On July 1st, my wife had surgery. It was not the end of the world, but they did have to knock her out and, well, it was surgery. Afterwards we stopped by the pharmacy to pick up medication and almost everything was denied. Not “pending decision” denied but “Nopenopenope” denied. It turned out the issue was that our health insurance had, at the end of June, changed something-or-another and so we had to fill out a completely different form and had a different account number.
Our problems only started there. As it happens, the surgery itself was no longer covered at the hospital where it was performed. We live in a tri-state area where a lot of our services are provided across state lines. New policy is nothing non-emergent can occur across state lines under any circumstances. We can’t go to the hospital that’s twenty thirty minutes away, or the one that’s thirty minutes away. The nearest major hospital in the state is actually three hours away. This new policy of course took effect July 1st, the day of the surgery.
We will grant that the policy was not necessarily tailored around denying us coverage. Most people don’t live in the odd geographical nook that we do. We would even be understanding if we weren’t already sitting on about eight thousand dollars of medical bills that they are either evading or outright denying. Some of them we knew would be a long shot. For example: Not only is one of my wife’s doctor’s not covered because they’re across state lines, but they are also denying coverage for the prescription that doctor wrote. They are, in fact, doing this mid-prescription.
Every insurance company and insurance plan we’ve had seems worse than the last, but this one is really ambitiously bad, and it’s getting worse every year. We’re at the point where if we could, despite our significant medical expenses, we’d just get a high-deductible plan and pay out-of-pocket just so that we know what our outlays are. PPACA makes that difficult, unfortunately, and more expensive because I am still considered a smoker.
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