I have tried not to write much about my personal life issues on here. This is about We the people as a whole and our collective problems with Government & Big Business and how they are fucking us over, left, right, up and down. Every day, all day. But I thought I would share a little story of my trials and tribulations in dealing with the State Medical Insurance and trying to navigate that cesspool without smashing my head into the wall repeatedly. I have a sneaking suspicion that many others are having the same issues.
As I have mentioned before, at the beginning of April 2020, just at the start of Quarantine 2020 I fell and tore my quadricep tendon from my knee cap. Didn’t have insurance. Got state funded insurance, yay! And thus began the journey to getting my knee fixed so I can go back to work and support my family and fulfill all those financial obligations we have incurred. My travels through the jungles of referrals and sand pits of backed up appointments during the spring of 2021 finally brought me to the promised land of meeting with my doctor to schedule my surgery for the beginning of June 2021!
Then I had a heart attack,
Knee surgery put on hold. Going to need “Cardiac Clearance” before I can get my knee fixed. Just like I need clearance from the doctor before any restaurant will hire me. Liability and all that shit. So the side quest began.
Since the hospital I went to is not “in network” my stay was covered but I was unable to be treated after leaving the hospital by any of the doctors who treated me there. I began to search for an “in network” cardiologist to get the treatment I so desperately needed. I need to get back to work. My unemployment got cut off and they want their money back! So I search and make calls. And make more calls. The first appointment I can find is late September. It was the first week of June! WTF!!
Luckily, one of the cardiologists from the hospital agreed to see me pro-bono so I could get my marching orders and he could check on my progress. He was insistent that I get an angiogram as soon as possible to make sure I wouldn’t be in danger of a second more severe episode in the future. I whole heartedly agreed. Can’t die yet, got bills to pay! I told him I had been trying to find an “in network” cardiologist but September was the soonest I could find. But I was going to keep trying.
The next day I got a phone call from this awesome Doctor, he had contacted my insurance and had got approval for his to do my angiogram. I just needed a referral from my primary care physician. Not a huge problem. When I needed a referral for the Orthopedist I just called and they faxed it right over. Easy, right? Well not this time. After weeks of them telling me they had faxed it. Faxing it to the wrong number to be exact, I drove the 30 minutes to pick it up myself and hand delivered it to the cardiologist. They get it, my procedure gets scheduled and I’m on my way to getting my “Cardiac Clearance”!!!!!
Not so fast!! Two days before my procedure I get a phone call. My insurance has decided they will not pay for an “out of network” provider to do the procedure. I must use one of their people. So……. Back to the search. Around 20 phone calls later I discover that between Annapolis and Northern Baltimore there is not one “in network” cardiologist accepting new patients. An hour drive or more just to get appropriate medical attention? I did however have a very informative conversation with a nurse from a medical group that is not in my network. She said my MCO would let them see me in office but they were not allowed to perform any procedures. How stupid is that? She suggested I call Health Choice and ask to switch MCOs to one with doctors closer to where I live. Which is what I am going to have to do. Every time I call my MCO to get a recommendation for a cardiologist they give me the number of a doctor who can’t treat me. If I switch MCOs, I will have to send back the wearable defibrillator I have been wearing since my heart attack. Or pay out of pocket. So back it goes.
If they won’t switch it now, I will have to wait till open enrollment, in November. Which means I won’t have coverage till December. Maybe get a PCP appointment in January with a journey through the Referral Jungles to a cardiologist appointment in February. All the while participating on the side quest of finding an “in network” orthopedist , getting MRIs and awaiting the ever elusive “Cardiac Clearance” so I can fix my knee and get back to work, pay back unemployment , catch up on bills and the mortgage and not lose my home. Now that every thing is “back to normal” it’s time to pay the pipers. And they don’t care about your sob story. You busted your knee and can’t work? Fuck You, pay me! Knee surgery got postponed because you had a heart attack? Fuck You , pay me! Unemployment cut you off and wants their $8500 back? Fuck You, pay me!
This isn’t a sympathy post. Not at all. I know that I am not the only one going through shit like this. Bullshit that we go through on a daily basis just to get the minimum. That we just accept as “the way it is”. I can’t imagine how hard it would be to deal with this with the added stress of children or a full time job or two. Or a medical condition(s) far worse than mine. I have gone back to work. Three days a week of nightly knee and leg pain from standing and walking when I’m not supposed to. But my job is really fun and my boss lets me sit and do the register when my shit starts to hurt too much. So I have that going for me right now.
Government and the Medical Insurance racket is choking the life out of We the People. Every day, All Day. Even the free health care for all idea will fail because it’s paid for by the government yet still run by the insurance companies who are only worried about the bottom line and certainly not worried about those of us who are living well below the bottom line.
End of Line……..
We the F%#n' People 