When did it become a situation of, ‘We have to have $3,535 upfront because your insurance won’t pay it all?’
My husband’s teeth have been falling out, breaking off at the gum line! He is in terrible pain almost all the time anymore. So we called around and got an appointment at a local Dental Clinic. They took x-rays and decided on what to do at the first appointment and set up an appointment for several extractions almost a month later. When he finally got in, the dentist at the clinic gave him two shots in the gum and said she would return when he was numb. When she returned she tested him to see if it still hurt and because it did, she gave him another shot and left again. The next time she returned and tested him, he seemed not to react and she began the extraction. She had told him that if the pain got unbearable, the left hand was the ‘safety hand,’ letting her know to stop. Two minutes in the hand went up!
Through the years I have seen my husband go through a lot of painful situations so I knew when that hand went up he was not just ‘being a wimp.’
The dentist told him he would have to go to an oral surgeon to have these teeth extracted because it had taken an hour and 45 minutes and he was still not numb enough for her to get one tooth out and he needed several ‘stumps’ (my word) removed. She wrote a prescription for a strong pain-killer (requiring much paperwork-they don’t hand out the heavy-duty stuff easily) and gave him a referral to an Oral Surgeon. Hopefully the pills would last until we could get an appointment with the Oral Surgeon – which turned out to be three weeks later!
When we finally got in to see the Oral Surgeon and he checked him out, he told us that because of his heart condition he wanted a letter from his Cardiologist approving the surgery.
Thus begins a Merry-go-round of phone calls and dentist visits – plus an ‘up-front cost’ that is approximately three times our monthly income.
We called the Cardiologist’s office and got his nurse to talk to the doctor; the doctor said he wanted the surgery done ‘in a hospital setting.’ Then the nurse (Jennifer was so nice and helpful to us) sent a letter to the Oral Surgeon and we thought everything was okay. To us, ‘a hospital setting,’ meant one of those offices connected to the hospital and this office was only separated from the hospital by a parking lot – and not a big parking lot! We were shocked when they called us and said, ‘your cardiologist requires this be done in the hospital.’
By now my husband is in so much pain that we do not even argue with them; just ask them to refer us to someone who can do this. Their reply is, ‘call your insurance company or the hospital. You need to call the hospital and find out what they’ll pay for the outpatient procedure anyway.’
So we call the insurance company only to find out they will not pay anything because our policy does not cover dental. ‘I knew that but if he has to go to the hospital you cover that, don’t you?’ Nope, not even a portion because it’s only because of the dental procedure that he would be there!
So we call the hospital to get referrals and they want to know ‘the whole story.’ Then they transfer us to someone else whom they have told part of ‘the story’ and we have to repeat ‘the whole story.’ Finally, on the third (?) telling of ‘the story,’ someone says, ‘but a hospital setting does not mean IN the hospital.’ (Well duh, we didn’t think it did but dentists offices keep insisting it is.) So she says, ‘it’s Friday before the holiday (4th of July) so I will pin down just exactly what doctor means by ‘a hospital setting’ and call you back on Tuesday. I will need Monday to research this but I PROMISE to get back to you Tuesday, okay!?!’
Okay, it’s the Tuesday after the fourth and we’re waiting for ‘the call.’ Just what does ‘in a hospital setting’ mean?
Wednesday morning my husband says, ‘is she gonna call?’ So I call – the wrong number! After going round-and-round with this lady who answered, we hang up. While I am praying over this problem again the Holy Spirit brings into my mind the words, ‘wrong extension.’ I grab the telephone; dial the right extension, and get – her voice mail. So I leave a message referring to our conversation on Friday, hang up – and wait.
Here’s the call!
I pick it up and it’s her! After she identified herself I realized checking out what ‘in a hospital setting’ means involved checking out our finances too (why was I surprised) because she quickly got to the point that ‘since you don’t have any money,’ you should go to Lexington – the university there has a dental clinic. (Why can’t they understand that when you are in excruciating pain money is the least of your concerns? It’s because everybody else cares about getting paid, not about your pain silly!)
Lexington is slightly less than a hundred miles away; we would have to make several trips to set things up (not just my thinking, they told me this), and when they did the surgery we would have to be prepared to stay there for the (at least) 24 hours before Roy could drive again! (Did I forget to tell you I cannot drive for medical reasons?)
I know this might offend someone but I need to get it out of my head! Maybe if I say it out loud it will stop ringing in my head. My husband’s heart function is down to 15 and I think his teeth have a lot to do with that. Is he supposed to die because everybody can’t get their ‘pound of flesh’ out of him?
When Jesus said, ‘…ye have the poor with you always…,’ (Mark 14:7) why do you think that is? What do you think he meant? Could it possibly have been because those who have are so busy holding on to what they have, or making more – that those who have not will continue to be with us?
Please pray for us saints, be blessed!
charlottehyatt 