I Hate PacifiCare

So my insurance instructed me to go to an Urgent Care to x-ray the foot. We did so Monday night, and found it was fractured. The doctor said I need to be seen by an orthopedic surgeon, and may need surgery.

However, PacifiCare refuses to pay for me to see a specialist out of state. I broke down Tuesday after speaking on the phone with one of their reps; we were going to have the neighbors over for dinner, but I just was so disheartened and worried that I was in tears. I also realized Taylor would need to go to the Urgent Care after work, instead of rushing home to dinner, to pick up a floppy disk with my x-rays. (Don't ask me why the Urgent Care has digital files but is unable to just email them to us! I was just glad they'd give us the files at all.)

We emailed the files to my dad, who asked a favor of his orthopedist friends, Drs. John Erkkila and Leon Malkin. Those guys all deserve medals, and my dad deserves honorary status as an orthopedist, since he called what they too said: I don't need surgery. It's a so-called "Dancers Fracture" and not a "Jones Fracture" which would have required surgery. I just need to protect it with a big removable boot and the use of crutches for a few more weeks. About 3-4 weeks I need to re-x-ray it. (Will PacifiCare cover that?? I'll be in Oregon at the time.) And about that time I can start being weight on it. Total healing process will be about 6-8 weeks. So stupid that a 2-second mistake is costing hours and hours of care and lost time.

I wrote an ugly complaint letter to PacifiCare and cc:ed it to the Better Business Bureau, consumeraffairs.com, my district, and the PAEA president (who said it was actually the fault of my clinic, the Palo Alto Medical Foundation, though my doctor explained why it was not). My letter writing kind of lost steam once I got the news that I would not need surgery. But I am still angry about how lame this coverage is.

Reminds me of the staff-student musical this past February, "Alice Down the Healthcare Hole: A Musical Coma," which poked fun at the American health care system. It really is a mess. I need to talk to my dad to hear what he thinks would be a reasonable solution.