This is still an unpleasant work in progress…read more
I am 68 and went to get my eyes checked for the purpose of getting new glasses, as well as to get a new driver's license. It has-been 6 years and the state requires you to take an eye exam when renewing your license after 65.
During the exam, it was found that I had cataract. I am also actively looking for part time work and need a car. This was on 10/14. My license expires on 1/26./2026.
My plan is UHC (Medicare Advantage) and no matter who you contact, the very first thing they do is check your insurance. Getting glasses was a special rider in my plan. Lasik surgery is Medicare and that has different requirements. Evergreen knows these requirements.
I make an appointment for 10/30. I explained the circumstances and the need for timeliness. Everything seems OK. I ask if there is anything they need. They say no and the waiting begins.
On 10/23, I get a text from their insurance person. I need a referral from my PCP. What referral? Why wasn't I told this when I made the appointment. This was my 5th PCP in 7 years. (they all left for one reason or another) and I have not seen the new person yet. Mind you, this was discussed when I made the appointment. Can you talk with him please? Should I change my appointment? I do not work in scheduling.
I arrange everything. I contact the PCP. I forward the information back to their insurance person, heart nothing from anyone and went for my appointment on 10/30. Where is your referral? What referral? All information was sent to your insurance person. I have a text. Would you like to see proof? I even asked if I should change my appointment. Where is the referral? You tell me? You want to pay out of pocket? If not, then leave.
Mind you, this is a situation that they, themselves created. Yes, I got angry and yes, I was thrown out.
Now began the song and dance with the PCP, his organization and UHC. For the next week I went through this horrific approval process that I would not wish on my worst enemy.;a situation that could have been easily avoided if Evergreen was direct from the start Back and forth, forth and back, as well as multiple visits to my PCP's office...to then be told by UHC that I should not have been involved with this at all.
Made another appointment for 11/14. Same song and dance. Can you do it in time? Yes, Can I schedule surgery now? No, but it will be done. I go through the exam, take measurements, meet the doctor, go over yet again my needs. Can we schedule the surgery now? No, we will get back after final approval.
They call a few days later. Surgery cannot be done until mid January.. Why? Why tell me a lie? Why tell me you can do it? Come 12/03 and we will discuss everything. Why wait until 12/03? Tell me now. Check your other offices. I need the surgery ASAP.
Now comes the caveat. This is Medicare open enrollment period I was thinking of changing my insurance. Now I cannot. In addition, even if I stay with the plan, because it is a new year, everything goes back to zero, including deductibles. I wanted to avoid this and explained that to Evergreen as well.
So not only did I throw myself out of their office, I incurred greater cost upon myself. Even when you ask and have written proof, you are made responsible for what they do.
Who knows. According to UHC, it is supposed to be covered 100%, but there are ways around this. For Evergreen, this is a game. Why should they care. UHC tells me that if I wanted to change providers, then I have to start the referral process over again. I will still need glasses after the surgery. I even asked if I could forego surgery for now, get glasses and wait two years. No!
I still have no answer, but clearly, only I am responsible, even if I ask everything up front. I threw myself out. I clearly ask stupid questions. I wanted my license to expire. I wanted to payt more for no reason at all.
Mind you, if it was just glasses, then I would have them now, as well as my new license., Instead, I am put in a situation where I have no control, yet told everything I want to hear until I heard everything I do not.
It does not matter what you ask or even if you have proof.
There is no need for this, yet it happens all the time in our medical system. They embrace this type of subterfuge and blame you for your own expectations. Worse, it is designed to wear you out. Ever when you ask, it has no meaning in this world.
I do not know what is going to happen. I do not expect anything good on 12/03. I have no reason to. Just more needless, careless problems that did not have to be.