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Here’s a thread about my emergency appendectomy in July 2020. 1/ https://twitter.com/lorihensler/status/1307750061464530944">https://twitter.com/lorihensl...
One Sunday evening in late-July, I had a bellyache. It started with minor discomfort in the late afternoon but by the evening, I knew the pain was too bad to sleep. I called the nurse line provided by my insurance company, @Cigna for advice. 2/
When I described the pain and the progression, the nurse told me to go to the ER. I asked which hospital to go to, and was given the name of the closest in-network hospital. Given the pandemic, my two small kids, & no nearby family, I left my husband at home and drove myself. 3/
By the time I got admitted to the ED, my pain level was similar to the active phase of unmedicated childbirth. Which is to say, a lot of pain. After some pain medication (my experiences with obtaining basic pain management in hospitals is a whole ‘nother thread), tests began. 4/
After a few hours and a few tests, the working assumption became a ruptured appendix. I was admitted to the hospital and was told I would be brought down to surgery in about one hour. I texted my husband but do you know who I knew I needed to call? @Cigna. 5/
I spent the entire hour before going into surgery on the phone with Cigna in an attempt to manage my financial exposure. It did not matter one lick. 6/
The surgeons assigned for my emergency surgery were not in network. Since I had “left” the ED and had been admitted for an outpatient procedure, Emergency coverage no longer applied. 7/
I actually tried to see if there were ANY in-network surgeons that practiced in the hospital that could perform the surgery. @Cigna gave me 2 names. We conference called both. One was retired. One only worked on Tuesdays and Thursdays. 8/
So to recap, I:
https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">Let @cigna pick the hosp. for my emergency visit
https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">Spent (literally) the entire time that I was scheduled for surgery on the phone w/ Cigna looking for literally any in-network surgeon to perform my surgery, which wasn’t an emergency anymore “b/c Dept change” 9/
I was told I could apply for a waiver, given the circumstances, so that the available surgeons would be considered in-network. How long would I have to delay the *emergency* surgery to be eligible? Two days. 10/
Well, I decided that I wanted to live, money be damned. I got off the phone and let them roll me down the hall and cut out that dangly bit of damaged and obsolete gastrointestinal system. Since then, I’ve received well over $10,000 in related bills. 11/
I have years of background in patient advocacy. I knew what I was supposed to do to get affordable emergency medical care. I did it. I also know what I’m supposed to do next, and that my efforts may be just as futile. I understand the system. That’s not enough. 12/
Insurance cos have outrageous rules (like: https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤡" title="Clownsgesicht" aria-label="Emoji: Clownsgesicht">Call us before heading into your https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤡" title="Clownsgesicht" aria-label="Emoji: Clownsgesicht">emergency surgeryhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🤡" title="Clownsgesicht" aria-label="Emoji: Clownsgesicht"> so we can explore other in-network optionshttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🤡" title="Clownsgesicht" aria-label="Emoji: Clownsgesicht">) but the rules are there in part to obscure that there often is no way to get the care you think your premiums are buying. 13/
You can play by every rule, but via motivation and apathy insurers will always find another rule that lets them off the hook. There are plenty of people who are doing great work to raise awareness of this, e.g. @sarahkliff @DGlaucomflecken. Follow them.
Right before I was sedated, I felt the intensest form of regret I’ve ever experienced in my life. It sunk in that I was about to be sedated. I hadn’t gathered myself. I hadn’t meditated. I hadn’t spoken with the people I love the most. I only talked to @Cigna. 15/
Appendectomies are low-risk surgeries. I was discharged less than 24 hours after arriving at the hospital (though you wouldn’t know it from the price tag). But all surgeries are scary & have risks. I spent one of the more precious hours of my life on the phone w/ @Cigna 16/
Earlier in this thread, I insinuated that Cigna is a joke (https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤡" title="Clownsgesicht" aria-label="Emoji: Clownsgesicht">) but the point of the thread is that at this point I see I’m the real clown. I really thought I could box Cigna into doing their job. That I could outplay them at their game at their stadium in front of their refs. 17/
I’ll probably negotiate these bills down somewhat one way or another. I can’t understand how I could possibly owe them this much money. E.g. My out of pocket maximum must be relevant, right?? 18/
I use to have hubris. I used to believe insurance coverage was a stacked game that was only winnable for over-informed super users like me. I still thought that that was a major, irredeemable problem. Now, I see it’s a kangaroo court. Fin/19
