Bad Girl, no Nerve Block
My health insurance is a PPO plan. If you go to plan doctors, you have a $25 copay. If you use a plan doctor for surgical procedures, it's a $100 copay. I'd though that the nerve block would fall under this umbrella, since I'd be be booked into a surgical suite and under anethesia.
No, my insurance covers the nerve block under the other half of the policy that is subject to the 80/20 rule. What this means is that I must pay a $500 per person deductible (and I received a 5:45 phone call that payment is due when services are rendered). I don't have that kind of money, which means I will be living on the Vicodin and Lyrica until the pain goes away or we come up with the money. At least any other nerve blocks done in the same calendar year will be paid at 80%.
Argh. My only option was to cancel Monday's procedure. After last week's call to the insurance company's 24 hour nurse line, I received a call from a nurse case manager. She explained that the company offers this service to ALL their subscribers for free, but it's not widely known that it is available. Anyone can ask for one to be provided. She said she'll check in with me periodically to discuss my care options and answer questions. When she called me the other day, I was driving and unable to write her phone number down. She said she will call me sometime this week to follow up and make sure I get her number. When she calls, I'll ask about this.
Wouldn't it make more sense for them to pay for a procedure of this nature to get me off of long term RSD meds and painkillers? Drugstore.com shows that my Lyrica prescription would cost 223 a month and I've been on it several months now. While the hydrocodone is a generic, again, it's been filled regularly since December.
I hope that in discussing the financial ramifications with the case manager, we can have a meeting of the minds on these things. Like that spa I'd mentioned a while back. If they want to pay for my physical therapy long term, that's great, but a spa tub large enough to do the recommended exercises would probably cost them less in the long run.
Will the case manager assignment ultimately help them AND me? My goal is to be off drugs and pain free, theirs is to spend as little as they possibly can. I think we've got the same goal, we're just looking at it from different perspectives.