The Great Phone Chase: Battling an Auto-Immune Disorder, Part 3

I called my PCP’s office the next day. “The U.W. shut the door in my face. What do I do now?”

I was left with: 1) Pay out-of-pocket for a specialist in town, or: 2) Go to the U.W.

File:Money Cash.jpg

Wikimedia Commons

“But the U.W. turned me down,” I reiterated for the hundredth time. “And if we had the resources to pay out of pocket for a specialist, I wouldn’t be talking to you!”

Ever try explaining Trigonometry to Mino the Slave?

I slammed the phone down. What’s the point in having “insurance” if no one accepts it and you can’t get an appointment?

That’s when I learned the difference between “health insurance” and “health care.” They’re not the same.

stethoscope, mobile phone, diagnosis, pulse, cardiology, medicine, healthcare

Public Domain

In the meantime, three separate insurance carriers pulled out of my county over six months without warning, leaving patients scrambling for whatever they could dredge up.

Additionally, there’s no such thing as “shopping” for health care in my county, because only one insurance company operates here. There’s no “shopping” or “choice” because there’s no competition. And only one option.

Meanwhile, letters from the state “Healthcare” Exchange arrived in my mail box almost daily. Often two or three letters showed up on the same day, with the same date, and contradictory statements about the status of my coverage.

Will the last adult out of Olympia please turn out the lights?

So I got on the phone to my state legislators. One state representative could give state medicrats a run for their money. This guy from Washington’s 24th legislative district is famous for never returning a phone call or answering an email. “Dude, what part of ‘representative’ do you not understand?”

So I phoned my state senator. His legislative assistant answered on the second ring. I outlined my situation to Laurie. “Does it really take an Act of God to get a fifteen minute appointment with a dermatologist?” I griped.

“I wouldn’t think so,” Laurie responded. “Let me see what I can find out and get back to you.”

Laurie called back two days later with the direct number to my state insurance carrier.  She had already talked to them. Perhaps because of Laurie’s outreach, I started getting heard. Finally.

“Have you considered Dr. K. in Pierce County?” Mona the insurance navigator (or whatever her title was) asked. “He’s about an hour and a half away from you, but he’s an outstanding dermatologist and he’s in your network.”

“I’d love to see Dr. K.,” I replied. “I’ve seen him before. But I was told I couldn’t see him, that I had to go to the U.W.”

“Who told you that?”

“My PCP’s office.”

“I don’t know who you talked to, but they gave you bad information. That’s not accurate at all,” Mona responded. “Dr. K. is in your network and you’re fully covered. You can see him any time. You just need a referral.”

Ever feel like hanging your head out the nearest window and screaming?

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