Insurance Woes

Getting health care in this country is a pain in the ass.

I’m not saying it’s perfect elsewhere. But it sure as hell is messed up here!

As I said before, my OBGYN referred me to two great specialists to help me with problems I’ve been having a few years. I did not know such options existed at all, so I certainly wasn’t asking! But while delivering a baby she managed to remember my history (outside of “do your girly bits look normal”), check in with me discussing it, and tell me about these great new resources she was sending me to. I was psyched!

Unfortunately, neither specialist is covered by my insurance. The whole “in-network” crap is in place, so OK, that’s fine, I get it. It’s a bit weird, because when my hubby searched for them before he thought his provider told him they WERE both covered, but at my first appointment today the doc informed me she’s not by the plan we have. And when we checked today, she’s not. But anyway, the second specialist will be covered to a lesser extent because, in our plan, we get some out-of-network coverage for all doctors.

All doctors EXCEPT naturopaths. And the first specialist, who I saw today, and who was amazing, was a naturopath.

What the hell, insurance?? You will provide coverage for ANY type of doctor…except a naturopath, who is specifically excluded in your policy? Come on!

And this doctor is amazing. Just amazing. I talked with her for an hour. And she recommended all kinds of great stuff. She’s running blood work. Only about 5 tests. One of them is so freaking obvious for my chronic fatigue…but no one has ever run it. I didn’t even realize it could be run. And it’s the first thing she suggested. Another is so freaking obvious for some of my other problems. And again, no one has ever run it. Or suggested it. It’s amazing. She just gets it.

And she looks at all of me. Really. All of me. The whole thing as one. She would just say things and it was like..oh..duh..yeah, that would help! I don’t even know how to begin to approach that, but it makes sense!

Did I mention she spent an hour with me? A full hour! Actually, more! No doctor does that! Every primary care physician I’ve ever had has made me feel like I’m wasting their time every time I come in. And she made me feel comfortable and talked with me for an hour!

Oh, did I mention she could be my primary care physician? And while I thought I was covered, I was totally psyched because I thought she could be it and I’d finally found someone I would trust to guide me in managing my health?

And then the crushing realization that not only is she not covered, no doctor like her is covered, so I can’t even find another one?

ARGH!!!

This is, of course, after my insurance informed me that I could have 10 therapy/psychology sessions a year.

Because, naturally, any psychological problem can be solved in 10 hours. I mean, most physical illnesses heal in 10 hours, right?

Yeah, right. Luckily the law changed and it was no longer legal for them to limit the number of times I see a mental health doctor, unless they also limit the number of times I see every other type of doctor…which no one is going to do. I am so glad this law was enacted.  ’cause my therapist? Is awesome.

Hey, do you want to know how freaking cool this naturopath is? Part of my treatment plan (we discussed many issues)? Is to buy and go through this book. I am also supposed to visit this store and talk to the evidently very well educated staff there. I am so not kidding. This woman fucking rocks.

(And yes, of course we also talked about eating habits and exercise, she gave me sleep advice that “she’s sure I’d heard before” but I never had, etc. etc. Those are just my favorite things we went over :-D )

I get so tired of hearing about how hard people have to fight their insurance for coverage, and this is my own tiny corner of problems that I’m getting sick of dealing with insurance for. Thank god I can still function, so I can space out said treatments in such a way I can afford them. Thank god I don’t have a sick child, who desperately needs help to be able to stay in my home and heal, or leave the home and heal, or just heal, and I can’t get services because they don’t exist or aren’t covered.

I’m sorry, but our health system is fucked up. We may not agree on how to change it. But can we stop calling it the greatest in the world and at least admit it needs change?

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1 Comment

Filed under Life

One response to “Insurance Woes

  1. Erica

    I’m so glad that you found someone who works for you. I just hope that something can be done so that you can actually go see her more often. I have so many questions about what she talked to you about. :D

    Also, those two things you linked… they are going to be bad for my budget… I can just tell ;) :D

    By the way, would you like any awkward presents any time soon? Should I start looking for a wish list? ;)

    I’m sorry I kinda dropped off the planet for a while there. Internet issues still abound but hopefully they will be fixed soon. Until then, know that I am reading and fb stalking you as much as I am able and that I <3, miss, and want to talk to you a WHOLE bunch. Feel free to write me and I will respond as soon as I am able.

    <3
    ::SCOOP!!::

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