EIGHT YEARS LATE AND ONE DAY EARLY

The reason this post has ANYTHING AT ALL to do with Panama is that I so, so, so cannot wait to get there and when I need simple medical care, such as a physical,  yearly exam or even a  mammogram, I will not have to deal with a flippin', flappin' insurance company!  Okay, I am not stupid.  I will be getting/paying for major medical insurance once there, but when it comes to a simple cold, sinus infection, toe problem, blood work, yearly girlie visit and so on, I am going to walk in and pay that (from what I have read) nominal cost in cash.  And not hand over an insurance card, pay my co-pay and hope for the best when my Explanation of Benefits comes back showing that I owe nothing.  Yeah right!  Like that happens often with me.  With Ray, he gets his colonoscopy, and it's all paid, the angels are singing overhead when he opens up the envelope, and I bet they even want to throw money back at him, but they (the insurance company little people) have to refrain from doing so.  His gallbladder surgery this week, it will be all paid for (the pre-auth says so).  (See my post about my physical that I had done back in May--still waiting for the Quality Assurance Board to review the coding, and yes, they told me I can call them daily to ask "how's it going in QA today?").  Okay, back to me and my day.

The reason I have never listened to my sister about having a baseline colonoscopy done at the early age of forty or even forty-two or before now is because my insurance company shows that the little people will pay for this procedure when I hit the age of fifty.  It does not state anything about "family history and deaths due to colon cancer".  They leave that part out.  I have in the past asked (as in last year), but the PA at the office I went to for my normal yearly exam didn't seem concerned.  The PA at the office this year did, and the doctor that did my yearly physical did, and he said that with family history the insurance company will pay earlier than age fifty.  When Ray went to have his gallbladder evaluated, he was told by the gastroenterologist that he was late for his colonoscopy due to family history.  Well, off I went this morning to consult about when I should be scheduling my thirty minutes of "the best nap ever" (Ray says) and colonoscopy.  It was an easy appointment, but the computers were slow, down, and then slow.  My prescription couldn't be filled (for those thirty plus pills I will have to take), and I couldn't schedule the procedure in the office.  (This was another thing that worked so lovely for Ray.  No kinks.)  I left the office calling the other office to make the appointment.  So eight years later, I will have this procedure done....in October.

Moving along to my other appointment--the good ol' yearly mammogram.  I called the office, which is about fifteen miles north on I-95, and asked if I could be seen any earlier than 10:40.  It was now 8:45.  Can I come in for 9:10?  Sure, no problem.  Forgetting that it was a Friday morning (doesn't matter the day), and that the highway is a mess with construction.  Hating to be late anywhere, I called at 9:00 and said that one lane was shut down on the highway (like the receptionist cares--I know this because I work in a dental office where you need to just call and be quick with your troubles, and let's move onto the next line that is ringing off the hook).  I would not make the appointment.  She tells me there is a fifteen minute grace period.  Perfect.  I arrive at 9:15 (the lane opened up).  I had all papers filled out, declined the 3D imaging for an extra $40 and waited.  I was called up to verify my information.  Backing up here, when I made the appointment for today, I knew that I was a day early (I had my last mammogram August 12th, but with the 365 yearly calendar it comes out to today being a day shy of one year).  I asked the receptionist about this and was told that my insurance pays for mammograms once a year.  I checked my benefits booklet online this past week.  It states the same.  Today, the receptionist hands me a waiver to sign.  Because it is one day before the one year mark, if my insurance doesn't pay for the mammogram, I am responsible for the cost.  This waiver shows that I agree to that policy.  "How much is the mammogram (without 3D)", I ask?  $348.  Uh, no.  Absolutely not.  I ask if I should call my insurance company (telling her what I was told when I scheduled the appointment and what my benefits booklet states).  She proceeds to tell me that we are well into my appointment (not my problem that even though the forms are filled out at home, it takes them another fifteen minutes to process it all and call me up to review everything that was processed) and also tells me that even if I am told that the X-ray will be covered, if it isn't, I will owe $348.  I reschedule and leave.  Knowing my luck, I will owe.

What I did decide is that I will do the 3D imaging when I return and pay the $40 cost.  A friend has breast cancer and the mammogram did not show the little guy of a tumor, so I will go for the extra depth most definitely.

I also decided that I will count my blessings for being so healthy up to this point, not sweat the small stuff so much as frustrating as my morning was, and just hope the healthy reports continue when I do decide to go to the doctor and play with the insurance company.  And I think I only have one more year of these fun and games and then I get to experience these visits Panamanian-style.  Oh boy.  I better watch what I wish for here.