More like furious with occasional episodes of rage, but as post titles go, “Angry” seems a little less like something written by the scary old woman who won’t let the neighborhood kids play in her yard, right?
So, I’m pissed off in an extreme way and I intend to express that here. If you don’t want to read anger, cussing, or hard core liberal politics? You should leave now because I’m in no mood to hold back.
You have been warned.
I’ve written before (often) about how bloody expensive our insurance is. The premiums are huge and the deductible is high. And with the deductible plan (to which Brian’s employer switched 2 years ago), I expected that once we’d paid the deductible, the insurance would then start paying 100% of our medical costs, right?
No. Seriously, no. Once we’ve paid off the deductible, we start paying co-pays. This seems to me like the most fucked up, abusive, unfair system ever, but in fact, when I called the insurance company to get a better understanding? It turns out (this might not surprise you) that I am a complete idiot. Also? A nag, a bore, and a whiner, but mostly an idiot.
Let’s segue to a conversation I had about a year ago with a representative of our health insurance company. I was trying to make sense of our policy, because really? Co-pays after we pay off a deductible makes no fucking sense at all. It’s all the worst of a PPO combined with the worst of an HMO, like the love child of a hyena and a buzzard.
Plus, there are the costs associated with services that the insurance doesn’t cover, or for which it covers only a small percentage, but that’s not what this post is about so we’ll lay that aside for now.
Did I mention that this is a Blue Cross and Blue Shield policy? And it’s expensive because it’s one of the “best” policies?
Back to that conversation with the insurance company representative. First thing the rep says to me: Yes ma’am, I understand your concern, but are you aware that you won’t pay a co-pay for preventative care visits?
No shit. We don’t pay for those during the first part of the year when we’re still paying our deductible.
Next up from the rep: I’m sorry you’re frustrated, ma’am, but we find that our system encourages healthy-living habits. A great deal of chronic illness can be prevented with healthy lifestyle choices!
In case you were wondering, that was the first time during the conversation that my head exploded. Newsflash: not all illnesses can be prevented. I know it’s the Official Religion of the United States, this belief that none of us are victims, that we are all masters of our own fates and captains of our own souls. Sorry to bust your bubble, but I call bullshit. Yes, fat people are more likely to get diabetes and most of the people with lung cancer are smokers, but they are not the only sick people in the world. There are millions of people who are ill to the point of disability through no fault of their own. People like Carter.
Hey, have you heard what we do with disabled people in the US? We drive them to total financial devastation because they’re easier to ignore if they’re living in poverty, away from the nice neighborhoods and the respectable people.
Finally, from the rep: Yes, ma’am, but we have to control costs by discouraging the frivolous use of medical care.
That was the sound of my head exploding for the second time. Who the fuck are the people who go have a frivolous MRI? Is that a fun thing to do on a Sunday afternoon? Or how about laparoscopic gall bladder surgery? That sounds like a total hoot! Oh, I know! A mammogram! And let’s follow that up with a colonoscopy! Yeehaw!
Seriously, if you are one of those frivolous users of medical care? I want you to call me because I think you’re a damn rare breed.
My problem last week, though, had mostly to do with the company that manages our flexible spending account.
You know what those are, right? Here’s how it goes: Brian and I, in an effort to pretend that we are responsible adults, allow Brian’s employer to take some money out of every paycheck and put it in a dedicated account from which we are allowed to pay for all things medical. This has a couple of advantages, the primary one being that the government can’t tax the money we use to pay for medical care and medicine. The other major benefit is that all our medical costs are removed from our budget; we never get a chance to choose food or electricity over medicine because the medicine money is already there.
That’s the idea, anyway. I’ve written before (often) about how our huge medical costs keep us living hand-to-mouth. With almost no wiggle-room in our budget (OK, honestly? Here’s our budget: try like hell not to overdraw the checking account. Also, try like hell to never let the electricity get shut off.), removing the money for medical care from our day-to-day decisions is handy as hell.
When it works.
We’ll come back to our depleted bank accounts later. Don’t forget about that.
You know how when you go to the doctor there’s a sign right there next to the receptionist that says, “Pay up right the fuck now or we’ll shoot you between the eyes!”? It probably says something more like, “Payment is due at time of service,” but we all know what they really mean.
