and grudgingly faxed it to the orthopedist's office.

A week later, I received a bill from the medical records copy service. To copy six pages of records--two of which being the letter and release I'd sent--and fax them to me (which wouldn't even require any copying, come to think of it), they wanted $25 ($20 of which was for "labor"). Or, they would fax the records to another physician's office for free.

Are you fucking serious? If my mother-in-law didn't work in a pediatrician's office, I would have seriously considered calling them to congratulate them on screwing me without even having had to buy me dinner first. Instead, I emailed them my mother-in-law's office fax number. That's right, I'm seeing a pediatrician now. What of it?

The next morning, I faxed the records to Blue Crap Blue Shit. Later, I received the following email:

The underwriter has some additional questions and also wanted to know where are the notes from your follow up visit with Dr. Doofus please see below:
1. Where are the notes from the follow up visit with Dr. Doofus

2. What is the status of your arm pain.
3. Did you have physical therapy or surgery
4. Where you diagnosed with carpel tunnell syndrome
Please have follow up visit notes faxed to my attention 816-xxx-xxxx. If you have any questions let me know.
Thank you


Yes, I have questions--beginning with "at what institution of higher learning did your underwriter learn to spell?" But first, allow me to address your query:

1. There was no follow-up visit, as indicated by the "DNKA" (Did Not Keep Appointment) notation for 11/16/06. I obtained the EMG results by phone, and upon learning they were normal, canceled the scheduled follow-up appointment. I have not seen Dr. Doofus, or any other orthopedic physician, for any reason since 11/06.
2. I have no arm pain. I have not had arm pain since the matter resolved on its own in mid-November 2006.

3. I did not have physical therapy or surgery or any other treatment of any kind.
4. As clearly stated on the EMG report, the test was "well within normal limits." I was not diagnosed with carpal tunnel syndrome, cubital tunnel syndrome, or any other abnormality.

Seriously. If you can't read medical records, don't fucking ask me for them! Beyond that--you know from my application I am of child-bearing age. (Okay, it's a little late, but it could happen.) You know I am married and therefore might be "gettin jiggy wit it" on occasion. I have also admitted to you I am not taking any form of birth control. Therefore, I would think you would be much more concerned with the possibility of my becoming knocked up (not that your crappy policy for which I'm applying covers any form of prenatal care) or some other female-type health issue. I should think you'd be more interested in, oh, I don't know, ANYTHING other than busting my balls over a fucking slip and fall that happened THREE YEARS AGO and which was such a non-issue I completely forgot about it.

After my last email, the offending party emailed me to advise they would pass the information on to the underwriter, who would contact me if there were further questions. That was last Friday.

I swear on all that is good and holy, if those asshats come back to me with a higher rate than $105 a month based on my "pre-existing condition," I will personally invite them to accompany me to the gym, where they can watch me lift weights with my apparently useless left arm. And then I will personally invite them to kiss my ass.

Health care reform? Nah. We don't need it. It's all good.

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