Most of you know I've been having problems financially, health, unemployment, etc, etc, etc.
After much back and forth, and my cousin helping, I finally managed to get a minimal health insurance plan that my cousin could afford to pay the premium on. I wasn't eligible for Medicaid (long story, but it probably would be the same situation I'm about
to describe). When I was calling about
this policy I specifically asked if they would cover surveyllance endoscopies for my Barrett's esophagus and precancerous condition, and they said yes, at 100%. There's only 4 doctor visits a year covered, and no Rx coverage, but the precancerous stuff was my #1 worry (obviously). This was also a conversion policy from my old BC/BS policy so although it took a lot of wrangling around, there was no pre-existing exclusion on the policy.
Well, I had my visit with my new GI, who I liked and who's from a different hospital. Scheduled the EGD for Dec. 14th. Today I get a message left that I had a $1,000 deductible on this procedure!!!! Was instructed to call my insurance company. So I did (you know what these calls back and forth are like). Was told I had NO deductible, HOWEVER, if the procedure is done in an "ambulatory surgery center" - you know, those places where most of us go these days for same day surgery stuff - that they weren't participating with the insurance so the insurance only pays 70% and I would be billed the other 30%! 30% of these procedures, with anesthesia and biopsies and all is not going to be any small change. So it's not a "deductible'. Big deal. Same difference to me. I called BOTH local hospitals and their outpatient surgery centers are just that - ambulatory surgery centers, and yes, I'd be responsible for 30% of the cost.
So now I have to try my doctor's office back and see if they could do it in the hospital, which is participating, but I know what the answer will be. No. But I'll ask. I understand they need to pay their costs, truly, I do. And that this is the way hospitals are likely going to keep getting around their contracts as "participating providers" in the future, but I don't have that kind of money to pay!
Interestingly, the HALO procedure IS done in the hospital, so I may ask if my insurance would cover that and just have the HALO done now. But you know, I SHOULDN'T have to base moving prematurely into the HALO on cost! And that's exactly why I'd be doing it.
Truthfully, I'm more scared than angry. This is only the beginning of it for me. Even if I got Medicaid, the same thing will be true - even worse, as specialists don't even take that at all.
I'm not asking for fancy, unnecessary stuff. Just to stay alive. Is that too much to ask?
And, BTW, this just a few days before my birthday. Yea, happy birthday to me. NOT.
As a somewhat separate issue, as I've mentioned in a previous post I've been closing down my business, and this post isn't about
that, but I was at the office until mid-morning, and have boxes stacked all around me. Had to move it in small boxes, but boy do I hurt today. Can hardly turn my neck. I was shopping at WalMart at 3am, and had been drinking coffee, so of course was awake once I got home until around 6am! And then I slept half the day away only to awaken to have to deal with this insurance business. I just wanted A DAY OFF!!!!!! A day to grieve my business closing. A day to REST MY BODY. And now this.
Sorry this went on so long, but I had to come somewhere I knew people would 'get it'. And I know you do.
Thanks for listening!