Insurance Shenanigans

So I got a phone call from my insurance company last night. A sweet-sounding grandmotherly type verified who I was and then proceeded to read her script – dropping all sorts of phrases like “at no cost to you” and “free enrollment” and “we feel this would be a benefit to you.”

Of course, she never really said what “it” was up front, except that it was some sort of “program” that involved me talking to their highly trained nursing staff about my lower back. You know – so I wouldn’t have to be bothered going to those nasty doctors and wasting all my time.

Now, my previous insurance tried the same thing with me once. I had gestational diabetes when I was pregnant with Lucy, so of course I had to deal with that. I was injecting myself with insulin and testing my blood sugar and all that.  And then the diabetes went away after the birth (as it is wont to do, normally.) But I still got these calls off and on about talking to the nurses about helping to manage my condition. Which I no longer had.  Took several rounds of running at the mouth for them to figure that out, but eventually they got the hint that two years later, I really wasn’t pregnant anymore.

For the back stuff?

Meh. Previous insurance sent me letter after letter from their lawyers trying to get me to admit that surely my back problems were due to some sort of work-related injury. Did I fall? Was it a car accident? Was I riding elephants in the in the clown rodeo?  (Shit – it was like they wanted me to commit some sort of workman’s comp fraud so they could be off the hook.)

Nothing like being made to feel like some sort of criminal for a lousy set of genetics.

It irks me, though. I pay for the highest level of insurance I can – that whole PPO plan – which basically means I can go to whatever doctor I like, whenever I like – without a referral. I may pay more for docs who aren’t in plan (and sometimes that bites me in the ass…but I don’t have much choice either.) My time is limited and my pain is often severe. I hate my GPs, which is probably something I should remedy, but the thought of having to go see them every time something gets gorked up to get a referral to go see someone else just irritates the fuck out of me.

Which is why I pay the extra for the “better” insurance. So when specialist Doctor A says I really should go to specialist Doctor B, I can do that. I don’t have to waste another copay and hour or two of my time sitting at the GPs office. (In theory this is saving the insurance company money, right?)

Anyway, back to the nice grandmother on the phone, whom I interrupted within about 30 seconds to ask her what this was all about. She paused, clearly a little lost since I was pulling her out of the script, mumbled something about the nurses and my lower back.

And I laughed and explained very gently about the $800 I spend every six weeks on the treatments that aren’t covered by insurance. And how I can’t take any painkillers during this process. And how I have some sort of connective tissue disorder. And that my joints are hype mobile. And that I already had had back surgery. And acupuncture. And trigger-point injections. And both of my legs are currently hyper-extended. And I’ve had more physical therapy than I care to mention. (It’s the PT that sparked this, I suspect, since I’ve been to a few sessions since I switched insurances and clearly that sort of thing makes them grind their collective teeth.)

She hung up shortly thereafter. I’m not mad at her or anything – I mean, that’s her job and she has to do it, but I do feel a bit put out by *why* the insurance companies are doing it. I know everyone wants to save money and maybe people go to their doctors too much. I don’t know.

I do know I’m getting tired of having to prove that YES, I have issues. YES, I am doing the best I can to fix them. But why rub it in my face? (Although I am a bit curious as to what said nurses would have talked to me about. Stretching? Walking? Ice? Posture?)

On a good note? I think the prolotherapy stuff is actually starting to work. 🙂 And that is worth quite a bit.

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