I Hope My Health Insurance Covers Straight Jackets

by Marinka on September 27, 2010

The other day my daughter was referred to physical therapy by her orthopedist. An orthopedist who gave me a list of about a million physical therapists in our neighborhood. Because I’m vying for the Mother of the Decade award, I started calling right away, hoping to find someone who accepted our insurance.

Here’s a pseudo transcript of our conversations:

Me: Hi, do you accept HealthNet?

NotMe: We accept HealthNet but we are out of network for HealthNet.

Me: I don’t know what that means.

NotMe: Give me all your information and I will tell you.

Me: Why can’t you just tell me?

NotMe: We need to call HealthNet to find out.

Me: So you don’t know?

NotMe: Every policy is different. So give me your policy number, your name, your social, your mother’s maiden name and your PIN. (Editorial aside: I’m worried about the whole mother’s maiden name thing. Because my maiden name is the same as my regular last name. So everyone knows it. Does this mean that I have to add “fraud” to the things that I worry about in terms of my children’s future?)

A few days later, Not Me called me to say that I would have to meet a $1,000 deductible, of which I’ve only met $25 so far, before HealthNet would cover the physical therapy.

Therefore, just to save you some time in the future, “We accept HealthNet but we are out of network for it” means “We accept cash and checks and major credit cards.”

Finally I broke down and just called HealthNet and got phone numbers of physical therapists not conveniently located to me. The good news is that they accept HealthNet, so I only have a FIFTY DOLLAR co-payment per visit.

So here’s my money saving tip for you: don’t seek out medical services.

In other news, Husbandrinka has been trying to pressure me to switch pediatricians. I love our pediatrician, but like the rest of the free world, she doesn’t accept our insurance. This means that all visits are out of pocket, although we do get reimbursed for the annual check ups. But I love her because she’s a good doctor and smart and there’s never a long wait (probably because no one can afford to pay out of pocket). So, dilemma. Except I know that we have to cut out unnecessary expenses, so I’m coming to terms with finding a new pediatrician (sob!).

And then Husbandrinka tells me that we have to find a male pediatrician for Young Ladrinka because “he’s at that age where seeing a female pediatrician is embarrassing.”

This is more than I can handle because although I have no idea who the new pediatrician will be, I was assuming that I’d get another female pediatrician so that I wouldn’t have to take my two kids to two different pediatricians. And although you could argue that I should just take them both to a male pediatrician, I am ready to nip that mother in the bud by proposing that most pedophiles are male, especially if we get one of those priest-pediatricians that are so popular these days.

So now I don’t know what to do.

The only thing that could make my dilemma better is if Awesome Dude showed up in the comments to tell us that men are genetically superior to women as doctors.

One year ago ...

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{ 24 comments… read them below or add one }

Amy September 27, 2010 at 9:33 pm

Have you written a book yet? Cuz I want to buy it.

Reply

Keyona
Twitter:
September 27, 2010 at 9:33 pm

I kept a straight face until the priest-pediatrician comment. That’s just fucking scary.

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Glamamom
Twitter:
September 27, 2010 at 9:40 pm

Try Premier Pediatrics. I LOVE them (and have never waited). Dr. Julie for your daughter and Weinberger for Young Ladrinka. With all the good health care in Manhattan and what you probably pay for your insurance, you shouldn’t have to come out of pocket. PT is a different ball game for some reason. I’ve never been able to find a good one that takes insurance.

http://www.premierpediatricsnyc.com/

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anna see September 27, 2010 at 9:56 pm

Oh my. This explains why my kids’ haven’t had last year’s physicals yet. Aaargh.

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Tracie
Twitter:
September 27, 2010 at 10:20 pm

I just hope that Husbandrinka is ready to go in the room with the son and the male pediatrician (hopefully not of the priest pediatrician variety!) to supervise whoever you find. Scary.

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ShallowGal September 28, 2010 at 8:19 am

We just finished open enrollment where we learned that our new insurance costs more than the GNP of some medium size countries and yet still totally sucks.

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Loukia September 28, 2010 at 9:26 am

See… another reason why you should move to Canada… 😉

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Whitney
Twitter:
September 28, 2010 at 9:28 am

I wish I had had a female when I was a kid.

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Julie September 28, 2010 at 10:42 am

Find a pediatric service/practice that has several Docs. You’ll be able to a female for your daughter and a male doc for the lad. Good luck!

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Vicki
Twitter:
September 28, 2010 at 10:55 am

Two different doctors? What is this, Separate but Equal?

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Jane September 28, 2010 at 11:26 am

especially if we get one of those priest-pediatricians that are so popular these days…………. wow I am laughing so hard right now and I somehow know I shouldn’t be!!

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Awesome dude September 28, 2010 at 11:39 am

1. Good news, straight jackets are covered, with Gucci, Prada and D/G carrying $75.00 co-pay requirement and unlike the bra business no fitting appointment is needed.

2. We are not going to debate or discuss obvious stuff:

The only thing that could make my dilemma better is if Awesome Dude showed up in the comments to tell us that men are genetically superior to women as doctors.

3. Even our esteemed president B. Obama knows that Ins. Co’s are placed on this Earth to screw everybody on their sight and even beyond the horizon line.

As responsible citizens, taxpayers and health practitioners we are very ill equipped to screw them back. Our only hope is to work within the system and adapt to the environment like sole fish to the checkered pool floor.

Priest/pediatrician situation is very remote from but a good number of OBGYN’s I knew through the years would rather room in the whore houses then work in their offices.

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Robin September 28, 2010 at 11:58 am

Hahaha…….’priest pediatrician’!
Seriously though, wouldn’t it be nice to not have to worry about going broke when your kid needs medical services? Hmm…….I wonder how I could swing moving to France……….

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Peajaye
Twitter:
September 28, 2010 at 12:51 pm

The best part of this post was that there was an actual insurance ad at the bottom of it .

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Issa
Twitter:
September 28, 2010 at 1:37 pm

Is it bad that I clicked into the comments to see what Awesome Dude said? Not because I had anything to add?

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SubWife September 28, 2010 at 4:45 pm

Me too!!!

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Joie September 29, 2010 at 10:47 am

ME TOO!!!

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magpie September 28, 2010 at 2:05 pm

Okay, that editorial aside? Shit. How come I never thought of that? Clearly, male chauvinist pig dogs invented that whole mother’s maiden name as secret ID thing.

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MommyTime
Twitter:
September 28, 2010 at 9:19 pm

Okay, this was funny. But your dad’s comment about how most OBGYNs would rather work in a whore house than work with a priest/pediatrician had me laughing loud enough to wake the children. Personally, I think that all insurance company CEO’s should have to carry their own worst policies and then should be faced with quarterly emergencies such as Sunday morning high fevers, broken ankles out of state, and sustained needs for physical therapy.

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the mama bird diaries
Twitter:
September 28, 2010 at 9:56 pm

you really should just stop going to the doctor. all of you.

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Sophie@Fabrications October 3, 2010 at 11:40 am

I totally agree. And I don’t even have to pay,’coz of this whole different-system we got here.

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Renee September 29, 2010 at 1:01 am

I love your dad!

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Astrid September 29, 2010 at 10:44 am

You vs. Awesome Dude has added a whole new layer of Great to the experience of your blog.

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Heather, Queen of Shake Shake October 2, 2010 at 6:01 pm

Just go rogue, Marinka, and go WITHOUT A PEDIATRICIAN. Get a GP instead.

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