I tried to put it off, but it’s time to have The Talk:
Reader, when a mommy wants a baby, and she loves herself very, very much, she uses her prodigious research skills to attempt to obtain the least-terrible healthcare her freelance salary can afford. And when the health insurance company decides she’s allowed, she confers with a few strangers about the state of her uterus, and tries to talk them into helping her get knocked up. It’s a beautiful thing that you’ll understand when you’re older.
Or maybe I will, because I sure as shit don’t get it now.
Today I will attempt to muster the strength of rage required to detail the process of sourcing and procuring my current health insurance policy. But don't worry! Reading about me doing it will be way funnier and less rage-inducing than doing it yourself. Besides, I’m worried that in my old age I’m losing my rage reserves as quickly as my viable egg supply. AYE OHHHHH!!! Aww... I burned myself.
Anyway, the point is I ended up with an HMO. Now’s the part where I challenge myself to explain health insurance policy types WITHOUT looking them up. It’s like walking a tightrope without a net below you, which I would not actually do in real life, because I’m sure my broken neck would end up being called a preexisting condition and therefore not covered by sed insurance policy. Maybe this literary feat of daring will refill my rage reserves? I feel like that’s how it works for dudes, idk.
So there’s, like, a PPO and an HMO. Don’t ask me what they stand for; my brain is so full of fertility abbreviations already I think I have alphabet soup leaking out of my ears at all times. The biggest big time difference between a PPO and an HMO is that with a PPO you get to be more picky about which doctor you go to, whereas there is a much smaller group of doctors with an HMO, and occasionally they are assigned to you. As a result, you tend to pay a little less with the HMO. It’s like shopping at Kroger with a PPO (32 brands of boxed Mac and cheese) versus at Trader Joe’s (1 box of Mac and cheese, but it’s organic and cheaper than the organic kind at Kroger).
This explanation could be total bullshit, but I like it and this is my blog. I demand space for my possibly erroneous analogies!
For me, I’ve moved so much and ignored my health so spectacularly that I’ve never had a relationship with a doctor, so getting to go to “my lady” is not a thing for me. Saving money with the HMO seemed reasonable. Also, hi! Hi, I’m a Hermione, so of course I spent a solid five hours AT LEAST on the potential insurance provider’s website looking at doctors that were in their HMO network, then cross checking them with various doctor review sites as well as trying to find their birth time to see if our astrological charts would vibe.
There were plenty of doctors that had great reviews and profiles that included some language about “helping ALL people have families”. (I know this is a wink at LGBTQI+ people, but I those folx are blazing the way for us alternative types, so that’s what we have to go on.) Rudely enough, none of the doctors bothered to list their rising or moon signs on their Yelp profiles, but one works with what one has.
So, satisfied that I would have plenty of great OBGYN doctors to choose from, I put electronic pen to electronic paper and typed on the dotted line: I was signed up! And once it became a real policy on January 1st, I called the practice I found on their site, which was first on my list since they were down the street and had admitting privileges at the hospital that I can walk to, to make an appointment with one of the six doctors that were on the health insurance provider website listed as taking my insurance.
Yeah. They don’t take my insurance. No HMOs there; away with ye, peasant!
"Sorry, gov’nuh!" I picked the rotten lettuce out of my hair and limped along to the next practice.
Say, are you good at plots? Do you already know what’s going to happen next?
Yes. Not them either. They're on the website, but they don't manage the insurance company's website, so they're not sure why they are listed.
I may be mixing Dickens references (Siri: Add “Mixin’ Dickens” to my list of band names), but it is not an exaggeration to say that I went full Miss Havisham: I stopped showering or acknowledging the passage of time. I’m not sure if she chugged as many cheap beers as I did, but we must update our literary heroines for our times.
And I haven’t even mentioned the other big characteristic of the HMO: referrals. Any time you want to get an appointment with a “specialist” you have to go to your primary care physician and get them to say, “yeah, ok, you got issues above my pay grade: I hereby delegate you to a specialist. Amen.” Emphasis on the “-men”.
Friends: if you needed any evidence that being a woman in this country is treated as a deficiency, I present to you the HMO referral: I needed to get permission to go to a gynecologist. Having my female body attended to requires permission from a PCP.
