Welcome to my Nightmare: Health Insurance Issues

“This is a damn good outlet to spew the bullshit off my brain!” Stone Cold Steve Austin

WELCOME TO MY NIGHTMARE: HEALTH INSURANCE ISSUES

I hate dealing with health insurance companies. They’re nothing but a big pain in the ass. The proverbial thorn in my side. I wrote two weeks ago concerning my hospital stay (Read the last blog post: “Last Week’s Hospital Stay”). Hours after releasing my blog for the week, I received a letter from my health insurance company. Informing me that they denied my admission into the hospital. The hospital I was transferred to. Why? The reasons were mind boggling. All centered around something I haven’t had for over a decade: pneumonia.

I must have spent a total of ten hours last week on the phone and online. Reasons why I didn’t post a blog as I was too consumed with this shit. My phone call to the insurance company revealed that my hospitalization is considered observation. Sounds like Medicare gouging to me. If you’re in hospital for any health issue would be considered observation. The medical staff pays attention to you throughout the day. Denial letters makes me wonder: why go to the emergency room? Why bother? The longer my appeal takes, the less I feel comfortable going to the Doctor/Specialist. The thoughts of them not paying for services constantly run through my mind. The insurance company dictates everything. What services are approved or denied. I remember seeing the beginning of one of Michael Moore’s documentaries (either “Sicko” or “Capitalism: A Love Story”), when a woman talks about how her health insurance company denied her ambulance fees/charges to the emergency room as it was not preapproved. I’m sure she had a great time talking to her insurance company. How do you get preapproval when you are unconscious?

The overall lack of immediate care or concern pisses me off. In December of last year, my new Rheumatologist asked if I had pneumonia recently. No. He could hear with his stethoscope that something was off while I took a deep breath. Apparently, he found what he referred to as “Black Spots” within my lungs. Unfortunately for me, no tests were ordered. Was the issue in my lungs that insignificant? I contacted my new Primary Care Physician concerning the issue. She said she would collaborate with my Rheumatologist and perform the necessary tests. She explained that if I don’t hear from the Rheumatology Department, I should contact her. Nothing. No calls or emails from them. So, I emailed her (via the clinic’s website) that I haven’t been contacted by anyone within Rheumatology. AS fate would have it, I never heard back from her. Oops. Must have forgot about me. Or never received my emails. And now I’m paying the price, no pun intended, with my insurance company.

(FYI – Heed my warning, if you haven’t heard anything in 48 hours, call them! Make damn sure you and your Doctor/Clinic to ensure everyone is on the same page).

I can’t help but wonder, was my health condition being taken seriously? If tests were performed months ago, could I have avoided the hospital? Maybe they would have an answer or start working towards one. Could the spots be something other than scar tissue from pneumonia? Could there be more than meets the eye? I grew up around secondhand smoke. Could that be a cause for concern? It seems likely according to the Google Doctors, Pulmonary Edema jumps out due to the excess fluid in my lungs. However, Pleural Effusion deals with fluid outside of my lungs. Pulmonary Fibrosis, the scarring in the lungs. Interstitial Lung Disease caused by Lupus. I’ll have to wait until Sept. 9^th, which should start the “Process of Elimination.” Read my last blog post: “Last Week’s Hospital Stay” to understand the meaning behind the “Process.”

As I finish, my question to health insurance companies is why do you have to make life so difficult? My letter of denial has caused both an increase in anxiety & depression. You can add anger to the list. I hate all the hoops you have to jump through. Paperwork. Phone calls, The headaches from being on hold. Talking to people who have no clue/understand what you’re asking about. Waste of time. Things should be simpler. The country has the ability. Why not change things. Universal Healthcare/Medicare For All? Not likely.

Cool news for this week:

I have two more interviews for podcasts. A release date for The Real Life Show: Living with a Chronic Illness Podcast for Sept. 29^th. Cool. I have another one interested, The Chronic Sisters. I emailed them my book and hope to hear back from them. Two women from Australia. And I have to contact two more as they are on hiatus until September. Got to keep my fingers crossed for an opportunity.