20 May 2010

Why I Wish I Could Fire Aetna and My GP.

I was going to write a happy entry about how my pre-Mother Mother's Day was awesome because my husband knows me and took me to see Iron Man 2 and bought me a burrito. Then, I briefly thought about writing about how the Never Ending Home Renovation Project® is about to start this week-end because my father isn't capable of actual advance plans. Or possible about other, Serious Things have been happening.

But no, I really want to write a crankypants blog about how I want Aetna and my GP to DIAF.

I'm sick. Starting sometime last Monday, I woke up feeling kind of blech with a sore throat and swollen glands. Generally, that means I should just get a little more sleep and stop stressing, which I did. And then? It got worse. Now it's a chest cold. I thought it was gone by last Friday, but no. It came back in FULL FORCE, completely with a fever and Christmas boogers on Sunday. OB suggested I phone my GP for an appointment to make sure it wasn't A Plague or something.

My normal doctor wasn't in and my preferred back-up was also out, so I got to see the doctor I like least; the one who makes me feel like an idiot. And of course, he's all LULZ! It's a virus and you should feel better, oh, yesterday, because they only last about 10 days. I could have saved my 10$ and watched Keeping Up with the Kardashians or something for that. Then, he informs me I need to see the office manager on the way out.

I want to pause and mention I have Aetna for insurance. Here is what they cover: sick visits and related treatment, random things they deign coverable. Here is what they don't cover: EVERYTHING ELSE. Why do we have this insurance? Because it's what his job offers and we could not afford the better insurance offered by my work nor could we afford private pay.

What makes this even more awesome is that sometimes, the system glitches and it appears we don't have insurance, eg. Steven has been terminated. This isn't a hard fix since his cheque very obviously states that we've paid, but sometimes it takes a week or two to straighten out. Generally, the doctor's office resubmits the claim and all is well. On rare occasions, it takes a couple months of the office resubmitting paperwork to finish the claim.

Having told my doctor's office this, I naïvely assumed that they would, I don't know, let me know when there was an issue and either they can resubmit or Steven can phone them and THEN they can resubmit.

I assumed that was the reason the office manager wanted to talk to me. No, apparently I have a balance of 1100$ and oops, they just forgot to tell me. I have not received a single bill from them. So I'm wtfing over this and asked if they've tried, oh, resubmitting the claim like I've asked and, haha, nope, they've been sent to collections and whoops, no one has sent me a bill from them either. One of life's great mysteries, huh.

Now I'm being told they're going to fire me as a patient and pursue this, so fine. I asked about a payment plan and they're looking for 100$ a month.

Let's review: I am 5 months pregnant, I am out on disability indefinitely, and, let's be honest, we weren't living the high life before I was pregnant. I have these other bills, like my car insurance, that like to be paid and, oh, I don't know, sometimes I like to eat, so I guess that's out. I countered with 10$.

This means I will basically be paid off with this by the time I am 39. Wonderful.

I can't even think what I could possibly have done to keep this from happening. I was told everything was fine when I'd gone in for sick visits, I've never received a call or a bill,  and I haven't received any suggestions from my insurance company that they weren't doing their job.

Without getting into the political aspects of this, since I am not interested in debate and I am not going to understand your side about how things are fine they way they are especially after today, this is why things need to be reformed. I pay a stupid amount of money a month to get at least basic care and I apparently can't even get that.

2 comments:

  1. That's really messed up. I don't think they can get away with never sending you a bill, can they?

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  2. You see, I was also under that impression, but apparently they can. That or it came to the house and disappeared, like a lot of my mail.

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