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Insured or Not Insured - My Misadventures with Cancer (long)
It's been several years since this happened, but I think I'm ready to tell the whole story. The following is my misadventures with a shady "health care coverage and discount program."
As some of you know, in 2008, I was diagnosed with testicular cancer. Truth be told, I had self-diagnosed correctly before any doctor did, but I definitely wanted professionals involved. I wasn't about to walk into a surgical center with a WebMD printout.
At the time, I was uninsured. I was working part-time for Major Electronics Retailer, and I was just wrapping up my bachelor's degree with secondary education license. Because of this problem, I had to back out of the teaching program and eventually seek a completely different career path. My employer did offer health insurance for part-timers, but the premiums were much higher than for full-timers and would have taken about 1/3 of my paycheck.
Saw a highly qualified medical assistant (not sure his actual title, but he wasn't a doctor yet) and got a tentative diagnosis. Had some tests and scans done and saw an experienced urologist to confirm the diagnosis. He told me to schedule a surgery as soon as possible but suggested I at least attempt to find some emergency sort of health coverage to make the costs a little easier to deal with.
I tried going for Medicaid funds. They told me that, at about $700-$800 a month, I earned too much to qualify for Medicaid. They actually suggested that if I moved into a more expensive apartment and used up all my $4,000 in savings, I might qualify. I wasn't about to do that.
So Mrs. Shirts and I did a lot of searching online. There were (and probably still are) some companies that provide short-notice health care deals for people with pre-existing conditions. They're not cheap, but they promised to help. I called several of them. I didn't qualify for This One, and That One was too expensive, and The Other One only offered coverage for expenses related to medical needs (like transportation) instead of the actual health care. But I finally found one that I thought might work, which for this story I will call Insuracare USA.
I called them on July 22.
Me: (explains background situation) I'm going in for the surgery on July 27. Can you cover that?
Nice Insuracare USA Agent: Yes, outpatient surgeries are part of our plan. (explains details about benefits) And the cost to you is the $175 enrollment fee followed by $125 a month under a 2-year contract.
Me: Okay. I think that's what I want to do. Can you sign me up so it's effective by the 27th?
NIUA: Unfortunately, no. That's the bad news. Our terms only start on the first of each month.
Me:
Crap.
NIUA: You can't move the surgery back to early August?
Me: I can't. The doctor wants me in as soon as possible. The earliest he could do was the 27th, and he's actually told me he would rather do it sooner than that if an opening came up.
NIUA: I'm sorry, there's nothing I can do to change the effective dates.
Me: *sigh* Well, thanks anyway. I guess I'll just have to keep looking.
And we parted ways.
I resumed my search, pretty sure I was just going to end up having to pay for this all myself but not yet ready to give up hope. The next day (July 23), I got a follow-up call from Insuracare USA.
Insuracare Follow-Up Agent: I understand you spoke with NIUA yesterday and were interested in one of our plans, but you didn't sign up. Can you tell me why?
Me: Well, simply, because you couldn't get me coverage as soon as I need it. I'm going in for surgery on July 27 to remove a fast-growing tumor, hopefully before the cancer spreads to my bones and lungs. NIUA said that the earliest she could make it effective was August 1.
IFUA: (re-explains benefits and asks if I'm still interested)
Me:
I would be if you could make it effective August 1.
IFUA: I think I can do that, actually.
Me: (ray of hope?) Really?
IFUA: Yeah, hang on a few minutes. Let me see what I can do.
Me: (listens to hold music for a while)
IFUA: So, it looks like we can make it effective tomorrow. Would that work?
Me: Yes! Yes, that would work!
IFUA: Great, I'll get started.
So, thanking my favorite deity for what looks like a miracle, I go through the sign-up process. Insuracare USA takes my $300 to sign up and to pay for the first month, and they email me a temporary card to use until the real one shows up in the mail.
But then I notice that the temporary cards show an effective date of August 1.
Crap.
I call Insuracare again and just happen to get IFUA on the phone. He assures me that, even though the cards show August 1, their computer system shows July 24, and that's what the doctors and hospitals will see as well.
July 24, I go to Grandma's house. It's her birthday, but I also need to use her landline phone because, thanks to all these phone calls, Mrs. Shirts and I are at 480 minutes of our 500-a-month cell phone plan. I call the hospital where I'm going to have the surgery and give them my new insurance information. I think all is well, but a few minutes later, the hospital staff calls me back to say that they can't verify the insurance. The next few hours of Phone Tag went a little something like this...
IFUA: Yes, you do have coverage, effective today.
Hospital: I can't find your coverage anywhere.
IFUA: They're wrong. You do have coverage.
Hospital: Nope. Nothing.
IFUA: Tell them to check this thing.
Hospital: Oh! There it is! But it's not effective until August 1.
IFUA: I made it effective today. They're wrong.
Hospital: No, it still says effective August 1. And it looks like it doesn't actually cover outpatient surgeries.
IFUA: Yes, it does.
Hospital: No, it doesn't.
IFUA: Yes, it does.
Hospital: I don't know what they're doing over there. I show no outpatient surgical coverage, and an effective date of August 1.
