Health Insurance Woes & A Year Has Passed

On October 20, I had lived here exactly one year. So many things have happened. Amazing how life can change so much in a year. Or a month for that matter.

My younger daughter moved away in May. That was a big shocker. She?d lived her for 10 years, was married and settled, I thought. But he got a great job offer, so off they went. That?s what happens when you shake up your life and move to be near your kids.

And there was my injury on July 9. And I?ve practically had to stand on my head to get physical therapy. Health insurance, or the lack thereof, is a hot topic. I?ve been on both sides. I have gone for long periods without health insurance. And I have gone for periods when I did have it. But it?s never without its headaches. Thankfully, when I fell I was insured by my ex-husband on a Cobra plan for a period of 18 months from the date of divorce.

When I went to the hospital to have my surgery, I was told I needed to put down a sizable down payment, which I did. Then I was told that my insurance did not allow overnight stays. I guess I?m very lucky there were no complications. After I awoke from my surgery, Judy took me home. Thank goodness my younger daughter came from out of town to help me that weekend. For I remember very little. For about two weeks I was in bed with water circulating around my foot via a machine.

Many of you have asked about my older daughter. And I have been vague for a reason. You see, sadly, we had a falling out the night before my surgery. And that?s all I?m comfortable saying.

Things were going along fairly smoothly with Judy taking me to the doctor, etc., until about four weeks ago. I was told at the PT (physical therapy) clinic, on my very first visit weeks ago, that I no longer had insurance. I assured her that I did. I said that my ex was mandated to pay the premium for 18 months, and I still have about 6 months left.

I phoned him and he said he had paid the premium. I called her back, and she said I still did not have insurance, and I would need to clear this up or expect to pay out of pocket for my physical therapy.

Finally it was determined that the health insurance from the State of Texas I was under had changed insurance companies. They no longer used BCBS, but had changed to United Health. They told me, once I got someone on the phone, that they had sent me documentation about all this in August. I assured them they did not.

I told them I was in a real mess now, because everything I had had done in the past two months was now being considered ?single payer? account. (The kiss of death.) You are treated far differently when you are a ?single payer,? I?ve learned. They said it was not their problem that the postal service did not fulfill their end of the deal. But that I had not gone one day in the interim without being covered.

I phoned the physical therapy office at the hospital clinic where my surgeon is located. They were not any nicer about the situation. In fact, they said that since this had happened, I would need to start all over again before I could continue physical therapy. I told them I had just had one brief visit. What did this mean?

It meant I was to see the surgeon again. Have him give me a prescription for physical therapy if it was indicated (this really riled me, since I can barely walk), and then I would have to work with the business office if he ordered it.

What do you mean work with the business office, I asked them.

?They will need to figure out if your new insurance allows payment for physical therapy, ? I was told. I was about to throw the phone against the wall and cry. I am already behind in my therapy close to four weeks. The surgeon, on my last visit, told me how crucially important physical therapy would be to my healing. He told me I was not to take a step without a brace or steel boot.

The woman in the business office told me that my new insurance company was considered not especially pleasant to deal with. She said it all depends on whether they are ?user friendly? on their website. (Will she call and talk to them, I wondered? Is there a way out of this mess?)

I have been waiting about two weeks for my medical insurance card to come in the mail. It finally came. I have been on the phone? trying to figure out if I will be allowed physical therapy. I still don?t know. I cannot afford to pay for all this out of pocket.

What has happened to our country with the bureaucracy we face with health insurance is horrendous. You are damned if you do, and damned if you don?t.

My 45 minutes in the operating room was $42,000. This did not include the surgeon?s fees, the anesthesiologist, etc. I did not have ?good enough? insurance to spend the night after having a steel plate placed in my ankle and seven screws drilled into it to hold my ankle in place. It has been over four months since surgery. I am still in a great deal of pain. I can walk for a short time, though with a limp, with the help of a cane. I cannot have my feet down long or the pain increases. Most of the day I am in the recliner with my legs elevated so the blood flow does not go down to my feet.

I hear horror stories about health insurance all the time. We are virtually held hostage by our health insurance companies. They hold the key to everything. I don?t know what it?s like to live in any other country, but I do know that you should not have to choose between your medication that is vital to your health, and food, no matter where you happen to live. And that is happening more and more every day.

In six months, if I cannot find affordable health care coverage for myself, I will be without coverage again. Then I suppose I can be expected to be treated like a leper. If I?m having to fight just to get back inside the doors of physical therapy now, I might not even be allowed in the waiting room then.

Heaven forbid that I don?t get to a better place in my recovery in that six months. Heaven help us all. We are damned if we have the insurance, and damned if we don?t. What are we to do?

Source: http://www.cozylittlehouse.com/2012/10/health-insurance-woes-a-year-has-passed/

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