I've not been posting lately because I'm in a heavy writing phase at work, and have been for awhile. When I stagger home after a 10-hour day of either writing or proofreading text about "rising damp" and other icky-sounding historic building maladies, coming up with blog fodder just ain't gonna happen before I pass out for the night. Hopefully we are getting to the end of it now. I think I see light at the end of the tunnel, but wouldn't bet the farm on it.
My foot is still troublesome. Long story short, after weeks of physical therapy, naproxen, an MRI, two steroid shots, one nasty peeling rash caused by the tape binding up my foot, and seeing two different doctors, the conclusion is that there are two related conditions going on, and that the most likely solutions to remedy it involve zapping key parts of my foot with some type of high-tech wand-like instrument. The second steroid shot is doing the trick for now, but once that wears off, I will undoubtedly be screaming to be wanded. Also, both docs think my long-put-off bunion surgery needs to happen sooner rather than later, though not until after I get this first issue dealt with. And survey says I need custom orthotics ($400, not covered by insurance, because I am not a diabetic). Good times.
I wish someone could explain to me why custom orthotics are not covered for most people. I mean, how many people go out and get custom orthotics just for the heck of it? It's not like you can just walk into a store and buy them - you have to see a doctor, get molds taken, wait several weeks, and even then they only work with closed and/or frumpy-looking shoes. They aren't going to improve your appearance, give you a buzz, or cause chemical dependency. I can't imagine there's this huge abuse of the system - it's not like people trying to get their insurance to cover Botox or cosmetic surgery.
Not to mention, greater availability of coverage for custom orthotics would probably mean fewer people needing surgical procedures for problems caused by lack of arch support. Insurance won't pay $400 for orthotics, but then they will cover a $5,000 surgery for the exacerbated version of the same basic problem? Do they just hate orthotics manufacturers, or non-diabetics with foot problems?
Also, some of the equipment I recently obtained as part of my treatment exposes yet another ludicrous insurance situation. Say your doctor tells you to get an xyz splint to relieve constant pain. You can order the xyz splint online or buy it at a certain pharmacy for $90. But your insurance says no, the xyz splint is durable medical equipment, and we will not cover this item unless you go to one of our approved suppliers of durable medical equipment.
So you then need to find and visit (by appointment only) some borderline-creepy medical-supply place housed in a semi-sketchy industrial park, to obtain your xyz splint. You assume this is some sort of arrangement intended to save money, or that you are receiving a superior version of the item. But no. It turns out that if you're buying from this insurer-sanctioned supplier, the xyz splint costs $400. And it's the EXACT SAME xyz splint that costs $90 elsewhere.
Can someone explain to me why this makes sense? Why are they paying over 75% more than they have to?
Also, I'd like it explained why something that is essentially a couple of pieces of plastic, tricked out with some foam padding and nylon straps, costs $400. And why will they pay $400 for this glorified plastic contraption (for one foot) when they won't pay $400 for orthotics (for both feet!) that will prevent me from suffering further foot problems?
Ah, mysteries.
My foot is still troublesome. Long story short, after weeks of physical therapy, naproxen, an MRI, two steroid shots, one nasty peeling rash caused by the tape binding up my foot, and seeing two different doctors, the conclusion is that there are two related conditions going on, and that the most likely solutions to remedy it involve zapping key parts of my foot with some type of high-tech wand-like instrument. The second steroid shot is doing the trick for now, but once that wears off, I will undoubtedly be screaming to be wanded. Also, both docs think my long-put-off bunion surgery needs to happen sooner rather than later, though not until after I get this first issue dealt with. And survey says I need custom orthotics ($400, not covered by insurance, because I am not a diabetic). Good times.
I wish someone could explain to me why custom orthotics are not covered for most people. I mean, how many people go out and get custom orthotics just for the heck of it? It's not like you can just walk into a store and buy them - you have to see a doctor, get molds taken, wait several weeks, and even then they only work with closed and/or frumpy-looking shoes. They aren't going to improve your appearance, give you a buzz, or cause chemical dependency. I can't imagine there's this huge abuse of the system - it's not like people trying to get their insurance to cover Botox or cosmetic surgery.
Not to mention, greater availability of coverage for custom orthotics would probably mean fewer people needing surgical procedures for problems caused by lack of arch support. Insurance won't pay $400 for orthotics, but then they will cover a $5,000 surgery for the exacerbated version of the same basic problem? Do they just hate orthotics manufacturers, or non-diabetics with foot problems?
Also, some of the equipment I recently obtained as part of my treatment exposes yet another ludicrous insurance situation. Say your doctor tells you to get an xyz splint to relieve constant pain. You can order the xyz splint online or buy it at a certain pharmacy for $90. But your insurance says no, the xyz splint is durable medical equipment, and we will not cover this item unless you go to one of our approved suppliers of durable medical equipment.
So you then need to find and visit (by appointment only) some borderline-creepy medical-supply place housed in a semi-sketchy industrial park, to obtain your xyz splint. You assume this is some sort of arrangement intended to save money, or that you are receiving a superior version of the item. But no. It turns out that if you're buying from this insurer-sanctioned supplier, the xyz splint costs $400. And it's the EXACT SAME xyz splint that costs $90 elsewhere.
Can someone explain to me why this makes sense? Why are they paying over 75% more than they have to?
Also, I'd like it explained why something that is essentially a couple of pieces of plastic, tricked out with some foam padding and nylon straps, costs $400. And why will they pay $400 for this glorified plastic contraption (for one foot) when they won't pay $400 for orthotics (for both feet!) that will prevent me from suffering further foot problems?
Ah, mysteries.
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1 comment:
Eliot also had to pay for his orthotics even though it would be obvious to anyone that he needs them for a major medical reason. Screwy indeed.
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