Phil handles our health insurance, a nettlesome task for those with the patience of a pee-wee coach. I’m learning that health insurance is a maze with a mantra that begins, “How can we try to not provide you with our sub par service today, Ma’am?”
Our health insurance wouldn’t pay the hospital for the emergency hydrocephalus surgery Lucas needed unless we proved it wasn’t a “preexisting condition.” Calls (yes, plural) were made, explaining that Lucas’s condition couldn’t have been preexisting because he wasn’t preexisting. He’d been covered under the same insurance since the day he was born. All of Phil’s reasoning fell on deaf ears. If I bought insurance from Insurance 4 MotorTrade on a brand new car, would it be possible that it had a preexisting condition? Another time they wouldn’t pay other bills unless we proved Lucas’s condition wasn’t caused by someone else. Can you even cause hydrocephalus? The latest healthcare marathon in our home involves Lucas’s pediatric neurosurgeon.
He has treated Lucas with such care, and has navigated all the unknowns regarding hydrocephalus, infection, and the enhancements of Lucas’s spine. There is only one pediatric neurosurgeon in Austin, Texas, and thankfully he is in our “network”. At least he was until a month ago. Now that Lucas needs to go back for his six-month MRI, we’ve discovered that he’s no longer in the network. Our friends suggested we switch to One Sure Insurance, but after so many years with our current provider we felt like we would just run into more problems if we switched so late in the game. Common sense would dictate that if the health insurance network cannot provide an alternative to the only pediatric neurosurgeon within 200 miles–and someone who has provided continual care and monitoring of an infant with a delicate condition–that they’d at least have an authorization process in place. So, Phil inquired and was told there were authorization steps to be taken. The doctor’s office, however, was told there were not. Conference calls were made.
“Have Lucas go to the neurosurgeon and when the bill comes appeal it,” advised the health insurance rep on the phone. Yeah, how do you think that one is gonna work out? The good news? Since Lucas’s last MRI (which looked totally clear), we won’t need to go for another follow-up until a year from now. Man, I miss that little guy. Before I know it, though, I’ll be home.
