Thursday, January 13, 2011

I'll be following the health care system up close

Well, as I hinted at in my previous post, I've been having some medical issues. I had been waiting on test results. But first, my run around with the health care system:

I went to the doctor with a dry cough. She gave me antibiotics for broncitis. She said if it was still there in a month, to come back. I thought it had been 2 months (I get distracted easily with my kids), but when I went back it had actually been 4 months. This time I got the nurse practitioner. She said with my history of breast cancer, she wanted to do an X-ray. Luckily, this was done at Medical City Dallas, where all of our doctors are but a couple. She wanted me followed up by either my cardiologist, or my oncologist.

When the results came in, she said it showed fluid on the lun (they told me right but it turned out to be the left). She wanted me followed up by my ONCOLOGIST. He ordered a CT. I got the CT at the oncologist's office. This was all before the end of the year. When I saw my oncologist the first week of January, he wanted me to get the fluid drained (a thoracentisis). He first sent all the paper work to Baylor Hospital at Garland. After waiting an hour and a half for it to get there (when it's right next door), they took 10 minutes to tell me they don't take my insurance. I called the other hospital my oncologist works out (Baylor Medical Center at Plano) and specifically asked if they take Tricare PRIME. I told them that there were 3 different Tricare's, and I had PRIME. She checked with her supervisor, and came back and said, yes, we accept Tricare Prime.

So I called the oncologist back to have them fax all the paper work over to them. After 3.5 hours, and they didn't have it yet, I had them resend them. So that was another lost day. The NEXT morning, I started calling Baylor Plano to see if they had the paperwork. They did. They schudeled the procedure for the next morning. I get there (a 45 minute drive), fill out the paperwork, and on the last page they list all the Insurance companies they accept. Mine isn't on there.

So, another waisted trip, and a 45 minute drive back home. My husband called the oncologist and got another appointment at Medical Center Dallas. They drained my lung and sent it to pathology. It took almost a week to get the results.

They found metastisized breast cancer. It's all good. I know where I'm going. And now I'll get to report on the health care system up close. I have to wonder if they'll start rationing. They did last time I thought I had it back. They refused to pay for a digital MRI, stating it was experimental. My surgeon fought for over a year and I ended up only paying $25 more. I have a good surgeon.

So this week I had a PET scan and a brain MRI. I start my chemo-therapy on Tuesday, and get an echo-cardiogram on Wednesday and speak to my cardiologist on Friday. Sometime next week I have to get a mediport put back in. We'll take record of when the rationing and denying coverage starts. Remember, Tricare Prime is government insurance...

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