Humana doesn’t cover medical emergencies, apparently.
Just gotta say the state of health care in this country is terrible because of how companies like Humana operate.
A couple months ago (in July), on a Friday night I began to feel terrible. My throat swelled up and I started running fever. I survived the night by loading up on Tylenol and by using chloreseptic throat spray. But I couldn’t really sleep because the pain from swallowing was so intense. All day Saturday I was out of commission as well. the fever would not subside. I was in the hundreds all day and into the night even with the Tylenol. My throat was getting worse too. By Sunday morning, after another night of no sleep, my fever was still in the hundreds and I could not eat any food or drink any liquids because the pain was so bad. On a scale of 1 to 10 I’d rate the pain about a 9.2 - Unbearable.
My normal doctor doesn’t have weekend hours and in fact the health care center intself doesn’t have weekend hours so I made a decision. Go to the emergency room. I was dehydrated, in pain, running a fever for day 3, and unable to get proper rest.
At the ER, I asked if I as over reacting and they said overwhelmingly that I had done the right thing by coming in. They immediately hooked me up to a machine that rehydrated me, gave me a steroid to decrease the throat swelling, and administered a small does of morphine for the pain. They ran some tests and a few hours later I was feeling 1000 times better. I honestly think Swedish Covenant Hospital in Chicago saved me that day. And I want to thank the staff for the efficient job they did.
So, this brings us to today. I received a “this is not a bill” explanation of benefits statement. According to this statement the hospital charged $1,420.80 for the services that day and Humana covered nothing. not one penny.
In fact, the “explanation” they give is that “based on presenting symptoms”…
- running a fever for 3 days
- dehydration due to the inability to drink or swallow anything
- and excruciating pain to the point where sleep is not possible during a weekend where a regular doctor visit could not be arranged
… “the emergency room was an inappropriate setting for care”.
My bad.
I’ll be calling them on Monday since Human doesn’t have weekend hours. (Why would they? Who gets sick on the weekend right?) And I’ll let you know how they handle the situation. I’m hoping they surprise me and cover my medical expenses… you know, like health insurance is supposed to.
