The Shifting Landscape of Health Coverage

I am about to rant.

Just warning you.

So that if you need to turn your head, delete this post and move along so you’re not offended, you can.

I realize that I’m not super tall, but I have had it up to my eyeballs with the freaking enigma we call health insurance in this country.

Twice in the past year I have been burned by the fact that my health care provider and my health insurance provider don’t quite match today when they sure seemed to yesterday.

You see, I went for my mammogram last year. Had the test. Went home, reinflated the boobs, and was covered 100%.

Went to the same facility THIS year for my mammogram. Had the test. Went home, reinflated the boobs, and got a freakin’ bill for $148.

You see, my mammogram provider is no longer a “preferred” provider. So, while they’re IN NETWORK, and 100% of my preventative care should be covered under my plan, I still have to pay.

The same provider.

The same test.

Me, following my SAME routine.

Damn it.

When did the change occur? Hell if I know. It might have happened between when I made my freakin’ appointment and when I actually went.

Another example: Last fall, I took my boys for their well child exams.

Went through the regular procedures.

Had the usual tests.

Got some immunizations recommended by the doc. These have always been covered at 100%

Got a freakin’ bill for $400 ($200 per immunization on two shots that weren’t covered).

So, I called because SURELY the health insurance behemoth had made a teensy tiny mistake on the explanation of benefits for this overworked, overwrought single mother of two. And the conversation went something like this:

Me: But the doctor recommended…

Health Insurance: It’s not covered.

Me: But it was recommended…

Health Insurance: It’s still not covered.

Me: How was I to know that?

Health Insurance: You are responsible for knowing what your policy covers.

Me: But that changes?

Health Insurance: Yes, from time to time.

Me: So, before I take my children to the doctor, I should thoroughly review my health insurance policies.

Health Insurance: Yes.

Me: Nevermind that I’m rushing from my job to the school to get the boys and then rushing to the pediatric office since there are no freaking appointments after 3:30 p.m. And, truly, it’s entirely possible that between the time I read the policy at 3:20 p.m. and when the children are seen at 4:17 p.m. (because you KNOW they won’t be seen on time)…the policy could change?

Heath Insurance: [stunned silence]

Me: And perhaps I should ask the doctor before each and every freakin’ move he makes if THAT is covered? Oh, and that? I see you’re preparing to check him for scoliosis, is THAT covered? How about his blood pressure, is that still covered? And wait…you say that examining the inside of his left ear is covered…but what about his RIGHT?

Health Insurance: Is there anything else I can do to help you ma’am?

Me: Do you happen to have a real estate agent’s number?

Health Insurance: Ma’am?

Me: I’m going to move to a shack in the woods and live on herbs and tonics. I’ll bet the Shaman doesn’t change his policies whenever the Hell he feels like it.

So, if you need me…I’ll be in the woods, digging up roots…