Insurance Drama

Last year in January, I received a full-time position at the company where I was working as a temp. I was due to have insurance coverage starting April 1st. Between those two dates, I managed to accumulate two ER visits and a 4-night stay in the psych ward. The ER visits were written off by the hospital under their charity program, and I received a 50% discount on the psych ward due to my position on their sliding fee scale.

Over the course of the year, I paid over $4,000 in medical expenses on top of what was covered by my excellent new insurance, and on top of the several thousand dollars I still owe to Community Mental Health Center (they have a policy of providing treatment whether you can pay or not). Eventually, I paid enough that my insurance started covering everything 100%.

Then I quit my job. I was very worried about how I’d manage my health care after that point, but my therapist assured me it would work out. I was paying the minimum amount that they charge anyone based on the sliding fee scale, with the expectation that any additional charges might end up being waived due to what they call a “fee reduction”. And if they aren’t, no big deal. It’s all tacked onto that giant bill that I continue to pay off at a rate of $50 per month.

After multiple rounds of paperwork, I was finally approved for a state-sponsored health care plan. I pay the minimum premium of $1 per month and have no co-pays for appointments or prescriptions. I was able to print a temporary ID card from the website on March 16th and struggled to use it at the pharmacy. After multiple calls from the pharmacy tech to the insurance company (and multiple days of me coming and sitting at the pharmacy waiting), they finally got my insurance to work and I picked up the prescription.

A week later, I went back for two more prescriptions and once again the insurance wouldn’t work. After returning a few days later with the same result, I decided to use my Effectively skill and go ahead and pay for the prescriptions, knowing I could come back for a refund once the insurance was sorted out. So I picked up those pills and went home to continue waiting for my official insurance card.

The card finally arrived in the mail today. I am required to choose a Primary Medical Provider and get referrals from that person for all specialists. This required a few phone calls. First to the insurance company to give them my doctor’s name and ask a few questions. Then to the doctor’s office to give them my new insurance information and ask for referrals to my individual and group therapists and my psych APRN. The first call went fine, but when I called the doctor’s office, the receptionist told me my new insurance wasn’t accepted, despite the doctor being listed in the provider directory. She put me on hold for a long while, and finally came back and said she would need to call me back later.

Cue panic. I had just gotten comfortable with that doctor (or rather, her nurse practitioner) and didn’t want to look for a new one. And obviously if she doesn’t accept my insurance she can’t refer me to the specialists whom I’m already seeing. I did eventually receive a call back though, and the receptionist informed me that she’d been confused, and they do accept that insurance for existing patients, they just won’t take new patients who have it. *sigh of relief*

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2 thoughts on “Insurance Drama

    • As it turns out, I got yet another call from the doctor’s office. Now they say I’m required to come to the office to sign paperwork in order to have them accept the insurance. Also that I need to bring a list of the names, addresses, and phone numbers of everyone to whom I need a referral. This is all manageable, I just have to take a rather long drive tomorrow to do it.

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