Monday, September 29, 2014

Frustration to the Maximum

Medical stuff is so hard to deal with.

As long as your doctor will accept your insurance and is "in-network" with your insurance company, all is well.

But just because that is true in one calendar year does not mean it will be in the next.

Every year doctors, pharmacies and insurance companies can change their positions on whether on not they will agree to one another's changes, charges, coverage, etc.

Aye, that is the rub, said one Shakespeare character to another.

I discovered today that the surgeon I saw six weeks ago is not considered "In-network" with my health insurance company. That means that much of the expense involved with cardiac surgery would not be covered and we would have to pay them "out-of-pocket."

That's not happening. It will be hard enough to pay the additional expense above what insurance does cover.

So, we go back to the drawing board, so to speak. I have to find out whether or not the surgeon who was recommended to me at the outset by my cardiologist is covered by my insurance. At present, they are in "negotiations" - and apparently it could go either way.

I sure hope I don't have to go to another whole different set of doctors. The stress of it all is likely to make me worse off than I am.


Celia said...

So sorry, it's a hassle but even more so when your health is on the line.

LL Cool Joe said...

About the only good thing in the UK is our NHS where all medical treatments are free. Okay it may be slow, and hospitals are unstaffed but at least no one is ever turned away because they don't have the money to pay for treatment.

robin andrea said...

That is such a disappointing development. I hope it all works out easily.

Granny Annie said...

Are you talking about Medicare?

Star said...

So much hassle ! As it is , I feel like I do more of the"legwork" than either the Dr. Or the insurance company. Good luck Judy. I hope it all works out your way.

amarkonmywall said...

Terrible, terrible- and you know I am sympathetic (as she trolls the streets for dermatologists, opthamologists, ENTs...)

Good luck. Hang in there.

OldLady Of The Hills said...

That is a stressful nightmare you surely don't need, my dear Judy....!
I pray it all gets worked out for you! I honestly hate doctors and Insurance Company's and all the red tape that goes with it!'s Health can go to pot for all they care.

Anonymous said...

Sorry to hear about this. You're anxious enough as it is. Don't most doctors accept Medicare? Or is it your secondary coverage that is balking?

Miss Dazey said...

I hear you! I don't understand why these mix-ups happen. I dread deciding on which plan to use each year. All this is to confusing.

However, you are smarter than the average bear and I know you will get the right doctor doing the right things.

Arkansas Patti said...

What a nightmare Judy. I sure hope you are able to navigate the awful waters of insurance.
I only use Medicare which has given me no problems. Yes I still have the 20% to deal with but they really do pay quite well.

G. B. Miller said...

I can sympathize with that. I have a dentist who I actually like and because he is out of network, I have to pay through the nose to use him.

Father Nature's Corner

Ginnie said...

Oh, I hat that for you Judy. As you say it's frustrating enough without this backlash. I will keep my fingers crossed.