July 27, 2011

It's things like *this* that is turning me into a grouchy old lady before my time.....and most likely ticking off the Breast Cancer Awareness crowd to no end

The other day, I received a bill for a recent mammogram.  I was more than a little surprised, because usually, I don't receive bills for healthcare as the doctor's office always files the claim for me.

So I made some sort of joke to Hubby along the lines of if they want to get payment out of me then they'll have to repossess these things.

The very next day, I received my Explanation of Benefits (which is usually a letter telling me what the insurance company has paid for, etc. - basically a receipt).  Upon opening it, I discovered that they had denied my claim for the yearly mammogram....

To the tune of $257.00!

Needless to say, I was not too happy.  But figured there HAD to be some kind of mistake.  Because, my coverage includes PREVENTATIVE care-which is a fancy way of saying "we check you out to keep you from getting sick on us and forcing us to pay even more money for you".  For the past 10 years (yes, I've been here for 10 years - go figure!) it always has.

I figured a quick call to the insurance company the next day would clear everything up and between us all; the doctor's office and myself at least, we'd all be happy and well, the insurance company?  They would be out $257.00.  What the hell.  I'm paying into the insurance, aren't I?  They are getting my money no matter what - in the hopes that I don't NEED their coverage for anything significant.

After my "quick" call to the insurance company yesterday (which, of course, was NOT so quick - thanks to the invention of "voice activated menus" which NEVER hears what you are saying properly.  Which, of course, leads to you yelling your private business into the phone for everyone to hear) I was in tears.

Apparently, without our knowledge, the coverage now only includes a bi-annual mammogram for women of a certain age.  Over 50?  Great!  THEN they will cover yearly testing.


It is apparent that no one has informed my doctor's office of this significant change - since they are the ones that sent the letter nagging me to get in.  Nor did they inform the insurance department that also sends nagging letters to remind us of appointments we'd rather not do - but deem a necessity - as I seem to recall getting one from them telling me to go in.  Nor did they properly inform the employees of this company of this SIGNIFICANT change to our coverage - since not one person I have talked to about this knew anything about it.

Lucky for the few I told about this change - at least they won't get dinged unexpectedly.

For years (basically for as long as I can remember), we have been told the importance of getting a yearly mammogram after the age of 40.  Period.

It has been ingrained into our very souls that "early detection" is the key to survival.

Now?  Now apparently, they would prefer that we get sick before we get diagnosed.

And that?  Well, that disgusts me even more than the thought of handing over $257.00.

And, yes.  I AM aware that lately this blog has turned into a huge "bitch-fest."  With any luck, things will change soon and I will go back to my regularly (HA! Yeah, right.  As if anything about me can be considered "regular") scheduled ramblings about nothing.


  1. Unbelievable! And of course nobody told you until you had already had the test. This really does suck. Thanks for spreading the word...

  2. $257? What the mother lovin' hell? I'm outraged right along with you.

    I suppose this wouldn't be the appropriate time to tell you that all my care for my RA is covered in what I pay in taxes (I knew paying those damn taxes would pay off eventually), with the exception of my drugs, which I only pay 30% of the cost (and the occasional cost parking at the hospital).

    Though, if it makes you feel better, I spent almost $150/month for my drugs (that's my 30%). And if I need my pain pills refilled (which is only every 3 - 4 months), it's $200.

  3. Someone outta pay that bill, and seriously it should not be you. That may be one I'd let go to collections.

  4. I'm kind of expecting to a get bill from our doctors office for hubby's early physical, which the insurance says you can do at any time... but it hasn't been a year, yet. It won't surprise me one bit.

    My sister (who is currently insurance shopping) called the doctors office the other day, to ask how much an office visit is. I think they said 48 dollars. Her co-pay had been thirty. I can tell you for a fact, that isn't what they charge the insurance company!

    Everything has gotten completely ridiculous and I'm going to shut my mouth now, because I was already in a VERY lousy mood and there's no point raging on your post. Sorry 'bout that.

  5. I am afraid this is happening everywhere.. cut backs .. etc etc .. Health is always first to suffer too..
    although as far as that is concerned I have become and ostrich.. I need a mammogram xx

  6. Sugar! I hear you on this! I have been getting bills from my insurance left and right. I wish someone at the doctor's office would have told me what would not be covered.

  7. It makes me sick that insurance companys keep reducing the amount they pay but increasing their premiums!!