Expectations Too High?
Last Friday, I finally saw a headache specialist. Instead of the results, optimism, and high spirits I expected to carry out hand-in-hand with new advice, I left the office disappointed and discouraged.
After driving three hours across Texas to meet with a $300/hr specialist, I had anticipated some treatment, some new information, something. Perhaps my expectations were too high.
Acting upon the advice of my specialist, I am now off Topamax and onto Bystolic: a blood pressure medication also used as a preventative. While I feel better mentally (no more Topamax personality takeovers,) my migraines have not changed in spite of the new preventative or the 6 bottles of Migranal I was told to use every 8 hours for 3 days in hopes of breaking the increasingly persistent Migraine cycle. In fact, the Migranal seemed to make things worse. After every administration, intense nausea set in and I almost blacked out – weaving to and fro, grasping desperately for something to cling to as my vision disappeared into black spots.
Other than new medications, he did advise I see an Ear, Nose, and Throat doctor in order to have an inner-ear balance test as I have such extreme vertigo and lightheadedness. His last word of advice? A hospital stay for intensive IV treatment lasting an undetermined amount of time. As I was given no guarantee it would work, slim chances that even if it did work the relief would be temporary, and my insurance deductible of $5K is no where close to being met – I’m having to ponder this a bit.
Insurance Debacles
When you’re the sick, the last thing you want to do is fight with your insurance company. You’re tired, fatigued. You don’t have the energy to spend thirty minutes to an hour on the phone haggling with someone who doesn’t have the authority to do anything for you anyway. The truly disgusting part is – they count on that.
While at work on Thursday, a notice popped up in my email: You have a timely message waiting for you from Humana.
I assumed it was another routine “we’ve processed a claim for you” email but decided to check it out anyway. The last two weeks had been exceptionally difficult ones for me and I’d seen my neurologist several times before she referred me to both a pain management clinic here in town and a headache specialist in Houston. (My parting impression: she’s run out of ideas and apparently I’m someone else’s problem now.)
Turns out, the message from my dear insurance company was informing me that my last visit to my doctor wasn’t fully covered by my $50 specialist co-pay. While at the office, for lack of anything else to try, she suggested an injection in the back of my head. I agreed since we had already attempted multiple IVs, IM-shots, investigatory blood work and even a cervical X-ray of my neck to no avail. The shot (an occipital nerve block) worked for my newest pain, which had begun at the back of my head in the last month or so, for about 24 hours but did little to touch my original migraine. And now, my insurance company was informing me that the 5 second injection – that one little shot – was a surgical procedure and therefore my $5K deductible applied on top of the $50 office visit co-pay.
Now, I work in health care. I understand the puny reimbursement rates doctors receive from insurance companies if they bill with an injection + drugs type of billing code. But, I never dreamed this type of injection could possibly be considered a surgical procedure.
The bottom line? I’ve spent over $2K on co-pays, Rxs, and an MRI in four months attempting to “break” this migraine cycle. None of this applies to my deductible or my max out of pocket. And, after thirty minutes on the phone, I just didn’t have the strength to argue any more. Makes me wonder though – what’s the point of having insurance?
