i'd rather be blind than deal with this
Mar. 24th, 2003 12:16 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
planktondreamsquietlyok, so this is going to be another long and boring story like the one about losing my car in allston, but i need to get this down while it's fresh in my mind in case i need to fight cigna for medical coverage...
thursday:
start to feel some pain in my left eye. not sure if i've got an unusally annoying eyelash caught in there, a late-night cornea scratching from luna, or perhaps some sort of infection. my eyes aren't all yucky and gummy like when i've had infections in the past, so i don't necessarily believe it's that. i just don't know. i'm all fidgetty about my eyes so this is bugging me a lot.
friday:
pain is even worse, eyes are a little gunky and bloodshot and my eyelid is swollen. go to work, get migraines every time i blink. now i'm a part of a PPO (rather than HMO) medical service, so i have much greater leeway over when i see a specialist vs my PCP (it's basically my perrogative). i call an optomitrist/opthamologist office (which was listed as covered by my insurance provider) and they try to give me an appointment for saturday. i tell them i'm in pain and want to see someone today. they set me up with an opthamologist (i thought i was seeing an optomitrist). btw, the difference between the two is that an opthamologist is a "real" eye doctor who deals with more serious medical conditions, an optomitrist primarily gives eye exams. i go in for the emergency appointment. at first they are taken aback a bit by the fact that i don't have a doctor's referel. i tell them that i have PPO coverage and that i want to see a specialist. eventually they say that everything is ok, i give my normal copay and wait. it ends up being pinkeye + some sort of infection in my eyelid, which is what is probably causing the headaches. i'm prescribed eyedrops and amoxicillin and am sent on my way.
(now there's a whole other mess relating to prescription coverage/CVS/7th circle of hell but i believe that's pretty much taken care of so i won't get into that here. nor will i say much about the weekend righ there, except that bridget was kind enough to administer the eyedrops cause i'm a wuss and my eyes are better but not perfect right now. thanks b!)
friday night i had some trouble getting coverage on the prescriptions, so i started doing some research on my medical plan. i found out two things which were news to me:
a) my prescription coverage isn't through cigna, but instead through a company i've never heard of (advancePCS).
b) i might need a referal to get the full benefit when seeing specialists
at this point i'm annoyed that there's more fine print on what seemed like a pretty basic medical plan (especailly since everything went smooth enough at the opthamologist's office), but i feel like i can get some sort of retroactive referal and all that will be covered. sigh, little do i know...
monday:
ok, so first i take care of wonky prescription coverage. i need to visit the 7th cirlce of hell once again tonight and i'll be credited the difference between what i paid ($200) and what it'll be with coverage (probably $30). as an aside, this is really scary - i can't imagine what life would be like without medical benefits. it's great to live in a country where taxes go toward the important things, like taking of the health of all its citizens. :(
so now i try and find out what i need to do to get the visit on friday covered. first i called my PCP and they didn't know if i needed referal and how to handle things, so they recommended i call cigna and see how to take care of it. i call cigna and tell them what happened on friday (i had eye pain and swelling and went to see (what i still believed was) an optomitrist). basically they tell me that i don't have vision coverage so they can't pay anything towards this. this i knew, but i tell them i was visiting a specialist as a medical emergency, not going in for an eye exam. they insist that since i saw an optomitrist i could not be covered (because optomitrists take care of everything that would be under vision coverage). an opthamologist might be covered since they have special training and would be covered under my right to see a specialist if i want to and it is necessary. so after that call i hang up dejected, thinking that i saw an optomitrist and will need to pay for all this. blah.
next, i call the eye doctor's office and start asking them questions, like why was i allowed to see an optomitrist and just offer up my copayment if i didn't have coverage for this. they tell me that i *was* admitted as an emergency and that i should be covered. not only that, but the doctor i did see was an opthamologist, so i appear to be in the clear. wonderful. they couldn't guarantee this would be the case and recommended i call my PCP and see if they could offer a referal and ensure that everything was ok.
