I had a few moments in the course of my cancer experience where I surprised myself finding a lot of silver linings. Like, I could joke about not having to shave becasue of the hairloss. And we all know that joking around is a form of coping. Using humor, sick as it may be, to make myself feel better came in handy.
Where is the silver lining in dealing with insurance companies? I spent the hours of 9am through 2pm today trying to deal with my lymph edema. What I need is not very complicated but United Healthcare makes it so. You see, I have no coverage outside of our network and, frankly, our network falls short. Repeatedly.
Issue du jour: Acquiring a Compression Glove.
This item can be purchased from a medical supply company, but not ANY of them. SOme specialize in, say, wheelchairs. So I had a recommendation from my physical therapist but that supply company is not in network. So I called the "dedicated customer service" 800 number. The news was not great. I was going to have to travel in the area of 30 miles, which is "acceptable", to purchase the glove for my hand. I was emailed a PDF list of 18 Durable Medical Suppliers. Of said 18, 2 (TWO!) provide gloves. One is a 35 minute drive west of here, the other, about 30 minutes east of here. One can't see me until sometime maybe the end of next week. And they seemed annoyed that I wanted help ASAP. The other had an individual who could make my appointment but she was out today, at a funeral, she could call next week. Maybe get me in sometime for a fitting.
These options were not terribly satisfactory. My swelling is not receding as much as I'd like it to. Last night I felt that my fingers were getting worse, red even from the swelling. I started to get concerned, hence the urgency of my calls to UHC and their approved providers this morning. I made calls, sat on hold, looked things up online at the expense of eating and/or playing with my son. I'm not happy about that. Why should Bailey get stuck watching recorded Wonder Pets for hours while I go round and round on the phone. Transferred. On hold. Transferred again. It was m ore like endurance training. My stomach growling and mood slipping into dark all morning has been so agravating.
You see, I called the supplier that is OUT of network. They could see me today. I could leave with the glove today. But I would be paying for it outright and not getting any credit to m e out-of-pocket max and so on and so forth. Total undeniable crap. And, it's not a $25 item. It's $135-150 or so. Hmm. That is an amount that I want to have go toward my coverage. Hell, I've reached my deductible, it may be completely covered. (unlikely, I know)
So I finally got the claim to get some kind of gap exception escalated. Woohoo. Now I can wait a few hours to call back and check on it. Or I can wait until they send me the decision in the mail.
In the mail? Seriously.
Am I the only person who finds it somewhat laughable that a big insurance company cannot deal with a pretty urgent health matter sooner than a few business days? Lets say I wait those several days for their response. My swelling, now making my hands look deformed not to mention being rather an inconvenient aspect of my daily life, will likely continue to worsen. Infection is a possibility. All because I am trying to use the health insurance benefits that we pay for.
We are part of a company plan, but we pay a significant portion for our coverage. And I could aleviate my lymph edema and buy the glove and try to submit it. But what do you think UHC will say to that? I'm going to go out on a limb and say that it will likely be declined. It will be declined as many times as I submit the claim. And, really, is it worth it?
So while I await the smoke signals regarding the decision, the work day is coming to an end and I'll have to wait until next week anyway. While the glove, the key to reducing the swelling in my hand that I have been dealing with since Labor Day Weekend, that glove will sit there in the out of network shop.
Great system guys. Really, I am not sure that the government could make it any worse with actual socialized healthcare. Could they?
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