My doctors have that sign in their offices, too. Pretty much if I don’t pay, they don’t let me through the door.
The flex plan people, though? They have a different idea. I’m not allowed to pay. I’m supposed to tell the doctor to see me first, then bill the insurance company, and then (and only then) is any money supposed to change hands.
My doctors are not down with this. They have the shocking notion that they are owed actual money for actual services rendered.
I, however, am not down with, you know, not seeing doctors. Call me crazy, but I have this wacky idea that maintaining my health is the right thing to do. So I went to the doctor.
I used my flex plan card to pay the doctor, seeing as how a) they won’t let me in the door till I pay, and b) my bank account is sadly depleted because the health insurance company and the flex plan managers have all my fucking money.
Two weeks later, I got a threatening letter: Submit supporting documentation for this visit to the doctor, you evil, stupid wench who paid the doctor with your own money! How dare you?
I printed said documentation, faxed it, and promptly forgot about it.
Two weeks later, another threatening letter, this one screeching as loudly as printed words on paper can screech, We will not let you use your card, you moron! Send your documentation or suffer the consequences! I again printed, faxed, and forgot.
Two weeks later, I went to pick up Carter’s monthly prescriptions. Raise your hand if you don’t know what happened next.
You know when a big company makes a mistake, but it’s never their fault? Yeah.
As soon as I returned home from the pharmacy (No meds in my hand; remember that perpetually depleted bank account? I didn’t happen to have on hand $876 for Carter’s monthly allotment of sanity-inducing pills.), I faxed my documentation again and called the flex pay people.
Me: I’ve just faxed my documentation again. How long will it take for our card to be re-activated?
Her: It takes 48 hours….blah blah blah long explanation about the process over there at Money Held Hostage Headquarters…blah blah blah…You’ve probably been using the wrong fax number blah blah blah… (Oh, remember how I’m an idiot and all that? Funny thing: I managed to swim through the fog of my stupidity and double, triple, and quadruple check the fax number when I got that second letter. I never used the wrong fax number. Never.)
Me: What can we do to speed up this process? My son will be out of medicine by tomorrow.
Her: There’s nothing you can do.
Me: Can I submit the documentation online?
Well. If there’s one thing Brian has taught me, it’s that I shouldn’t give up so easily. I faxed the documentation three more times and called the flex pay people again in hopes that a kinder, more knowledgeable person would answer the phone.
Me: (after explaining the whole sorry saga) What can we do to get our card re-activated faster?
Her: Did you submit the documentation online?
Me: . . . . . . . . . . ? (Thinking of various replies and rejecting them all.) Where do I do that?
Her: Well, you click on this and sign over your firstborn and you stand on your head while you gargle peanut butter and of course somebody over here at Money Held Hostage Headquarters will be verbally abusing you during this process…
So I submitted the documentation online. The rep says uh oh!
Go to hell, you and your uh oh.
Turns out, I paid the doctor $175, but the insurance only authorized $115. Our card won’t be re-activated till I send the flex pay people $60.
Me: Can I pay you now? (Because while I didn’t have $876, I could swing $60.)
Her: No, we’re not allowed to take phone payments.
Me: OK, where should I go on the website to submit my payment?
Her: Oh, no, you have to send a check or money order. Your card will be re-activated 48 hours after we receive your payment.
You are probably familiar with the sound of my head exploding by now.
I had, by that time, gone to the pharmacist and begged for three days of meds to keep Carter going until the day on which I believed, at that time, our card would be re-activated. The pharmacist was lovely and kind and happily loaned the medication (a good pharmacist is almost as important as a good doctor), but really? How was I supposed to go back and ask for 5 more days?
But how could I let Carter miss even one dose of any of his meds, much less do without them for the better part of a week?
I could go walk up and down Central Ave, but I’m pretty sure my ass isn’t worth $876 anymore, if it ever was.
So I counted pills and made decisions and went and bought the medicines Carter absolutely had to have. $442, plus a $20 overdraft fee. I submitted all of the receipts to the flex pay people (Online and via fax. Twice.), and I have my fingers crossed that the reimbursement check shows up in my mailbox before we run out of food or the electric company shuts down this whole operation.
Welcome to the USA, land of the free and home of the brave.
I suggest that you do not get sick.