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Wednesday, April 2, 2008
Boggle
It’s Health Insurance Open Enrollment season again.
I’m trying to figure out if it is in my best interest to switch providers (if there is a difference in mental health services etc) and came across the following:
What Is Not Covered
Some services are not covered by the PEIA PPB Plan regardless of medical necessity. Some specific exclusions are listed below. The following services are not covered:
1. Aqua therapy.
… blah blah blah …
29. Medical equipment, appliances or supplies of the following types:
• augmentative communication devices.
• bathroom scales.
• educational equipment.
• environmental control equipment such as air conditioners, humidifiers or dehumidifiers, air cleaners or
filters, portable heaters, or dust extractors.
• equipment or supplies which are primarily for patient comfort or convenience, such as bathtub lifts or
seats; massage devices; elevators; stair lifts; escalators; hydraulic van or car lifts; orthopedic mattresses;
walking canes with seats; trapeze bars; child strollers; lift chairs; recliners; contour chairs; adjustable
beds; or tilt stands.
• equipment which is widely available over the counter such as wrist stabilizers and knee supports.
• exercise equipment such as exercycles; parallel bars; walking, climbing or skiing machines.
• hearing aids.
• hygienic equipment such as bed baths, commodes, and toilet seats.
• motorized scooters.
• nutritional supplements, food liquidizers or food processors.
• orthopedic shoes, unless attached to a brace.
• over-the-door and/or gravity traction.
• professional medical equipment such as blood pressure kits or stethoscopes.
• supplies such as tape, alcohol, Q-tips/swabs, gauze, bandages, thermometers, aspirin, diapers (adult or
infant), heating pads or ice bags.
• vibrators.
• whirlpool pumps or equipment.
• wigs or wig styling.
I actually said “WHA?” when I read that. I can’t imagine the conversation(s) that lead the the addition of vibrators to the list.
April 2nd, 2008 at 1:04 pm
Wow. Not what I expected. My employee policy at UA specifically excluded coverage for injuries that occurred while willfully participating in a political insurrection or revolution.
I always wondered if they knew something I didn’t. About the future, that is.
April 2nd, 2008 at 1:21 pm
The insurance company prior to that one would routinely deny the office visit charges for a pap smear, but would pay the lab fees. Which we always found bass-akwards. We worked at a university. If they would pay for the collection, we could bring in our own samples and have the grad students check the cells. Heck, they had to learn what to look for on musk-ox, and we’re all mammals…
April 2nd, 2008 at 1:49 pm
Oooh! Insurrection and revolution! Did that have to do specifically with your state, or was it just thrown in there.
I see these things and wonder where the hell they come from. I mean, someone *has* to have made a claim for them to put these things in there, or else the people writing these exclusions have WAY too much time on their hands.
April 2nd, 2008 at 2:01 pm
I don’t think it was just for my state. It was in the Blue Cross/Blue Shield insurance policy guidebook.
But I figured the same thing you did – who filed a claim that caused the language to be changed? And what revolution was it?
April 2nd, 2008 at 2:06 pm
Damned Texans.
April 2nd, 2008 at 3:54 pm
Believe it or not, vibrators were originally invented as a medical device and used as a cure for “hysteria.” Look it up, for example in this news article. So it makes a kind of sense to specifically exclude it, to prevent people from using this history to claim that it should therefore be covered.
April 2nd, 2008 at 4:22 pm
I am concerned that Tom knows the history of vibrators. LOL!
“Texas, Georgia and Alabama all have anti-vibrator laws, says Maines, that either make it illegal to sell them or to own more than five. ” Why 5? It would have been interesting to hear the debate on how they come up with that number.
April 2nd, 2008 at 6:54 pm
Michelle, I knew that about vibrators. Scary. And ROFL on picturing the debates that went into all that! Tania, I have BC/BS of Alaska too, so when you and I take on the neocons w/ assault weapons we need to make darn sure that we don’t get a papercut.
April 2nd, 2008 at 7:36 pm
I wonder if couples are allowed to own 5 each, or they have to share?
April 2nd, 2008 at 7:47 pm
Tom, you have out randomed me on my own site. I bow down in awe.
I’m pretty sure if you live in a state where you’re only allowed to have five vibrators, you’re probably also not allowed to have the sort of relationships where both partners might like even on vibrator.
And when the revolution comes, please be sure to let me know so I can join in on the fun.
April 3rd, 2008 at 12:45 am
I’m not sure about Texas or Georgia, but Alabama law does make exceptions for “a bona fide medical, scientific, educational, legislative, judicial, or law enforcement purpose.” I’m not sure I want to know what a bona fide legislative, judicial, or law enforcement purpose would be. But please feel free to allow your minds to travel where they may.
April 3rd, 2008 at 12:56 am
Vince, I can think of any number of people who would claim to have been fucked by the legislative, judicial, or law enforcement establishment. My feeelthy mind is rambling all over.
April 3rd, 2008 at 2:03 am
> I am concerned that Tom knows the history of vibrators. LOL!
Yeah, I’d be pretty good at “Trivial Pursuit: NC-17 Edition” if there were such a thing.
April 3rd, 2008 at 9:35 am
Oh. My. God.
I finally read Tom’s like.
Two quotes in particular:
“The device was designed to mechanize a job doctors had been doing — believe it or not — by hand.”
and
“But some doctors complained the technique was difficult to learn. According to one biographer, Sigmund Freud tried to learn it, says Maines, but never got the hang of it.”
That may be the funniest thing I’ve read all week.
April 3rd, 2008 at 10:11 pm
The “never got the hang of it” quote cracks me up too.