I'm tired baby. Tired of the insurance run around.
When I saw Michael Moore's movie "Sicko" a couple of months ago, I had no idea I would soon be embroiled in my own insurance battles. Scratch that, I had a feeling. Still, things have been frustrating. My surgery was set, cancelled, set again, and then cancelled again. The first surgery was cancelled due to a bad cold I contracted that left me with a cough. The anesthesiologist wouldn't have it, I had to be symptom free for four weeks.
So, I rescheduled for August. The date was quickly approaching when I got a phone call from the surgeon's office. Poor sweet Pat had to break the news that my insurance had denied coverage because the surgeon I chose was out of network.
Let me clarify, "out of network" does not mean that my insurance doesn't cover this surgeon, just that within the greater insurance network there are apparently multiple networks, and my surgeon and general practitioner were not in the same network.
Ok, so I asked how much it would be if I paid for the surgery myself (some generous friends and family had offered to help me out with this). Pat told me that she would contact the finance department and get back to me with a figure. An hour later, her voice was a little softer, more hesitant.
"Um, you can't pay for the surgery yourself."
Moment of stunned silence.
"So, if my insurance denies coverage, I can't pay for the surgery either?"
"That's right."
"I don't understand."
"I know, neither do we. Apparently your insurance company and the hospital have some kind of contract...(awkward silence)."
"I see. That doesn't make any sense, does it?"
So now I'm pondering the idea of bringing a lawsuit against...well, that's the question isn't it?
Who exactly is responsible for this? The insurance company? The hospital?
Or, I could go to a surgeon in my network. Start the process over.