so i called my PCP and told them the situation, and how i received conflicting information from cigna (no coverage for you sucker!) and the eye doctor (it's all ok). they tell me they will call cigna and do what they can to clear this whole mess up. i get a call back and they tell me that it will most likely *not* be covered because this was a simple infection and that i should have seen the PCP for the care. but how was i supposed to know that i needed to see a PCP for this? i was in pain, i was admitted for an emergency visit, the eye doctor said i just needed to give the copay, everything seemed ok. how was i supposed to know that my migranes were bacterial and not something worse? how bad is bad before i can see a specialist?! the PCP gave the analogy that cigna wouldn't cover an emergency room visit if you just had a cough. my response was what if you were coughing up blood? is that good enough? i can't make these sorts of judgements so i tried my best to take care of myself.
i'm really fucking pissed about all this. i bought the luxury medical coverage because i didn't want to have to worry about be screwed out of coverage. i just wanted to something simple. and now it seems like cigna is doing everything they can to make sure i fall through the cracks. the PCP said i should fight this - it's a legit complaint. but why the fuck should i have to fight getting coverage for an emergency, especially when the eye doctor said that it was fine for me to see them?
this seems like a lot of bitching and annouyance for one (potentially) uncovered doctor's visit. i think part of it comes from imagining i was in a situation where the $100 or whatever it is i'll have to pay for my visit would affect whether or not i could eat or pay heat for that month or whatever. my brother is a doctor and he hates the health care industry. this is the first time i've really dealt with it and from my small, fairly simple care i can now understand.
sigh, another productive morning at work. time to eat and cool off.
thursday:
start to feel some pain in my left eye. not sure if i've got an unusally annoying eyelash caught in there, a late-night cornea scratching from luna, or perhaps some sort of infection. my eyes aren't all yucky and gummy like when i've had infections in the past, so i don't necessarily believe it's that. i just don't know. i'm all fidgetty about my eyes so this is bugging me a lot.
friday:
pain is even worse, eyes are a little gunky and bloodshot and my eyelid is swollen. go to work, get migraines every time i blink. now i'm a part of a PPO (rather than HMO) medical service, so i have much greater leeway over when i see a specialist vs my PCP (it's basically my perrogative). i call an optomitrist/opthamologist office (which was listed as covered by my insurance provider) and they try to give me an appointment for saturday. i tell them i'm in pain and want to see someone today. they set me up with an opthamologist (i thought i was seeing an optomitrist). btw, the difference between the two is that an opthamologist is a "real" eye doctor who deals with more serious medical conditions, an optomitrist primarily gives eye exams. i go in for the emergency appointment. at first they are taken aback a bit by the fact that i don't have a doctor's referel. i tell them that i have PPO coverage and that i want to see a specialist. eventually they say that everything is ok, i give my normal copay and wait. it ends up being pinkeye + some sort of infection in my eyelid, which is what is probably causing the headaches. i'm prescribed eyedrops and amoxicillin and am sent on my way.
(now there's a whole other mess relating to prescription coverage/CVS/7th circle of hell but i believe that's pretty much taken care of so i won't get into that here. nor will i say much about the weekend righ there, except that bridget was kind enough to administer the eyedrops cause i'm a wuss and my eyes are better but not perfect right now. thanks b!)
friday night i had some trouble getting coverage on the prescriptions, so i started doing some research on my medical plan. i found out two things which were news to me:
a) my prescription coverage isn't through cigna, but instead through a company i've never heard of (advancePCS).
b) i might need a referal to get the full benefit when seeing specialists
at this point i'm annoyed that there's more fine print on what seemed like a pretty basic medical plan (especailly since everything went smooth enough at the opthamologist's office), but i feel like i can get some sort of retroactive referal and all that will be covered. sigh, little do i know...
