Whew! That's a relief.

[llcoolvad]

A letter I got in the mail today. We switched health care insurers at work last year, so I am still not wise to the ways of BCBS and found this both ridiculous and amusing (and maybe a little nerve-wracking):

Dear Member:

After careful review by the Clinical Coordination Department of Blue Cross Blue Shield of Massachusetts, I am pleased to inform you that the request for hospital services made on your behalf has been approved.

Place of Service: Inpatient Acute Care Hospital
Type of Service: Medical Care

I'd like to remind you that your hospital admission must be medically necessary and may vary depending on your specific condition. We will work with your physician while you are receiving hospital services.

Also, in order to receive benefits during your hospital stay, you must remain eligible for coverage and the coverage must stay in force. The nature and level of benefits available to your are specified in your Subscriber Certificate. Should you have questions about your deductible or copayment, if applicable, please contact your customer service toll-free number shown on your Blue Cross Blue Shield identification card.

Sincerely,
Some Doctor
Physician Review Unit
Clinical Coordination
Blue Cross Blue Shield of Massachusetts

Was there some DOUBT that the big-ass MASSES in my CHEST weren't going to be covered? Isn't this EXACTLY what medical insurance is for? Holy crap. I didn't have any questions or worries BEFORE I got this letter, but now I dunno! I love the tone, like you'd get when you get accepted to college: "I'm pleased to inform you that you have been chosen to have your neck sliced open and stuff pulled out!"

Also, love the specificity. "Inpatient Acute Care Hospital" and "Medical Care" — like I'm going in for something other than medical care. Maybe hair care! And "I'd like to remind you that your hospital admission must be medically necessary" — as if anyone would have thyroid surgery on a whim. Hey! Can you remove an important part of my body for no good reason?! Thanks!!

I guess there will be more of this to come. Sigh. I suppose I should be relieved. It's covered!

Comments

[p-j-cleary.livejournal.com]

I love how they manage to sound begrudging of it, too. "I guess you can have surgery paid for by us, but you'd better stay in line, or else NO SURGERY FOR YOU! We're watching, don't think we're not!!"

[llcoolvad.livejournal.com]

I know, right? I liked Harvard's system so much better. BCBS keeps making me feel like I'm naughty.

[kicking-k.livejournal.com]

Sigh.

[llcoolvad.livejournal.com]

I know, everything must seem completely pointless to those who have delightful automatic medical care. It seems completely pointless to me, too! I hope I live to see universal health care in the U.S.

[kicking-k.livejournal.com]

The UK system's not perfect - you would probably have a much longer wait for surgery. I think the NHS is great in principle, and I hope we never lose it, but I do sometimes rather envy the speed at which the luckier people in the US can get things moving.

[livingdeb.livejournal.com]

It's so you know just what to say when the surgeon asks you certain kinds of questions.

"While I'm in there, would you like me to work on your vocal chords so you can get that deep voice you've always wanted?"
"Hmm, I'm afraid not, that doesn't sound medically necessary."

"So, would you like me to sew you back up when I'm done?"
"I don't know, is that medically necessary?"
"Yes it is."
"If you don't mind, can I get that in writing?"

Also, now is not the right time to quit your job, thus disqualifying yourself.

I've heard that an all-too-common scenario when someone gets really sick or seriously injured is that they are in the hospital for so long that their sick leave and vacation run out and finally they are let go and thus without insurance. (And now their problem is "pre-existing." And so then they end up spending all their money and then going bankrupt.) This idiotic form letter is some lawyer's idea of a good way to protect the insurance company from angry patients.