Where have I been for the last month? Well, I’ve been on the phone, mainly, waiting to hear more about whether my insurance company will allow me to have my stem cell transplant at the Hospital of the University of Pennsylvania, a.k.a. “HUP.” In sum, the answer is NO. The reason? My doctor is in-network, HUP is in-network, but the procedure itself, the transplant, is not in-network, according to my insurance company. They will only allow me to go to one hospital in Philadelphia, which I will not name here, or another in Hackensack, NJ. Or I could go to a number of places requiring extensive travel. Now is that just plain stupid, or what? If I were to go to Hackensack or somewhere out of state, they’d have to pay for hotel rooms and travel expenses for me and my husband. This would end up costing way more than anything HUP would charge. Such is the reasoning of insurance companies. Actually, I think they’re trying to get rid of me.
So my choices are: 1) to go to one of these other hospitals, to a new doctor, with who-knows-how-long of a wait for doctors’ appointments, possibly more tests, and scheduling the procedure itself; 2) change my insurance company as of January 1st to one that accepts HUP as an in-network “distinction center for transplants,” which it most certainly is; or, 3) pay it all ourselves (anyone have $200,000 to spare?). Take a guess which one I’m going to do? And do you see the importance of laws that prevent insurance companies from rejecting pre-existing conditions? I would have no recourse otherwise.
I could try to force their hand and tell them how much cheaper it would be to go to HUP instead of somewhere entailing travel, but even if they agreed, the charges would still be considered “out of network” and, therefore, they would only pay up to $100,000 maximum. Everything else, which supposedly could amount to another $100,000, would be up to us to pay, which is unacceptable and unnecessary. I figure we might as well enjoy Christmas and do the transplant sometime in January. I’m waiting to hear from Dr. Porter how we will keep the enemy (i.e., amyloidosis) at bay until then. I assume I’ll have to get another round of chemo, which is fine. As long as I can do the transplant with Dr. Porter at HUP, I guess a month’s delay is not too big of a price to pay.
When I first got the news, I was very upset and nearly in tears to hear that this was happening. Then I came to my senses. First of all, I do have insurance and I will get the transplant, it is only a question of where and when. I have to keep in mind that so many people are uninsured and cannot any treatment at all. So I am thankful for my insurance. My situation is not desperate by any means, it is merely inconvenient. I think of that poor man in Arizona who was recently on the news, whose liver transplant was halted the day of the operation, because the state government cut the funds and decided not to pay for it. His partial liver, which was donated by a living relative, went to someone else. Now that is something to cry about. So I am thankful for everything that I have, including my exasperating health insurance. Even if they have excluded a wonderful, nationally renown facility like HUP.
It may be obvious, but I’ll write it down anyway: if you have good health, then you definitely have something to be very thankful for. Happy Thanksgiving to everyone!
