Friday, February 4, 2011

Why I Hate My Insurance Company.

It is time for a mini bitch session!

I am changing the name of the insurance company to cover my ass. We will call them "And. Them" (Thanks, boyfriend!)

If you are friends with me on facebook, you know how often I am complaining about "And.Them."

So, let me explain... (If you know the drama from the fall, that's a totally different story that I do not have the energy to explain.)

Before my surgery, I received a letter from "And.Them" stating that they were denying my office visits to the dermatologist, the removal of my original mole, and my future surgery, based on a pre-existing condition. 

According to Wikipedia (I'm too lazy to Google "And.Them's" definition,) a pre-existing condition is any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan. Under the broader, "prudent person" definition, a pre-existing condition is anything for which symptoms were present and a prudent person would have sought treatment.

Let me state that my insurance plan began November 1, 2010. My mole did not even change until December 15, 2010. I got diagnosed with Melanoma on January 10, 2011. Please explain to me how that is a pre-existing condition? As I told the lady from "And.Them," if their wonderful company was somehow aware that I have cancer and failed to inform me, I will sue for everything they are worth. Her attitude changed after that.

Anyway, after Dr. Pink hassled "And.Them" they approved my surgery. 

I go to check in for the PET CT scan and the super sweet woman, Mary, informs me that "And.Them" has denied the scan. 

Denied a test that will be used to determine where else the cancer is in my body.

Really, "And.Them," really?

I am 23 years old. I am supposed to pay for a $6,000 scan myself? Or are you OK with knowing there is a very good chance there is cancer hiding in my body, but you won't pay to see where? 

How nice of you.

So, I say to Mary, I need this test. I want this test. Let me repeat, I need this test.

Mary, determined to help me, calls up to Dr. Bad Mustache, my oncologist. 

Here's the thing about Dr. Bad Mustache that I did not realize...he is not one you want to piss off. He told Mary to tell me to go ahead with the test, he will go to war with "And.Them."

I have to admit, when I heard how willing he is to fight for me, I felt pretty guilty knowing that I refer to him as Dr. Bad Mustache. 

 I know I complain a lot about this insurance company, but you see what I have been going through.  

"And.Them" is definitely on my enemy list.  


KayGee said...

Oh, Chelsea friend. I would never wish any of this mess on my worst enemy. It is absolute torture and, in my experience, humiliating and humbling. I mean, how often does the average person have to plead for their right to improve their quality of life--hell, to even try to figure out WHAT their quality of life is? How often does a person come to put a price tag on her life, a price tag assigned by a bureaucratic, money-grubbing institution that sees people as opportunities for business instead of individuals?

Soapbox over.

Here's to Dr. Bad Mustache and the courage you both have to stand up for one another and do what's right. Here's to guerilla warfare on the bad guys, including cancer and here's to the pretty girl posse that's going to show cancer that it's just not welcome here.

Chelsea said...

It IS humiliating! It is infuriating! It is exhausting!

And I am going to use what you said about the pretty girl posse! I'll quote you. :)

Avery O'Hurley said...

This is why the health care bill was passed... to protect people like you from arsewipes like Anthem... glad I didn't go with them... Sorry for the language...

Man that makes me upset. I really should become a lawyer... stuff like this just really makes me upset and want to sue someone or take them to court to get their heads out of their butts...

Anyway, I'm glad that you have GREAT doctors. Hope things go well for you. If they give you anymore trouble, let me know. I'll contact a friend of mine and see what can be done about it...

a said...

I am sure of one thing.... Anthem doesn't want a pissed of AJ calling on Chelsea's behalf but dear lord I will do it if its necessary. :) <3

Shelly said...

I say we round up a "Chelsea Posse" of the Price and Davis families and all her zillion friends and storm the insurance office and not leave until they get their asses straight....Let Aunt Shelly know if she needs to handle insurance fight for you or with you...I would be glad to help with that burden! It is so not fair to have to fight cancer..let alone your insurance company at the same time!

Chelsea said...

I am all for storming the insurance office! I can't imagine how they sleep at night.

At least I have a zilion friends and family to help me. And, Aunt Shelly, I will take you up on your offer to help with the insurance issues. Hopefully the doctor will be able to put them in their place.

I feel so horrible for the OTHER sick people who do not have a tribe to help fight for them.

Shelly said...

You let me know when and how I can help and I will try my best to jump right in for you. So glad your doctor's are doing their part. So many don't! Love you!

My mother in law is praying and crying for you...I am going to share your blog with her. okay?

Anonymous said...

Just reading your blog now.

"and them" are also this side of the pond, they will only cover one PET\CT Scan for MM but multiple for breast cancer. 4 Consultants fought for mine, am due to have more, suspect fun and games ahead