So I wallowed in despair about the lies that littered the “In-network Providers” search page until my next therapy appointment, where (as is most often the case), the very act of saying out loud to another human the words “...and now I’ll NEVER get to have a child, because NO ONE takes my insurance, and I’ll just dry up and DIE!” managed to pop me right out of that funk and back into can-do mode. Have I mentioned lately how much I love therapy? I love therapy. Awoman.
Step one was to make an appointment with my PCP.
Now, I picked a PCP when I first did my health insurance application, but when my card arrived there was a different name on there. The assigned doc was closer, but he was, how do I say this? A he. And, in general, when I’m talking to someone about the body parts of my body, I prefer to speak with a woman. Again, I’ve never had a regular doctor, so I’m sure there are lots of caring and intuitive male physicians, but... this guy didn’t make your case, my dudes, sorry! More on that in another post.
I called to make an appointment. Again, please keep in mind that this appointment was literally nothing more than getting him to say “Can confirm: this lady is a lady and can go to a lady parts doctor”. The quickest they could see me was 8 weeks out.
EIGHT. WEEKS.
Look, eight weeks is a reasonable wait period for, say, a custom couch, but please keep in mind that the point of this PCP person is that they are my PRIMARY CARE PROVIDER. So if I wake up sick, I should go see them. EIGHT WEEKS LATER? What if I fucking woke up and noticed a lump in my breast? I would have to wait two fucking months just to go to this dude and say, “Please sir, may I have some gyno?”
But not to worry; this doc’s office know that’s insane, so they offer a walk-on clinic on Saturdays. Each Saturday from 7:30am to 1:00pm they take the first 20 people in line for an appointment. And what time did they recommend I show up to secure my spot? And I quote:
“Usually if you get here by six, you should be fine.”
Six. AM. Ante Meridiem. As the scholars call it: the butt-crack of dawn.
So, I set my sad-ass alarm and drug my sleepy-ass ass out of the bed at 5:40 in the morning (ON A SATURDAY) to go get in a line. And, boy, am I glad I left that early: there was no standing line yet, but I got the absolute last parking spot before people starting inventing places to squeeze their vehicles. I pulled my trusty Kona (her name is Cora because I bought her the day before the Coronavirus lockdowns started!) in between the last set of white lines on the pavement, and joined the herd of humans variably starting and stopping our engines to warm ourselves up against the mere 35 degrees Fahrenheit Texas could muster that morning.
At some point close to 7:10am, someone got out of their car and started walking towards the door, so we all got out of our car and started semi-politely power-walking into a socially-distanced line in front of the door. We froze our tushies off for the 20 minutes before they opened the door and I just hope whoever the first one was is able to live with himself for making us all shiver and stomp our feet just to get in to see the doc.
I crawled my way to the front of the intake line, and after writing on a yellow legal pad my name and reason for my visit (I was still so cold and sleepy and cranky that almost wrote “Pussy doc recs” but I decided being asked to leave would probably mean another Saturday morning of doing an impression of an exhausted Popsicle, so I refrained.) I was told to go wait in my car, and they would call me when the doctor could see me.
Two and a half hours of podcasts and dozing later, I got the call! The call to go inside a patient room and wait another hour!
This seems like a time to point out that because I am a freelancer, my health insurance is paid for by myself, and in no way supplemented by an employer, despite the fact that I make a decent living and work slightly more than full-time. And when I picked this plan, unlike a wine list at a fancy restaurant, I didn’t immediately go to the bottom of the list for the second-cheapest option. This one is like... FOURTH cheapest. And it is not cheap! My monthly premium is nearly 400 bucks a month, some of which I get deferred via tax credits, but still: I pay out of pocket more than half of that for the honor of sleeping in my car on a Saturday morning to see the first person who tells me I can see the second person. And all of that doesn’t take into account my out of pocket max :)
Tell me again why socialized medicine sucks?
Woo! I’m exhausted just writing about this experience. It seems my rage reserves have been depleted, and I’ll need to save the rather infuriating details of the actual visit for the next post. But I’ve been inspired by a band I may have made up. Join me next time for: A Tale of Two Doctors. #MixinDickens
Both were first appointments, and both of them take my insurance, so the difference between these two experiences is just... nutty. I gotta walk some high wires to prep for this.
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