!! Medical Crisis !! Heart Attack, Insurance Fights, and a Status Update!
It’s been a month and a half since that fateful day when I suddenly felt a burning tightness in my chest while out paddling in my kayak, two miles from shore. It was an experience I certainly will never forget, and one I’m now slowly recovering from.
This post will provide you with an update on how I’m doing, what the status is on the financial fiascoes, and what my goals are for the near and longer-term future. This is part of my Medical Crisis series. Stay tuned, as I will be posting periodically on my progress.
Life 2 Months After
It happened on December 12, around 3pm. It was a Wednesday. I was off work, and I had paddled out in the morning to the Eden Property (about 3 miles from the public boat ramp) and had worked throughout the day on the new deck that would serve as the foundation for my hermit shack, where I would install a wood stove in a wood framed tent structure, small enough to keep me warm and dry during the wet and chilly winters of the local area, while still large enough to accommodate my hammock and other items.
I had left at 3pm, knowing it takes me an hour and a half to paddle back to my car. Halfway through, from out of nowhere, I was struck with a terrible pain in my chest. And, to make a long story short, it was a heart attack.
I managed to paddle back to shore, called 911, and was taken to the local hospital and had a blockage removed and a stent put in. After four days in the hospital, they released me.
Of course, that was only the beginning of my troubles.
Rehab, Rehab, Rehab
But first, lets talk about life after a heart attack. The first thing they do is send you home to rest. With that comes a big change in my diet (no salt, no processed food, etc). It also means Cardiac Rehab one to three days per week.
And, this is a joke.
I’m pretty much convinced it was designed purely to siphon more money out of the insurance company coffers, simply because everything I do there I could easily do at home.
I started at two days a week, and will be going to one here very soon. There is no reason to waste my time and my day driving all the way into town just to peddle a stationary bike for an hour.
But, with it I do get adhoc mini-lecture classes, and I’m supposed to get an appointment with a dietitian, too.
Status of the Fight with the VA
But, of course, what medical crisis story wouldn’t be complete without an massive, federal conglomerate, out to destroy the little guy only so it can increase its bottom line.
Well, maybe not so dramatic. I guess I could dial it back just a bit.
But, the status does not look very good at this point concerning the VA. I was able to visit my regional VA hospital’s emergency room and the doctor there released me back to work and renewed my medications (and they were willing to pay for something – shocker!)
The eligibility office once again re-confirmed that I was a Veteran and that I was fully covered – even if I had a heart attack and was rushed to a local community hospital. The billing department, though, says otherwise.
They state that since I have not been seen in 2 years by the VA, then they don’t have to pay. Some kind of arbitrary rule enacted by Congress before I was ever even in the military, which they don’t talk about at all at the Eligibility Department (convenient).
I asked the billing lady if I were covered now, in case I had an emergency and had to go back. She said no. Looked it up, then said, “Oh, yes. You are now covered going forward because you were seen in the ER today.”
What? Are you kidding me?
So, the bottom line is – this is all about skating out on the bill. I have not been seen by the VA in the last two years because the VA failed to assign me a doctor. I asked a year ago, and asked again this month.
But, hey. Don’t worry. This last trip may financially ruin you, but at least you’re covered going forward, right?
The Fight to Come
I was told that the VA had not actually denied the bill yet. In fact, all they did was tell the local hospital they would not pay the bill, just so the local hospital would not bother to send the bill.
Now that the bill was officially submitted to the VA, the collection process has been put on a 90 day hold (or, so they say). I’m told that if the VA does deny the claim, they will send me the appeal paperwork to fill out (yeah, I’m not holding my breath).
Bottom line, they just don’t want to pay and hope I will give up and go away. Well, I’m not going anywhere.
There is No Room at the Inn
The Eligibility Office told me when I went over there, “You are within the distance for a local VA doctor at the clinic, but there are no doctors there, the place is in a shambles. We can’t keep anyone staffed there. I’m going to submit you to the Choice Program so you can see a doctor in the community.”
I say, “Great.”
Of course, my local community, like most others in this country, have a shortage of physicians, and no one is taking new patients.
The agent tells me to wait for a call from the VA Choice Program. I say, “Is there a number I can call when they don’t call me?”
No calls. It’s been a month or more and I’ve heard nothing from the VA or the Choice Program.
In the end, the VA is like any other insurance company. You never accept a denial out of hand, because they will always try to skate on the bill. You never take their word for anything, because the medical community is build and operated by flawed humans who are all out for themselves and no one has altruistic motives. As the nurse in rehab told me on the first day, “The medical community is nothing but a business. Period.”
Hey, at least some of them are not bashful about it.
The Plan Going Forward
My plan currently is to finish rehab and get re-established at work. I also plan to call the Choice Program this week and get confirmation that, either there are no doctors available, even in the private sector, or, that the VA never bothered to actually submit my name into the program in the first place.
Either way, it will require yet another trip two hours away, where I will visit the VA Hospital the Eligibility Department (because trying to get anywhere with them on the phone is a waste of time – they simply don’t answer or return calls), and will also stop in on the Billing Department to find out the status of my first denial.
Once the bill is denied officially, I will then have to set up payment plans with the three billing authorities for the hospital stay, while the bill makes its way through the appeals process, which will most likely take a year or more. If I can’t get a payment plan, then I will have to file bankruptcy, lose my property and maybe even my house.
Then I will be a homeless, jobless Veteran, created completely by the VA, and you can guarantee, after finishing my rounds with all the media outlets that will talk to me, I will be showing up at the VA’s doorstep and then they’ll have to pay for everything – food, housing, internet, transportation, etc. Forget the medical bills. Nice going, you bureaucratic idiots!
I will keep you posted.
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