Stuck in insurance hell for back and nerve pain
TL;DR Need help finding PT thats local and can take Florida Blue myBlue HMO. Website shows 0 providers in 98 miles. Customer service was no help. I’m in Southwest Florida. MRI requires PT first.
Original post:
Hey everyone. I injured my back about a month ago and tried for about three weeks to recover and couldn’t improve. I went to the local urgent care who told me it was just a muscle problem, gave me muscle relaxers and anti-inflammatory drugs and a referral to PT. Ok great.
Three days later I go to my sister’s college graduation 4 hours away, it was a pain to get to and struggled my entire time there. I get home 3 days later and my left arm suddenly goes numb. Alarmed, I go straight to the ER. They do CT of lumbar and cervical, give me an IV drip, more anti-inflammatory drugs and more muscle relaxants. Now I have a referral to a neurosurgeon.
Sounds great, right? Well, now comes the insurance. First, insurance denied both referrals because they weren’t done by my GP. So I go to my GP and get referred again to the neurosurgeon and PT. Great. Go to schedule PT, then get a call back 2 days later saying PT done by the hospital group is considered “hospital“ and subjected to 50% coinsurance on EVERY VISIT. So $300 for consult, $294 for every subsequent visit until I hit OOP max. They tell me I’d be better off to find a “free standing” place for PT as the cost share would be lower. Great again.
They can’t provide any providers and tell me I’m on my own. I call Florida Blue for a list, and due to the language barrier, the CSR can’t give a list and tells me to try online. Awesome. I go online, and there’s no phys therapists in 20 miles, or 50 miles, or 75 miles. There‘s only one provider 98.6 miles away listed. That‘s way too far.
So I call the neurosurgeon office, they tell me they won’t schedule until I’ve had an MRI with results in hand and to go back to primary care for the order. He sends off the order, and boom MRI declined because need PT. The same PT I can’t get covered at all anywhere for 98 miles.
I’m stuck and need help.