Thursday, July 28, 2005

heartbreak not pain

I called the evil HMO the other day to double check that we don’t have acupuncture benefits, just a discount.

“Oh, you have those benefits,” the woman said. And then she told me I needed to get a referral from my primary physician before I could use the benefit.

So yesterday I called to request the referral.

Her: You’ll need to make an appointment with the doctor. How’s August 26?
Me: Nothing sooner?
Her: I’m not seeing anything. For how long have you been experiencing the pain?
Me: Pain?
Her: Acupuncture is only indicated for chronic pain. Where is your pain located?
Me: Well, I think my heart is breaking. Does that count? Um, I was interested in acupuncture for my PCOS and fertility. I’ve read some studies that show...
Her: Oh, for that you can self-refer. It’s not a covered benefit, but you will get a discount. I’ll give you the number to call...
Me: Is there someone I can talk to about that policy? That seems really flawed.
Her: Well, you can call member services.
Me: Will they be able to do anything?
Her: Probably not.

I knew I hated the evil HMO going into this - I used them as a kid and the experience was not pleasant. But they’re good for some things - J’s been getting decent care from them for a couple of years, and they’re good for basic medical needs, and they have at least some level of fertility benefits, which my old insurance didn’t have at all. So we gave them a chance. And now I’m done.

Except for maybe just one more cycle.

* When J called and used the “migraine pain” buzzwords, he got an appointment with the doctor for THIS WEEK. And it’s the same doctor. I think maybe they just don’t like me.

2 comments:

  1. Screw them. Can you switch doctors?

    ReplyDelete
  2. Any chance you could tell them you're experiencing pelvic pain or ovarian pain or, heck, that you're having migraines, too?

    --Bugs

    ReplyDelete