A Smear Campaign: You Gotta Love the American Health Insurance System

You gotta love the American health insurance system. People are ranting about how they don't want some nameless, faceless bureaucrat in Washington telling them what treatments they can and cannot get. Well, at the present time we have nameless, faceless insurance bureaucrats telling us what treatments we can and cannot get.

I was recently working for a state-funded agency. I had health insurance through my employer. I paid some, they paid some. Not unusual. My wife was insured under my name in this health insurance program. Not unusual.

She went to her doctor to get a mammogram. She paid her co-pay, had the exam and went home. Two weeks later we get a bill in the mail. The doctor's office reported that the insurance company would not cover any of the cost of the mammogram - please pay the balance due.

I called the lovely toll-free customer service number. After going through all those automated instructions, "press 1 for X, press 2 for Y . . . " I got to an actual PERSON! This young lady told me that under my policy, only the 'primary insured', that's me, would be covered for such medical treatments. My dependent would not be! I asked her if I understood her correctly. "You mean that if I had a mammogram, all I would have to pay is my co-pay of $25. And the rest would be covered by the insurance?"
"That is correct."
"You do realize that I am a man?"
"Yes, sir, I do."
"Does this make sense to you?"
"I'm just explaining the coverage under your policy, sir"

It took several more phone calls, but the treatment was eventually covered by the insurance company.

Next, my wife went for a pap smear. Guess what? Same thing! I'm covered by the insurance company to get a pap smear. She isn't!

More phone calls. More nice young ladies telling me that I can get one and my wife cannot. I asked if I could get that in writing so that I could bring it to my wife's gynecologist's office. I was told that "You don't need a written statement. It's in your policy, just read paragraph 23. "

I could just picture myself sitting in the waiting room of an OB-GYN office. Four women and me! "You here to pick up your wife?" "Nope, I have an appointment for my pap smear. Please pass the Lady's Home Journal."

Well again, more phone calls until - at last - my wife could get her pap smear covered by 'our' insurance. A government operated health insurance system can not be any worse than what we have now!