When you’re the sick, the last thing you want to do is fight with your insurance company. You’re tired, fatigued. You don’t have the energy to spend thirty minutes to an hour on the phone haggling with someone who doesn’t have the authority to do anything for you anyway. The truly disgusting part is – they count on that.
While at work on Thursday, a notice popped up in my email: You have a timely message waiting for you from Humana.
I assumed it was another routine “we’ve processed a claim for you” email but decided to check it out anyway. The last two weeks had been exceptionally difficult ones for me and I’d seen my neurologist several times before she referred me to both a pain management clinic here in town and a headache specialist in Houston. (My parting impression: she’s run out of ideas and apparently I’m someone else’s problem now.)
Turns out, the message from my dear insurance company was informing me that my last visit to my doctor wasn’t fully covered by my $50 specialist co-pay. While at the office, for lack of anything else to try, she suggested an injection in the back of my head. I agreed since we had already attempted multiple IVs, IM-shots, investigatory blood work and even a cervical X-ray of my neck to no avail. The shot (an occipital nerve block) worked for my newest pain, which had begun at the back of my head in the last month or so, for about 24 hours but did little to touch my original migraine. And now, my insurance company was informing me that the 5 second injection – that one little shot – was a surgical procedure and therefore my $5K deductible applied on top of the $50 office visit co-pay.
Now, I work in health care. I understand the puny reimbursement rates doctors receive from insurance companies if they bill with an injection + drugs type of billing code. But, I never dreamed this type of injection could possibly be considered a surgical procedure.
The bottom line? I’ve spent over $2K on co-pays, Rxs, and an MRI in four months attempting to “break” this migraine cycle. None of this applies to my deductible or my max out of pocket. And, after thirty minutes on the phone, I just didn’t have the strength to argue any more. Makes me wonder though – what’s the point of having insurance?