Oxford Circle

At all the jobs I’ve ever had, there has been – at one point or another – a meeting about health insurance, after which I’ve been unable to look most of my co-workers in the face without gagging a little.  Far too many of them seem to think that this is an appropriate forum for asking questions that blatantly reveal to your bosses, colleages and underlings every single itch, infection, goiter, dysfunction, episode, tingle, sensation, syndrome, -emia and -itis that has ever befallen them or their family.

Most of the time, the details of the new or updated plan are spelled out in the brochure you’re given ahead of time, so there really shouldn’t be any questions.  It’s as clear as the heel on a Bada Bing! stripper: whatever procedure or treatment you need isn’t covered. Whatever prescription drug you take is not on the formulary, and whatever doctor you use doesn’t accept this plan.  It’s really the epitome of simplicity!

Yet over the years, many of my colleagues have been confused by the statement “not covered.”

Like the gigantic, overly chirpy girl whose picture appears next to the dictionary listing for “eager beaver,” who wanted to know if her acupuncture would be covered at all. This was important because she had forged a very strong bond with her current acupuncturist out in Syosset and didn’t know if she could live without his healing touch. [Actual quote.] People might scoff at the concept, she realized, but the ancient Chinese practice had saved her from a lifetime of pain after she hurt her back in a cheerleading accident that could not possibly have occurred because she could not possibly have made any cheerleading squad, anywhere in the world. From then on, whenever I saw her, she was merely a spherical pillow shoved into adult Mary Janes with acupuncture pins sticking out of her limbs. And don’t think I didn’t fantasize about pulling one out and then re-puncturing her in a more lethal spot.

“What kind of pregnancy care coverage is there?” a male employee once asked.  

As if the room were full of really impressed smurfs, I heard a collective “OOH! AHH!”

This was followed by a less smurfy barrage of comments like, “Awwwwwwwwwlright man!” and “Woo hoo! Your boys can swim!”

“Calm down.  We’re just TRYING,” said the would-be impregnator. 

Aw! You’re trying! That is just so cute. A+ for effort. Think you can you try REAL hard?

I don’t know why, but whenever I hear that expression, I picture the following scenario:  you’re 3 and you’re fairly sure you don’t have to take a leak, but your mother tells you to “try” because the ride to Grandma’s takes 40 minutes. In this case, all it really means is that you’re having regular, unprotected sex with your partner, which is something I would rather not think about when you’re asking me to reboot my computer or telling me I have a call on line 2.  

Would-Be Impregnator’s inquiry prompted a thickly accented customer service rep to ask about coverage for abortions. No one was really sure about her country of origin, so it’s possible she came from a place where a question like that was perfectly reasonable. Here, not so much.

The sleazy insurance rep turned red and, unsure of how to respond, offered to speak with her privately after the meeting.  We, her supportive colleagues, chuckled to ourselves because we knew there was nary a chance in hell she was pregnant or had ever done anything that might have left her in that condition.  We were also pretty damn sure she had no reason to ask about STD screening, but she felt otherwise. And, as a public service to us, she made sure we all found out how often she liked to get pap smears and which gynecologists may or may not have felt her up during exams.

Then there’s the recurring 50-something woman (usually from Accounting) with a bum knee. Did you want to know how she hurt her knee? No? Too bad. She’s going to tell you in real time. And what a shocker! The physical therapy she needs can ONLY be performed at one place in the suburbs that doesn’t appear on the list of approved facilities. Isn’t there anything the cheap-suited insurance rep can do? No.

Also from the middle-aged injury department comes the man who has been involved in a freakishly horrid accident. He was walking down the street on a sunny day when he noticed a Baby Grand piano falling from the sky. It came within an inch of him, but he managed to jump out of the way just in time. Unfortunately, he tore his ACL in the process, causing his leg to give out, causing him to fall and land on a pile of foot-long nails that stuck his ass in seven places. The nails had been heated to temperatures of about 700 degrees because they were part of a “Fear Factor” stunt being filmed on that block, so he also sustained third-degree burns on his intestine. Turns out he’s deathly allergic to steel, so he went into anaphylactic shock at the hospital. He’s fine now, and it didn’t really hurt that much, but there are some residual issues, and maybe their treatment is covered? Maybe. But probably not.

I’m also a fan of the official spokesperson from Irritable Bowel Sufferers of America, who seems to follow me from job to job.  Don’t get me wrong — stomach woes are one of my favorite topics! But not at this particular juncture.

“Let’s say you have irritable bowel syndrome, you’re on a business trip, and you start pooping pebbles,” Arlene from Purchasing posed.

“What’s your question?” replied Oxford Bob.

“Is it covered?”

“Is what covered, Ma’am?”

“The pooped pebbles!”

I have to admit I did wonder whether or not Arlene was literally emitting pebbles in the crappair.  If she was, I had just discovered a fascinating new medical condition to research. 

But seriously, what part of “not covered” do you NOT UNDERSTAND? 

Then one day, not that long ago, I learned that my employer would be taking us all off Oxford and putting us on a different plan my beloved (and expensive) therapist did not accept.  I could feel the inner rage boiling as I listened to Insurance Man tell us how wonderful the new plan was, and how lucky we were to work for people who would choose it for us.  A co-worker stood up and bravely admitted that he saw an out-of-network shrink.  How much would the new plan reimburse him for?

Insurance Man adjusted his tie and said, with a fine New Jersey accent, “It’s a great, generous plan. Yuh benefits fuh dis type uh service will be comparable to duh ones you had wit Oxford.”

I could no longer sit back in silence. I said, rather loudly, “That’s actually not true.”

“Shuh it is! Yuh get 12 whole visits uh year, and the new insurance pays fuh fitty puh-cent! You guys uh lucky!”

That was it. I stood up and explained in great detail how much Oxford had paid for mental health care — both in- and out-of-network — and how little this plan covered by comparison. I expressed my disdain for a society that placed so little emphasis on those of us with ill-firing synapses and low neurotransmitter levels.   I had become Michael Douglas in “Falling Down.” I had become … ONE OF THOSE PEOPLE.

Special thanks to PG for sharing his tale!

Oxford Circle

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