When Insurance Doesn’t Cover It

I’m not really sure how this guy got the Mission Waco Health Clinic phone number.  When I answered his call, I realized I was a third party on the line with him and his insurance provider (Care Improvement Plus).  I have heard a lot about CIP, and I was aware that although this Medicare supplemental covers dental, its coverage is extremely spotty and not a single oral surgeon in town accepts it.  Once the insurance rep had me involved, she was more than happy to hand off this frustrated patient to me.

So, I listened for over 20 minutes as Timothy complained about his situation.  He had been trying to get 3 problem teeth pulled for over 2 years!  One day, he saw a commercial on TV that looked promising.  He called the local dentist who assured him they would accept his insurance.  Hopeful, he went immediately to the dentist’s office where, according to Timothy, the dentist performed (and charged him for) a service that his insurance didn’t cover, and informed him that he needed oral surgery, which this dentist couldn’t perform.

Now, I know there are two sides to every story, but the bottom line is that Timothy really needed his teeth removed, and he was beyond frustrated at his lack of access to care even though he had dental insurance!  I could hear the frustration building in his voice as he jumped from story to story about how he felt taken advantage of.  Honestly, I was beginning to get frustrated myself… I was tired of listening to him complain, and I did not appreciate the fact that he was spewing all his anger onto me.

Finally, I interrupted him and told him that we could get him access to an oral surgeon who could pull his teeth at a minimal charge.  For the first time, there was silence on the other end of the phone line.  For a moment, I thought we had been disconnected, but then I realized that Timothy was crying!  Just like that, this angry, frustrated man melted into a grateful, blubbering patient.

Many of our patients – for good reason – feel taken advantage of and helpless to get the services they need.  Sometimes this frustration spills over into anger and bitterness.  Lord, open our eyes to the needs of those around us and help us to see the world from the perspective of the least of these.