Sunday, September 3, 2006

health insurance

(reading between the lines)

2 weeks ago: Husband receives e-mail received from boss - we are changing health insurance companies, effective September 1, and since you folks out in the field cannot come to the office for the meeting, we are sending out a video for you to watch. (Don't leave the job, you can do this on your own time at home).

Buddy replies: Yippie! A new video to watch! We will make popcorn, and get out the Preparation-H because I know when I am about to get !@#$%ed… - (sorry, construction humor).

Highlights of the video:
  • Insurance is simple - if we pay out more in claims than we collect in premiums, your rates go up. (Don't send in claims, claims are bad, we don't like claims) Question - So, if our claims are less than the premiums paid in, do we get a rate decrease? ROFL (roll on floor laughing)!

  • Never, never, NEVER go to the ER! You should only go to the ER for 3 reasons: Break, bleeding, or dying. The first two are obvious, breaks and bleeding. But you may think you are dying when you are not, so call the number on the back of your insurance card and speak to the nurse. If she tells you to go to the ER, then you can go, but be sure to get her name (so we will know who to blame later).

    And if the chest pain turns out to be gas, we will pay for the first time, but no more after that, next time you will have to pay the entire ER bill, and it will NOT go toward your deductible.

  • If you are feeling sick, don't just automatically go to the doctor, try other methods, like the local CVS pharmacy has a 'mini clinic' where they will check you out and write you a prescription. If after you try this for a couple of times and you are not better (or you die), then you can go to your physician. (Real doctors charge more, so try to avoid them).

  • Get your teeth cleaned twice a year, all sorts of things can be detected like gum disease, mouth cancer, etc. (If we find that you missed a cleaning and get one of these diseases, we won't pay).

    Also, by getting the plaque cleaned off your teeth, you avoid the risk of that plaque breaking off and getting into your bloodstream, causing a stroke (the last time I checked, whatever came off of my teeth might go into the digestive system, but I am pretty certain it couldn't find its way into the bloodstream…).

  • And check out this perk:
    Toll-free call to our Work-Life balance program will get you a confidential telephone consultation with an expert concerning everyday issues such as home repairs, emotional wellbeing, financial, legal, addiction and recovery, parenting and childcare, education, older adults and work related issues. (So the next time I can't program the VCR or am stranded on the side of the road, you know who I will be calling!)

Was all this really on the video, you ask? Yes, it was very entertaining! "This here is real. You can't make this stuff up." (~Larry the Cable Guy)

Okay, the deadline has come and gone. We are no longer insured by the old company. We have yet to receive new cards from the new company.

Now we are into a holiday weekend with the heightened potential for injury and illness.

For example - hypothetically speaking, of course - what if I am out hiking and get a snake bite - of course my first instinct would be to whoop out my insurance card in the woods and hope my cell phone has a signal so I can call the number on the back of the card to get permission for treatment. Oh, wait - I don't even have a @#$%ing insurance card!

And say… I go to the ER anyway (at least they have that sign that says - we don't treat in the order of arrival, but in the order of severity of injury/etc.) Unless you have a pitiful story about not having an insurance card...


Motherkitty said...

Yikes. Boy, are we glad we're on MC with BCBS secondary. We may pay $88/mo each for Part B, and $300/mo for the BCBS, but THEY PAY FOR EVERYTHING WITH NO DEDUCTIBLE OR COPAY. Am I gloating? In a way. It paid entirely for my new knee for which I am truly thankful (approximately $60K). Will they pay if my back goes out and I have to go to the ER? Who knows.

When I worked, had to deal with the insurance companies all the time. They are only in business to make money -- they don't give a flying rat's *** if you are broken, bleeding, or dying -- as long as you don't cost them anything. If you do, the key word is deny, deny, deny until you threaten to sue.

Good luck. Hope you get your cards very soon. I guess you will have to stay in the house so you don't step on a rusty nail and get lockjaw or something more serious.

Hope you and husband have a great holiday weekend. Try to stay out of trouble.

Finn said...

Hi Susan, hate to rain on your parade, but the item about plaque(or other "material" getting into the bloodstream is valid. Since the mouth(and kidneys) are considered "dirty", there is always a risk. Primarily it's to anything metal you may have in your body. Such as my stainless steel knee replacement.
I'll never be able to have my teeth cleaned again, without the dose of antibotic one hour before. Same with any kidney procedure. IT's just worth the risk, as once in the bloodstream it's carried to the "replace part". I could lose the replacement if it got infected in that way. I don't know if it applys to the less than FULL replacements. You become a card carrying member of the "joint" club..LOL, when you have surgery.
And when you have a catarac removed and they give you an artifical lens in your eye, you get a card with a recall number...just in case...LOL I couldn't believe there might be a recall on an implant!

Alipurr said...

that was funny....