Tuesday, July 24, 2012

Medical Insurance: Ahhhhh!

We have instituted the most ridiculous health care system in the world (not hyperbole), all because we insist that health care is a private business (capitalism gone amok) and not a public responsibility, as it is viewed in most civilized countries (we are fast falling off the civilized list if we have not already).  This is my private tale but I'm sure it can be applied to so many others out there.  My provider is Oxford Medicare Advantage (one of the advantage plans established during the George Bush administration and currently being dismantled by the Obama administration).  I like the advantage plan (or at least I did) as it gave me excellent Medicare coverage with some very nice extras (including gym membership) for my willingness to use only Oxford doctors.

Since January, when United Health purchased Oxford, I have had a myriad of problems with medical bills, getting treated at physicians' offices, etc.  In January, I had to cancel three colonoscopy appointments until we got the issue straightened out when United Health issued new cards with new numbers.  Then I received a rejection of a bill from my dermatologist (for $1,200) for freezing with  liquid nitrogen a few pre-cancerous spots on my face.  (As an aside I thought the bill for $1,200 ridiculously high.)  The insurance company said the doctor had to get pre-approval for the procedure, which is also ridiculous.  It's the standard treatment for this problem and has been for about 40 years. After making an appointment with a ophthalmologist and being assured on three different occasions by telephone that he was covered by my insurance, I was told that he did not participate when I arrived for my appointment. Today I received a dunning bill for a trip to the ER at NYU last year, although I had already paid the bill a while ago, and another bill for $205 for a visit to my primary doctor, stating that my doctor was not covered by my insurance. She's listed on my card as my primary.

Finally someone at NYU told me the problem. Apparently, United Health wants its name plastered on everything and issued the new cards under its name although I'm still with Oxford, which is why all these denials. But it's taken me from late December of last year for someone to explain the problem, despite my many complaints. It appears when I show my card I have to tell the provider to ignore the United Health logo and to send the bill to Oxford.  If we had a single payer system like all those infamous European socialist countries the Republicans accuse Obama of wanting to establish, none of this would be happening. Why are Americans so resistant to doing the right thing?

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