Monday, October 11, 2010

More Drama? Or just the Same Drama?

I talked to Mayo today and they mentioned that I might need pre-approval from MCHA before they'd cover me there. This was the first anyone had mentioned of this, so I called MCHA and found out that Mayo is in-network, meaning I don't need a referral. This was what I had thought originally, but it worried me that Mayo was unsure. But then again Mayo was still thinking I was on MinnesotaCare (which practically needs an act of congress to cover Mayo) so I can understand their concern. But still I got that settled once and for all.

While I was on the phone with the MCHA rep, I played dumb and asked a what-if scenario just to see what they'd say: if I Term my own insurance, rather than having it Termed on me, will I have the 6 Month PreEx clause? SHe put me on hold and did some checking. Yes, she said. You will not have coverage for 6 months, this is clearly stated in our rules, she said.

Back where we began, are we?

I took her name and called Karen back at Gallagher. I told her that I've talked to 3 different people there and they've all said the same thing. WTF. I asked her to get ahold of her contact at MCHA and find out why the story I'm hearing is different from what she's hearing. She called him and he said he'd check into the policy. It would take until tomorrow, Tuesday ( at the latest) for him to get back to her with the answer. Why he was able to give her and off-the-cuff answer originally, and now this one takes 24 hours, is a mystery to me.

So we're back in the undecided column. I may be covered. I may not. I have conflicting information, but so far more people have told me that I will *not* be covered than have told me I *will* be.

Oh and the billing office gave me the rundown on how much this entire Mayo thing (9 days of fun) will cost: roughly $110,000.00. So, yeah: I don't want to get that bill in the mail if I can avoid it.

It seems to me that for $110,000.00, one could rent a palatial estate for a month, complete with an army of servants, stock it with food, and have a surgeon and nurse on hand 24 hours a day and have some left over. But what do I know.

I should know more tomorrow about MCHA. It will still be a verbal assurance, but at least we should know why I'm getting conflicting information.

Oh, and today is a postal holiday, so no Term letter from MNcare. One more day of delay on that front.

What is more, Mayo definitely wants me to come down on Thursday for a fasting blood panel at 11 am and I will need to hand deliver the CT scans to them at this point. It will take 4 hours for the blood work to come back (hmmm: my Oncologist managed to do it in about 20 minutes...) and then I will meet with Dr. Hunter at 3pm. They require an in-person meeting the day before any surgery. At 8:15 that evening (and not before) I can call an automated line, enter my Mayo number, and find out what time of day the biopsy has been scheduled for the following day, Friday.

It is very likely that I will *not* have the insurance number in hand when I go down Thursday. Getting the MNCare notice one day later and having to be at Mayo one day earlier has squeezed this thing just a little too much at both ends. It is conceivable that I will try to push the surgery back, but I will wait until Friday to make that call.

On the plus side, I got together with Sean and managed to do some home-improvement planning/shopping (while simultaneously trading phone calls with Mayo, Gallagher and MCHA) and installed some space-organization things in my house. So all is not doom and gloom, of course.


Kelly McCullough said...

I am continually amazed that anyone is willing to defend the insane mirror maze/ horror house that is the American health care system.

M said...


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