Insurance Companies – The Big Screw
Today my main irritation is with Medical Insurance Companies. Take mine, for instance. I’m with Humana. It’s an EPO. What this means is that as long as I go to one of their contracted providers, I pay a $20.00 copay. Well, that’s what it was supposed to mean, anyway.
A month ago I went to see a doctor, got a shot, got a prescription. I went to a Network Provider (who, I’ll remind you, is CONTRACTUALLY bound to only charge a certain amount, and who my insurance company is CONTRACTUALLY bound to pay). I paid my $20.00 and not once did anyone say to me, “I’m sorry, Ma’am, but you have Humana Insurance, and they are “deciding” whether or not they are going to cover these services going forward.” No one said to me, “You may have to pay $300.00 after the fact, IF your coverage is modified and this service is no longer covered since Humana has demanded ALL of our records for ALL Humana patients”.
Not only did I receive NO notice that Humana is “deciding” whether or not to change my benefits, the doctor’s office calls me up and reminds me that I’m due for my one month checkup. I say sure, I’ll be there. Two days before I am to go in, the lady from their billing office calls me and tells me that Humana is auditing ALL of their patients with that insurance. In addition, they are taking their sweet time deciding who and or what they will still be covering. AND I may be receiving a bill for up to $300.00 dollars upon their final decision. AND, she adds, like it’s no big deal…. AND if I come in for my check up I will need to pay $70.00 in advance. “The good news is”, she adds, “that we’ll only charge you a reduced amount if your insurance decides not to pay.” “What is the reduced amount?”, I ask. “ONLY $150.00″, she says. Hmph. So much for $20 bucks.
Here’s why this irritates the crap out of me. One, I pay my insurance premiums every month, on time, at whatever rate they decide to charge. I have never called them up and said, “You know, I just don’t think I’ll pay you this month. I know there are claims outstanding, but maybe I’ll get around to deciding to pay you next month or the month after that.”
Two, while they’re ‘making up their mind’ about what they are going to cover this month, or not, myself and all patients like me, are left in limbo. We can’t get our prescriptions refilled because the doctor won’t prescribe another month since we’re all too stupid to know whether or bodies are reacting well to the medication. I have to go in to the doctor’s office for several hours so that the doc can come in, look at me, ask me how I’m doing, and then say, “Okay, well, here’s your prescription”. Couldn’t I have just looked in the mirror? (Speaking of doctor’s, watch for a full posting on this issue.)
Three, I CAN’T go in, because if I do, and Humana “decides” not to cover my service, I’ll end up with another bill that I can’t afford right now.
And that brings me to the fourth, possibly the biggest, reason to be pissed off. I CAN’T change my provider until the first of the year. Just another self-serving, greedy-assed, industry keeping us in PRISON against our wishes. (Can anyone say “Cell Phone Companies”?)
So we’re screwed, blued and tattooed, folks. Another nail in the coffin of our society. Another noose around our necks. Another…. well, you get the picture.
