The "Best" Health Care in the World

At a recent checkup, my doctor gave me a referral to dermatology for a mole check because she didn't like the look of one that has appeared in the past few years. She said I should first see whether the visit would be covered under my insurance.

I was also told to get a mammogram (it's that time again!), and when I scheduled that, I was asked if I wanted the newish 3D topographic kind or the old-fashioned kind... and that I should check if 3D was covered under my insurance.

When I called to ask those two questions, this was my experience.

First, despite the fact that I have both a bachelor's and master's degree, I could barely understand the language used by the customer service rep, who was clearly reading from a script written by lawyers. I can't give you the language, since I didn't record it for "quality-assurance purposes," but you can probably imagine it if you've dealt with insurance companies before.

I translated back to her what I thought it meant and she confirmed I was correct:

1. The mole check is not covered because it's not preventive, even though this is clearly the only way to prevent skin cancer. Oh wait, I guess the only way to "prevent" skin cancer is nonmedical (sunscreen, wearing clothes when you're in the sun, not smoking, not using tanning beds). Checking a mole is considered treatment—while doing a Pap smear is preventive. Right. That's logic.

2. The 3D mammogram is covered (because it's preventive and they've incorporated the new tech into their coverage) but if they do anything else based on its findings, that won't be covered until I hit my deductible, and then 80% of the cost will be covered. This was the part that was really hard to understand in the language the phone rep used. I really wasn't sure if I understood her words, but when I said what I thought they might mean, she confirmed I was correct.

I know I have been lucky with my roll of the dice in this thing we call a health care system. I'm just venting about how language is used to hide just how bad all of this is, as with the misleading term coinsurance, which I've written about before.

For an alternative, check out this Twitter thread to get a glimpse of a person whose health care experience in this country makes mine look like nirvana.