Living in Madison, we were part of some of the best HMO's and insurance programs in the country. We never worried about care--they told us where to go, who to see (and allowed us to change easily if we didn't click with our doc, or to choose a doc we liked), what to do, and we never paid out of pocket for anything except prescription copays, which were never more than 15$ (even for pricey migraine meds). We had it good.
Then came Pennsylvania.
After the third bill came in saying the insurance wouldn't cover it, we were really starting to get ticked off. Dr. B is under enough stress being a first year professor. He doesn't need to add this crap. He put the bills in his briefcase, and set up a meeting with the insurance people on campus.
Then he started having chest pains. I wanted to take him to the ER, but he refused. After arguing with him for a while, I knew the only way to get him in was to manipulate the entire situation. I didn't like doing it, but you gotta do what you gotta do.
After calling our insurance company and getting the OK, and trying to set up an appointment for him and getting told to take him to the ER right away (I set one up just in case he was really stubborn), I called.
"What time are you done with work? I'll come pick you up."
I neglected to tell him where we were going. He figured it out en route, but couldn't argue any more.
And after six hours waiting, pacing the halls with the baby and eating horrid vending machine food, he got the diagnosis.
"We don't know."
They did an EKG, blood tests and an Xray, as well as a bunch of other stuff, and nothing was apparent. He's stressed*. He's pretty sure that's the reason, but the doctor at the ER wouldn't tell him much of anything.
Today, I got a call from the business office of our health care provider. She wasn't happy about resubmitting a bill to insurance with a changed code, but she was doing it. (Well, I wasn't happy about getting a 200$ bill for some tests I didn't ask for, that they say I did. Who would ask for a comprehensive screening panel when you've got chapped lips? I didn't even know the words "comprehensive screening panel". Give me a break.) I'll still have to pay for part of it, but hopefully they'll get it changed and resubmitted so I don't have to fork over the entire bill.
And now I have a new mantra when I go to the doctor.
"But, will my insurance cover it?"
The things you learn when you leave Wisconsin...
*He promised to take a nap today, and I'll nag him more about taking bike rides, meditating and doing yoga. Asking him to stop obsessing and worrying about stuff is like telling the grass not to grow, but I'll do my best to counteract what I can.