Tuesday, May 19, 2009

Medicare Replacements Can Eat My Butt

I had just laid the receiver in its cradle for the 50th time that morning when Allison buzzed me from checkout.
“Hey man, didn’t you say that we’re not in network with the Humana PPO Medicare Replacement?” Her voice sounded muffled and hushed so I assumed that the patient was standing right in front of her.
“Yep, we are not sooo…” and apparently that was all she needed to hear as her response was just a quick “o.k.” followed by a dial tone.
I continued on with my toiling until moments later when Allison came bursting through my faux glass sliding cubicle door. It’s a pathetic excuse for a door but at least it’s frosty. I always feel like I’m inside of a beer mug when I look through it and that’s not too shabby.
Anyways, Allison seemed exceptionally frustrated as her arms waved about like those blowy clown things they put in front of mattress stores to attract attention from the highway.
“Look man, will you come up front and talk to this dude? He’s being totally unreasonable and he’s gotta bill because it was applied to his deductible and he says someone should’ve told him this was going to happen and I dunno…. just please come and deal with him because I can’t do this shit.”
By this point in the morning I was totally over ALL of it so I had no issues with going up front and giving this cat the old “It’s your insurance” speech.
Still, it was kind of odd to see Allison so rattled by an indifferent patient.
With an “A-Team “ like spring in my step I set off to kick some ass when Allison abruptly jumped in front of me and stopped me in my tracks.
“Look, I should warn you that he’s like a “Christopher Reeves” and shit. Like he’s in this chair and he controls everything with a tube that goes in his mouth annnnnnd…..he’s a bastard.”
I recoiled in horror. “You’re fucking bullshitting me?”
Her slowly shaking head sent the chill down my spine that graciously attacked my legs and made them walk forward to face the situation.
My fellow biller Tory in the next “cube” was laughing uncontrollably at her own good fortune. Luckily for her, she was taking a call or fate wouldn’t have afforded her the luxury of skipping this one.
“Your going up the next 4 times whore. I get a quadriplegic?! Horse shit.”
I could hear her laughing intensify as I cut the corner heading towards another grueling encounter wherein I explain to some sad sack that they’ve “been screwed over by their Insurance plan” and that “yes” they Do owe us money. It sucks major balls and I despise it.
Only this time, my song and dance would be delivered to a “quad”. Christ help me. I’m a horrible collector anyways but especially from the elderly or the crippled. I’m much more suited for my furious key-stroking talents but budget cuts have dictated that I adapt and do the best that I can.
Long story short (too late) this handy-snaps was an incredible human being who accepted the line of shit I had to give’em.
It goes like this- the insurance plan that he had last year was “Humana Gold Choice” which was a “fee for service” plan so even though we were not in “Network” , they still paid us at 100% after co-pay. What had now happened to this gentlemen was that “Gold Choice’s” price went up exponentially and he was offered this new “Humana PPO” Medicare replacement that was cheaper and (supposedly) had hardly any changes. It even used the same ID number.
However, one BIG difference was that if the Doctor or hospital you go to is not in their Network then the patient is subject to a $500.00 deductible. I don’t think you ever feel more evil than when you tell some70 year old on a fixed income that he has to come up with 500 extra bucks. I had one cry on me when I told him.
See and here’s the thing, freakin’ Medicare doesn’t even impose a 500.00 deductible on a regular Dr.s visit. It’s more like around one hundred dollars for the year on office visits. AND the practice I work for as well as the hospital we are in conjunction with have decided not to sign contracts with any of these “gazillion” Medicare Replacement programs that are out there because they don’t even guarantee the same rate of reimbursement as shoddy ass Medicare. That’s sorry if you hadn’t guessed.
But back to the pole smokers at Humana- They totally butt raped the old and the mangled by not fully explaining to these folks what would happen to them by going to this “Network” based plan and giving them the option to just go back to Medicare or switch to a different Medicare replacement that’s also a “fee for service” type of deal. Now they’re all stuck with it for the year.
It was extremely sad to see the anger in this man’s eyes dissolve into bitter acceptance. Like every fucking day isn’t a struggle for this guy. He has to pay someone to get him up, to feed him and on top of that he has to pay avoidable deductibles that have been put upon him by lying cock-face insurance companies.
ANDI also find out as I’m writing the pre-signed check out for his balance, that 10 years ago he was just like me.
“I was just cruising down this two-lane country road one night in my “Jag” with the top down and out of nowhere…… I hit a mother-fucking cow. Just random ya know? Cow asleep in the fucking road.”
I really had no response other than to tell him that I loved his bumper sticker.
It read “CAUTION- I Swerve and Hit People”
Hopefully a Human Medicare Replacement “Rep” will cross his path again soon. Bastards.


  1. That's a really sad story. I worked as a mid-level manager at Sam's Club while an undergrad and the worst thing I was told I had to do was ask a man without shoes to leave the store. After I told him he needed to go, he tearfully explained to me his apartment had caught fire and he lost everything, including his best friend, his cat.

    My boss told me he had to go anyway. You can't be in the building without shoes, even if the reason you're in the building without shoes is to buy a pair because you don't have any.

  2. The greatest feeling isn't it? Those are the times when I really wish life was more like the movies and you could just say....

    "Ya know what douche bag? Not only is he gettin' a new pair of shoes,they're going to be a gift from Sam Walton and if you have a problem with it... I can beat ya to death out in the parking lot."

    Stupid reality.