Now I'm pissed.
I call Insuracare again and get a manager of some sort.
Insuracare USA Manager: I understand your frustration, sir.
Me: So, how can we fix this?
IUM: Well, I do apologize, but we always make our plans effective on the first day of the month. Whatever IFUA told you, your plan is effective August 1, and there's nothing that can be done to change that. I believe he also explained the benefits to you?
Me: Yes, and he said outpatient surgeries are covered.
IUM: Outpatient surgeries are covered under certain circumstances such as (examples).
Me: But not my circumstances, huh?
IUM: No, sir.
Me: So IFUA lied to me?
IUM: It would seem so, sir, and I will speak to him about this. If you would like to cancel your plan, I can offer you a refund of the monthly premium.
Me: Yes, I will cancel. And I expect a full refund because I would not have signed up if I didn't have this deliberately inaccurate information from your employee.
IUM: I understand your frustration, sir, but the $175 enrollment fee is non-refundable.
Me: You do? You understand that I'm in a life-threatening situation here, and your staff lied to me just to make a sale?
IUM: Again, I understand, and I will speak to him.
Me:
I'd like to speak to him myself! If I don't have this surgery, I will die. If I don't have this surgery right away, the cancer will spread, causing much worse health problems for me. He said he had a way to help me pay for the surgery right away, but you're telling me that's incorrect only after I paid for it. This is not just another sale; this is my life on the line! He deliberately lied to me, and all you're willing to do is apologize and give me less than half of my money back?
IUM: That's all I can do, sir.
Me: Fine. Do it.
IUM: (processes partial refund)
Me: Now, I want to talk to IFUA and get an apology directly from him.
IUM: I will talk to him myself, sir.
Me: Why can't he apologize directly to me?
IUM: I'm just not going to do that, sir.
Me:
Your whole company disgusts me. I will find a way to get the rest of my money back. (hangs up)
Now, maybe I was a bit of an SC during that call, but I was furious. At the time, I felt justified, and I have to admit that I still do.
So I gave up on the search. I paid for the surgery myself with my savings, my credit card, and a little help from my family. This fiasco actually caused even more trouble later on with the surgeon's office sending me a bill for $800 almost a year after the surgery because Insuracare USA apparently still couldn't decide whether I was covered or not.
As soon as I was recovered enough to get on my computer and do some typing, I submitted a complaint to the BBB about Insuracare USA. I detailed my complaint and said that I wanted the rest of my money back. About a month later, and with nothing more than a curt letter of acknowledgement, I got it.
And, through what I figure is a combination of good doctors and divine intervention, the tumor was removed before the cancer had a chance to spread anywhere.
As some of you know, in 2008, I was diagnosed with testicular cancer. Truth be told, I had self-diagnosed correctly before any doctor did, but I definitely wanted professionals involved. I wasn't about to walk into a surgical center with a WebMD printout.
At the time, I was uninsured. I was working part-time for Major Electronics Retailer, and I was just wrapping up my bachelor's degree with secondary education license. Because of this problem, I had to back out of the teaching program and eventually seek a completely different career path. My employer did offer health insurance for part-timers, but the premiums were much higher than for full-timers and would have taken about 1/3 of my paycheck.
Saw a highly qualified medical assistant (not sure his actual title, but he wasn't a doctor yet) and got a tentative diagnosis. Had some tests and scans done and saw an experienced urologist to confirm the diagnosis. He told me to schedule a surgery as soon as possible but suggested I at least attempt to find some emergency sort of health coverage to make the costs a little easier to deal with.
I tried going for Medicaid funds. They told me that, at about $700-$800 a month, I earned too much to qualify for Medicaid. They actually suggested that if I moved into a more expensive apartment and used up all my $4,000 in savings, I might qualify. I wasn't about to do that.
So Mrs. Shirts and I did a lot of searching online. There were (and probably still are) some companies that provide short-notice health care deals for people with pre-existing conditions. They're not cheap, but they promised to help. I called several of them. I didn't qualify for This One, and That One was too expensive, and The Other One only offered coverage for expenses related to medical needs (like transportation) instead of the actual health care. But I finally found one that I thought might work, which for this story I will call Insuracare USA.
I called them on July 22.
Me: (explains background situation) I'm going in for the surgery on July 27. Can you cover that?
Nice Insuracare USA Agent: Yes, outpatient surgeries are part of our plan. (explains details about benefits) And the cost to you is the $175 enrollment fee followed by $125 a month under a 2-year contract.
Me: Okay. I think that's what I want to do. Can you sign me up so it's effective by the 27th?
NIUA: Unfortunately, no. That's the bad news. Our terms only start on the first of each month.
Me:
Crap.NIUA: You can't move the surgery back to early August?
Me: I can't. The doctor wants me in as soon as possible. The earliest he could do was the 27th, and he's actually told me he would rather do it sooner than that if an opening came up.
NIUA: I'm sorry, there's nothing I can do to change the effective dates.
Me: *sigh* Well, thanks anyway. I guess I'll just have to keep looking.
And we parted ways.
