Insurance companies ARE death panels!

January 16, 2012

I look back on 2009 as our “lost year.” Progress was made, but slowly, and it seemed like every two steps forward were followed by one step back, both medically and financially.

We started off the year in the greatest way, by celebrating our marriage with a reception at Keen’s, one of our favorite restaurants in Manhattan with 60 of our best friends and family. It’s one of the most wonderful days of my life.

Still glowing from the joy of the wedding reception and thinking that so far this had been a breeze, I looked over my list of required pre-tests and set out to complete them. I had left the “uncovered” ones til last. My health insurance through work did cover infertility treatments (supposedly up to $7,500 per lifetime) and most of the diagnostic tests. Since most of the bloodwork (e.g., HIV, STD, and other screening and diabetes testing) is considered routine, insurance covers it as standard. But I was soon to find out the hard way that one test, the echo treadmill stress test, was not considered a routine yearly test.

I now will digress for a moment to crawl up on my soapbox and make a few observations about insurance companies, or as I like to call them, proof that Satan and his minions do indeed exist and roam among us on earth.

My examples of insurance company horror stories are legion, but I’ll narrow it down to a few of my favorites:

For those unfamiliar with the term flexible spending account, I will define it. This is an account of YOUR OWN MONEY, which you put away to pay for the medical expenses that your insurance company SHOULD pay, but has figured out how to weasel out of paying. Seriously. The IRS has ruled that OTC (over the counter) medications can be reimbursed out of these accounts. I submitted a receipt for $4.99 for Vicks Vaporub when I was pregnant and had a bad cold, but my insurance compamy denied it because Vicks Vaporub is, wait for it……COSMETIC. Because nothing is more alluring on the formerly perky but now very saggy and floppy bosoms of a middle-aged pregnant woman than a thick smelly coat of mentholated rub? This “mistake” was, of course, cleared up immediately, after I made 4 phone calls and finally involved a director of benefits at my company and the insurance company’s regional manager.
In July, 2008, I realized that infertility treatments needed to be “pre-certified” by the insurance company, so I called the 800 number. We are led to believe that pre-certification is a way for your insurance company to oversee your health care to ensure you are receiving the most appropriate treatment at the best prices. Ha! Silly fools! Pre-certification really is simply a way for your insurance company to get a heads-up in order to prepare to deny, deny, deny, obstruct, frustrate, and otherwise fuck you over. During this first call, I was told that before I would be pre-certified for treatment, I would have to wait 6 months to prove that we were not able to conceive naturally. At 48 years old, I should wait 6 months for what? Maybe a bright, unexplained star to appear over our apartment or an archangel on a layover? Really? Not willing to wait 6 months, I proceeded to Option B.

Option B: If you don’t like the first answer you get, hang up, call back, get another minion on the phone, and you will absolutely get an entirely different answer. It won’t be the right one, either, but it will be different. You can continue to do this indefinitely. No one at Satan’s office knows what his right or left cleft hoof is doing.

And one more thing before I crawl off the soapbox, if you’ve been frightened into believing in “death panels,” let me ask you this. Who do you think determines your health care options now? Your doctor? You and your family? Nope. The ULTIMATE death panel determines what care you will receive and it’s called “<Insert your insurance company’s name here>”.