monday:
ok, so first i take care of wonky prescription coverage. i need to visit the 7th cirlce of hell once again tonight and i'll be credited the difference between what i paid ($200) and what it'll be with coverage (probably $30). as an aside, this is really scary - i can't imagine what life would be like without medical benefits. it's great to live in a country where taxes go toward the important things, like taking of the health of all its citizens. :(
so now i try and find out what i need to do to get the visit on friday covered. first i called my PCP and they didn't know if i needed referal and how to handle things, so they recommended i call cigna and see how to take care of it. i call cigna and tell them what happened on friday (i had eye pain and swelling and went to see (what i still believed was) an optomitrist). basically they tell me that i don't have vision coverage so they can't pay anything towards this. this i knew, but i tell them i was visiting a specialist as a medical emergency, not going in for an eye exam. they insist that since i saw an optomitrist i could not be covered (because optomitrists take care of everything that would be under vision coverage). an opthamologist might be covered since they have special training and would be covered under my right to see a specialist if i want to and it is necessary. so after that call i hang up dejected, thinking that i saw an optomitrist and will need to pay for all this. blah.
next, i call the eye doctor's office and start asking them questions, like why was i allowed to see an optomitrist and just offer up my copayment if i didn't have coverage for this. they tell me that i *was* admitted as an emergency and that i should be covered. not only that, but the doctor i did see was an opthamologist, so i appear to be in the clear. wonderful. they couldn't guarantee this would be the case and recommended i call my PCP and see if they could offer a referal and ensure that everything was ok.
so i called my PCP and told them the situation, and how i received conflicting information from cigna (no coverage for you sucker!) and the eye doctor (it's all ok). they tell me they will call cigna and do what they can to clear this whole mess up. i get a call back and they tell me that it will most likely *not* be covered because this was a simple infection and that i should have seen the PCP for the care. but how was i supposed to know that i needed to see a PCP for this? i was in pain, i was admitted for an emergency visit, the eye doctor said i just needed to give the copay, everything seemed ok. how was i supposed to know that my migranes were bacterial and not something worse? how bad is bad before i can see a specialist?! the PCP gave the analogy that cigna wouldn't cover an emergency room visit if you just had a cough. my response was what if you were coughing up blood? is that good enough? i can't make these sorts of judgements so i tried my best to take care of myself.
i'm really fucking pissed about all this. i bought the luxury medical coverage because i didn't want to have to worry about be screwed out of coverage. i just wanted to something simple. and now it seems like cigna is doing everything they can to make sure i fall through the cracks. the PCP said i should fight this - it's a legit complaint. but why the fuck should i have to fight getting coverage for an emergency, especially when the eye doctor said that it was fine for me to see them?
this seems like a lot of bitching and annouyance for one (potentially) uncovered doctor's visit. i think part of it comes from imagining i was in a situation where the $100 or whatever it is i'll have to pay for my visit would affect whether or not i could eat or pay heat for that month or whatever. my brother is a doctor and he hates the health care industry. this is the first time i've really dealt with it and from my small, fairly simple care i can now understand.
sigh, another productive morning at work. time to eat and cool off.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
no subject
Date: 2003-03-24 10:24 am (UTC)no subject
Date: 2003-03-24 11:02 am (UTC)and thanks for bringing the bunny icon into this thread, can't hurt my eyes on that puffball!
no subject
Date: 2003-03-24 10:34 am (UTC)no subject
Date: 2003-03-24 11:01 am (UTC)and i am grateful and happy for that, i just hate feeling like my insurance company is telling me what is an emergency and what is not, when i'm the one who's dealing with the illness.
Re:
Date: 2003-03-24 11:44 am (UTC)no subject
Date: 2003-03-24 12:18 pm (UTC)no subject
Date: 2003-03-25 11:26 am (UTC)well, we need stock and onion
i've got carrots and broccoli
some bread would be good. do you want to add peanut butter? we could do that too....
i think we've got cauliflower, though i am actually not too sure.
no subject
Date: 2003-03-25 12:03 pm (UTC)no subject
no subject
Date: 2003-03-25 12:15 pm (UTC)no subject
Date: 2003-03-25 12:31 pm (UTC)no subject
Date: 2003-03-25 12:38 pm (UTC)i wish email worked
no subject
Date: 2003-03-25 02:15 pm (UTC)the email thing is just baffling. never had trouble with anyone else. alas.