I resumed my search, pretty sure I was just going to end up having to pay for this all myself but not yet ready to give up hope. The next day (July 23), I got a follow-up call from Insuracare USA.
Insuracare Follow-Up Agent: I understand you spoke with NIUA yesterday and were interested in one of our plans, but you didn't sign up. Can you tell me why?
Me: Well, simply, because you couldn't get me coverage as soon as I need it. I'm going in for surgery on July 27 to remove a fast-growing tumor, hopefully before the cancer spreads to my bones and lungs. NIUA said that the earliest she could make it effective was August 1.
IFUA: (re-explains benefits and asks if I'm still interested)
Me:
I would be if you could make it effective August 1.IFUA: I think I can do that, actually.
Me: (ray of hope?) Really?
IFUA: Yeah, hang on a few minutes. Let me see what I can do.
Me: (listens to hold music for a while)
IFUA: So, it looks like we can make it effective tomorrow. Would that work?
Me: Yes! Yes, that would work!
IFUA: Great, I'll get started.
So, thanking my favorite deity for what looks like a miracle, I go through the sign-up process. Insuracare USA takes my $300 to sign up and to pay for the first month, and they email me a temporary card to use until the real one shows up in the mail.
But then I notice that the temporary cards show an effective date of August 1.
Crap.I call Insuracare again and just happen to get IFUA on the phone. He assures me that, even though the cards show August 1, their computer system shows July 24, and that's what the doctors and hospitals will see as well.
July 24, I go to Grandma's house. It's her birthday, but I also need to use her landline phone because, thanks to all these phone calls, Mrs. Shirts and I are at 480 minutes of our 500-a-month cell phone plan. I call the hospital where I'm going to have the surgery and give them my new insurance information. I think all is well, but a few minutes later, the hospital staff calls me back to say that they can't verify the insurance. The next few hours of Phone Tag went a little something like this...
IFUA: Yes, you do have coverage, effective today.
Hospital: I can't find your coverage anywhere.
IFUA: They're wrong. You do have coverage.
Hospital: Nope. Nothing.
IFUA: Tell them to check this thing.
Hospital: Oh! There it is! But it's not effective until August 1.
IFUA: I made it effective today. They're wrong.
Hospital: No, it still says effective August 1. And it looks like it doesn't actually cover outpatient surgeries.
IFUA: Yes, it does.
Hospital: No, it doesn't.
IFUA: Yes, it does.
Hospital: I don't know what they're doing over there. I show no outpatient surgical coverage, and an effective date of August 1.
Now I'm pissed.
I call Insuracare again and get a manager of some sort.Insuracare USA Manager: I understand your frustration, sir.
Me: So, how can we fix this?
IUM: Well, I do apologize, but we always make our plans effective on the first day of the month. Whatever IFUA told you, your plan is effective August 1, and there's nothing that can be done to change that. I believe he also explained the benefits to you?
Me: Yes, and he said outpatient surgeries are covered.
IUM: Outpatient surgeries are covered under certain circumstances such as (examples).
Me: But not my circumstances, huh?
IUM: No, sir.
Me: So IFUA lied to me?
IUM: It would seem so, sir, and I will speak to him about this. If you would like to cancel your plan, I can offer you a refund of the monthly premium.
Me: Yes, I will cancel. And I expect a full refund because I would not have signed up if I didn't have this deliberately inaccurate information from your employee.
IUM: I understand your frustration, sir, but the $175 enrollment fee is non-refundable.
Me: You do? You understand that I'm in a life-threatening situation here, and your staff lied to me just to make a sale?
IUM: Again, I understand, and I will speak to him.
Me:
I'd like to speak to him myself! If I don't have this surgery, I will die. If I don't have this surgery right away, the cancer will spread, causing much worse health problems for me. He said he had a way to help me pay for the surgery right away, but you're telling me that's incorrect only after I paid for it. This is not just another sale; this is my life on the line! He deliberately lied to me, and all you're willing to do is apologize and give me less than half of my money back?IUM: That's all I can do, sir.
Me: Fine. Do it.
IUM: (processes partial refund)
Me: Now, I want to talk to IFUA and get an apology directly from him.
IUM: I will talk to him myself, sir.
Me: Why can't he apologize directly to me?
IUM: I'm just not going to do that, sir.
Me:
Your whole company disgusts me. I will find a way to get the rest of my money back. (hangs up)Now, maybe I was a bit of an SC during that call, but I was furious. At the time, I felt justified, and I have to admit that I still do.
So I gave up on the search. I paid for the surgery myself with my savings, my credit card, and a little help from my family. This fiasco actually caused even more trouble later on with the surgeon's office sending me a bill for $800 almost a year after the surgery because Insuracare USA apparently still couldn't decide whether I was covered or not.
As soon as I was recovered enough to get on my computer and do some typing, I submitted a complaint to the BBB about Insuracare USA. I detailed my complaint and said that I wanted the rest of my money back. About a month later, and with nothing more than a curt letter of acknowledgement, I got it.
And, through what I figure is a combination of good doctors and divine intervention, the tumor was removed before the cancer had a chance to spread anywhere.
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