Thursday, March 20, 2008

As The Stomach Turns - the soap opera continues

The stomach turns, or is that churns? I want to scream and shout, but not in a good way. I want to strangle people I've never met. I want to tell the world about my crazy insurance company. This saga gets worse and worse. It just drags on. Here it is almost Friday, but as tomorrow's Good Friday and we're off work, today was the last day of our work week. I'm scheduled to take vacation starting Monday the 24th. I'm still scheduled for the BAHA implant surgery Wednesday the 26th. As of now, the insurance company, my doctor's office, and my insurance agent are still haggling whether or not my insurance will cover the surgery. Unfortunately, I can't afford the surgery without insurance. I can't tell my boss whether or not I'm taking vacation next week, starting Monday, starting Tuesday or Wednesday, or at all. I haven't a clue which is super frustrating. Other than the surgery, I didn't have exotic, expensive plans for this vacation. I was going to relax at home, do some heavy cleaning and some heavy writing (and probably more blog hopping). But I really needed a break of more than 3 days. It's been many moons since I've had a rest and I'm exhausted. I was looking forward to this time off. I imagine that at least my insurance agent if not also my doctor's staff and the insurance company, are also off tomorrow for the holiday. I can't blame them. But that means I'll have no answer about the surgery so I'll have to blindly go into work Monday. So much for having one long stretch of time for a vacation (two weekends tacked on both sides and even a holiday). The insurance company is giving us the run around. They tell us different things. They told my doctor's office that they don't cover hearing aids. They told my insurance agent that the doctor didn't prove the surgery is "medically necessary", but didn't mention the hearing aid part to him. They also didn't mention the "medically necessary" phrase to my doctor's office. They told me that hearing aids and implants are "excluded from my plan". They also mailed a letter to my doctor's office dated March 13th that my first appeal had been denied but then they verbally told my doctor's office on March 18th that no decision had been made yet about the first appeal. Huh??? Methinks the insurance company has their head up their asses. Either they're playing dumb or they really are. Either way, I have lost faith and respect for them. Unfortunately, it's not like I can afford to dump the insurance policy my company pays for me and pay for my own. My doctor's office doesn't want me to reschedule surgery yet. I tried that. My boss is being his usual great self and will allow me to reschedule vacation last minute and keep him guessing. The doctor's office is still hoping to push this through for me. They're trying very hard and I give them kudos, too. BTW, my doctor's office said they mailed and faxed all the documentation to prove the surgery is medically necessary for me. I can't hear out of one ear at all and I have the phone up full volume for the other ear and I still have trouble hearing the donors on the other end. I have trouble hearing my coworkers when they're standing right next to me. Soon, I fear I won't be able to hold down my job as my ENT tells me the hearing in my "good" ear is deteriorating and will continue to do so. My job deals with a lot of telephone work - customer service. I hate the phone so I wish it didn't, but it pays the bills, and supposedly I'm good at it - when I can hear - so I put up with that part. Stay tuned for the next episode of "As The Stomach Turns" - probably not till Monday the 24th. Meanwhile, regularly scheduled programming will resume.


lime said...

thank you for stopping by my place.

i am so sorry to hear the problems you are having with the insurance company (soulless entities that they are). in my experience you have to be willing to fight hard to get them to do the right thing sometimes and it seems as if what you are seeking is a very important and necessary thing. i wish you the best of luck and all the stamina needed to fight till you get what you need.

Molly Daniels said...

We've been battling with the insurance over a blood-testing machine ($2000), which if hubby were on Medicaid, would have been a non-issue and he could keep track of his ProTime (clotting time). But noooooo, insurance would rather shell out $40 a week for him to test at the lab, and sometimes we don't get the results for several days. Multiply $40 by roughly 30 (aometimes he can skip a week or two) and then again by 5 years...and minus our deductable...that's $3500 they have paid out for blood draws alone. Makes no sense, right??? And two of those years his surgeries caused our deductable to be met early in the year, so it's probably more. Stupid insurance.

Unknown said...

I hear ya, Molly. Medicaid paid for my friend's BAHA implant. I won't be old enough to get on Medicaid for another 15 years or so. I hope I don't have to wait that long.

I hope they do right by you, too. They make no sense lots of times.

Cath said...

I'd say they are deliberately being obstructive.
Here I don't have the insurance problem, but it's getting past the GP (family doc) for a referral to ENT. It took THREE years of deafness on one side before he would refer me. Didn't think it was that important as my right side could compensate!!!
I've changed GPs...

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