Tuesday, October 16, 2012

The Best Medicine

From Jenny Sue Got Married, originally posted on August 10, 2011. 

The Bible and Reader's Digest agree: Laughter is the best medicine.

Blue Cross Blue Shield? Not so much.

My husband was on the phone with our insurance company, trying to figure out what has been paid to the hospital, what was covered, if our deductible has been met, etc. In the course of the conversation, it came to his attention that "recreation therapy" is not one of the services they cover.

Al had been in the hospital 13 days. He had been moved from the main hospital to the outpatient rehabilitation wing. When I had moved him in there, I had a sick, sad feeling because my husband had to share a ward with 3 other men, separated only by a curtain for privacy. It reminded me of a prison cell more than a hospital room. He had a tiny little closet that was about a foot wide, and a TV that was mounted on a swinging arm so he could pull it right over his bed. And he got full cable - the only perk to being in that otherwise god-forsaken place.

So when I went to visit Al on January 18, I went into his room. He was not there. Very strange, since he didn't have the capability to go anywhere on his own yet. His therapy sessions were over for the day, and I saw that he had eaten dinner, but his tray had not yet been removed. I grew a little anxious: "Had something happened and they had to rush him back in for another CT scan?" I walked around the unit until I came to the "day room" - a nice, large room with a gigantic conference table, sofas, TV, kitchenette, a piano, and a computer. Basically, it was a rec room. That's where I found my husband doing what he was supposed to be doing in a rec room - recreating. He was playing euchre with 3 other inmates patients, assisted by a "recreational therapist." It was the first glimpse in almost 2 weeks that I had of my "normal" husband. He's pretty good at cards, and he really enjoys playing. So, he was sitting there joking around, engaging in table talk, as if he were at a buddy's house instead of in a cold, sanitized hospital.

Little did we know that he would be charged for his recreational time. Because the insurance company apparently thinks that the only services that are worthwhile are those which cause pain, discomfort, or embarrassment, which is what Al endured all day, every day for 5 weeks with physical, occupational and speech therapy, daily needle pokes in his abdomen to prevent blood clotting, and having someone assist him in the most basic needs, such as getting dressed and going to the bathroom.

Also, the therapy scheduling people must have assumed that my husband, 13 days post-stroke, would know the infinite details of his inpatient rehabilitation coverage, and would definitely know whether or not recreational therapy would be covered, and would have the presence of mind to tell the rec. therapist that her services weren't covered, and therefore he couldn't participate. I guess I can't argue with that - we are all supposed to know what's covered and what's not, so it's our fault for not perusing the inpatient rehab service coverage before Al had his stroke.

How foolish of us.

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