Crazy insurance rules!

[chrisinhouston]

My wife is scheduled to undergo an upper GI endoscopy today. She has suffered from reflux for many years and takes daily meds for it but every so often the Dr. wants to have a look see. The last one was in 2001 so she is way overdue. The delay is partly from the crazy work schedule and the fact that for several years our health insurance through her employer had a $2000 deductible before the insurance would pay anything and we didn't have 2 grand sitting around! So she put it off but now there is a $1000 deductible which she satisfied earlier this year with a biopsy and that crazy dizziness she had (since has cleared up).

So she saw the Dr. last week in his office and he said he could do the camera down the throat today but also wants her to schedule a colonoscopy soon. She asked if she just couldn't have both as she did with him back in 2001. He told her that insurance now won't cover the second procedure if she has it on the same day! It has to be on a separate day! She asked if that didn't increase the overall cost as the medical facility and the doctor have to schedule 2 procedures and wouldn't the costs double. He said yes and agreed it was stupid.

And the Republicans and Tea Party think the insurance we have now is so good?

[glatt]

I bet the insurance company is hoping that she won't bother with the second procedure because coming back is a hassle, and then the total cost will be less. Just to stick it to the fuckers, she should make sure to line up every possible procedure she can between now and the end of the year.

It's a truly messed up system.

[chrisinhouston]

Well she just came home and the doctor said she does have a pretty bad haital hernia that could cause pain and can be fixed surgically if necessary. She also has 40-50 pollups but she had most of those 10 years ago but he took some biopsies just in case. He encouraged some weight loss so we will work at that and to not lie down within 4 hours of eating dinner.

She is going to schedule the colonoscopy for sometime in the next few weeks.

[Lamplighter]

Our insurance provider (Kaiser Permanente) pays all but $15 (co-pay)
for a colonoscopy every 5 years, as a day-surgery (no hospitalization).

They must figure it's worth the cost to prevent colon cancer.

The good thing about such colonoscopies are that the polyps
can be removed by the surgeon during the same procedure.

[Clodfobble]

I have had more than my share of woes with multiple insurance companies and I am no fan of them.

On the other hand, it does make a certain amount of sense that two procedures at the same time should take less time/effort on the doctor's part, and thus a discount of some kind should be expected. Not nearly the discount the insurance company is asking for, to be sure, but as an example, we've had anesthesiologists charge us three times even though they only put the kid under once, because there were three procedures done by a different doctor while they were under. There's a lot of bullshit on both sides.