Well then why are you arguing with me about characterizing your posts this way?
So you stayed in forum rules to call me a liar, you still said it.
I characterized certain posts you've made as fictional. A liar is someone who deliberately states something false with the intent to deceive. I don't know if you're intentionally telling fictional stories about your experiences with massages to deceive people or whether it's part of some grand narrative architecture that's going to be relevant to the thread at some point....I certainly don't know, nor do I care, because I don't have to know to point out the fictional nature of the posts.
Oh, I do think we need to contrast it. For fun, let’s compare it to my original answer:
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It’s literally in my original post that it happens bi-weekly, lol.
That wasn't your original answer. Your original answer was...
Every day and twice on Sundays, Christmas, and my birthday.
That's pretty far from what you claimed later (and what evidence you've provided) but that's ok....maybe there was a good reason for this fictional story.
Also, your insurance doesn't cover it....as you're about to describe what that might actually look like if your insurance did cover it in the exact same post.
A lot, dare I even say most, people have medical conditions that are treated by doctors and are also treated by massage therapists. The doctor will treat you and then say something like “you know what? A therapeutic massage will really help support these treatments. Let me recommend some people.” Then those people go to the massage therapist and say “hey-yo, I’m here because I’m being treated for X by Dr. Y who recommended you as a coordinated treatment option.” And then they make a whole targeted treatment plan that, get this, is sometimes covered by medical insurance.
Odd....we've gone from "my insurance covers it" to "sometimes covered by medical insurance"
Now...interestingly, you described "most people" as having "medical conditions" that are treated by "doctors" and also "massage therapists" but I don't see any evidence of that (in fact, its such a clearly fictional statement that I didn't bother even looking it up) so despite being upset or uncomfortable with my characterizing your posts as containing fiction....I'm actually being generous with only pointing out a small amount of the fiction.
My insurer covers it. My employer also has one come in weekly for employees to use bi-weekly for free.
Again, if I were trying to be mean or attack you personally...I'd point out that this also appears to be fictional based on the evidence you provided. Your statement from your employer doesn't say that you've chosen both time slots available for a massage....it appears to be saying that you've chosen 1 of the 2 available, probably because you can't choose both, or it would say "and" instead of "or". I think that perhaps you meant to say "bi-monthly" (twice a month) instead of "bi-weekly" (twice a week) on accident or by mistake.
Isn't that nice of me?
Weird, it’s almost as if I literally said that a few posts ago:
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Oh ok...do you think I don't know how insurance works like every other adult here with health insurance?
Here's a hint....my insurance is so good that it covers any provider (even those outside the provider list) at 85% of the costs....and that's for any medical necessity or prescribed treatment. Wild huh? It's far cheaper than most as well....because I work for federal government in a job that has real health concerns.
Anyway, the point is that even if a provider isn't part of my insurance plan, even if they don't take my particular insurance company....guess what happens?
They still bill my insurance and find out that my insurance covers 85% of the bill.....before sending me a bill in the mail to me to cover the other 15% of the treatment lol. At no point....does insurance require you to pay for something that they cover, but need a receipt and diagnosis and personal letter from the physician explaining why the treatment was a medical necessity.
The only reason why all those things are required from your insurance is rather simple...
.they don't cover massages.
Your massage therapist doesn't bill your insurance because they don't either take insurance or they don't take your insurance. They aren't even taking a minimum fee that many providers require if they are uncertain about whether or not your insurance covers any of the treatment. You're quite literally paying for the entire massage....and according to the evidence you provided....hoping that your insurance might reimburse you for the cost if you can show....
1. You've been diagnosed with a condition that's on a very short list of conditions your insurance will reimburse you for.
2. Your doctor prescribed the massage as a medically necessary treatment.
3. Your massage therapist is recognized by your insurance as professionally certified to provide treatment.
4. You've got a receipt, showing that you paid for the treatment that they don't cover. That's what the receipt is for....it literally tells both you and your insurance who paid for the massage lol.
5. Your doctor also provides a letter explaining in detail why this was a medical necessity (you know, not something you can just take a couple of aspirin for, like a stiff neck, or sore muscles) and your insurance agrees with the doctor.
That's why unlike the things your insurance does cover....there was no little green checkmark to the left of "massage therapy" like everything else your insurance covers.
They don’t cover it, they just reimburse it?
And only in what seems to be very rare circumstances of medical necessity which are explicitly explained in detail by the doctor prescribing the massage....but yes, that would be the difference between your insurance covering treatment and your insurance reimbursing you for a very rare situation they don't normally cover.
Like… Do you not have insurance in the US?
I do...in fact, I'm all too familiar with how it works and why....and the sort of efforts that the overwhelming majority of insurance providers will go to in attempt to deny payment for treatments they actually do cover once it's clear a patient is going to cost the insurer more than they could hope to ever pay the insurer for coverage.
But hey....maybe I'm wrong because you've got some super duper version of BCBS that hardly anyone has....
Just provide a list of those massage therapists in your plan (because your plan would certainly have this list available to you) that you claimed was "basically everybody" and the short list of conditions that they would cover for massage therapy (also something your insurer would provide if they covered massages) and I'll admit I was wrong about the nature of your insurance and it's coverage of your massages....despite clearly being correct in describing the OPs situation as not even remotely likely to be medical treatment.
The difference between a reimbursement and a direct pay comes down the size of the provider and the frequency of the treatment.
Golly...I guess that's not basically everybody then. Perhaps your insurance does cover a physical therapist who also gives massages at the big expensive hospital nearby....but they would still tell you who they cover and what sort of conditions are covered.
And I don’t need to hope insurance reimburses me later
I believe this...because I think the massages you're getting are covered by your employer at about two dozen to half a dozen a year....since your email seems to indicate that frequency.
It also seems to suggest that you wear loose clothes, likely because this is a fully clothed massage, and the masseuse isn't described as a massage therapist anywhere in the email or text or whatever they sent you.
For real, it’s not that deep. If insurance pays for any portion of care you get, either through directly reimbursing the facility or reimbursing you for paying out of pocket for a covered service, it’s covered by insurance.
When insurance pays a provider....that's coverage...not reimbursement. I've only ever seen reimbursement for a mistake made by the insurer....not for regularly covered treatment.
And I'm not splitting hairs. Your insurance seems to be making it rather clear...your insurance is only reimbursing very rare or unique circumstances of medical necessity made very clear by your doctor and the specialist they referred you to.
Obviously, your doctor may prescribe you things that are or aren't considered medical treatment by your insurance. Telling you that you should watch your diet exercise more often to lose 20 lbs won't covered by your insurance. Of however, he refers you to a dietitian and physical therapist that you need to work with to lose 200lbs....might be covered by your insurance.
(Ok, they don’t say “k, have fun.” They say “number of massages at provider A approved through 11:59pm 12/31/(year), submit receipts via patient portal for direct reimbursement minus outstanding monies owed to BCBS.” But you get the point. I can take a picture, if you want.)
I don't think it's right to actually ask you for something that personal, nor do I think it's right to argue. I can think of how someone with like....Multiple Sclerosis or some ongoing chronic issue might be covered for massages....but that's obviously rare and specific. If you still really want to prove it...a list of in-plan covered massage therapists and a list of in-plan covered issues is fine. Neither I nor anyone else needs to know who you're seeing and for what.
I've had my doctor prescribe me 2 weeks off work (completely true) after allergen testing and other lab work had been unsuccessful in discovering why I couldn't sleep and had kept breaking out in random hives. It was just work/home related stress. I took an week off....and though my employer was giving me sick leave, I wasn't reimbursed for the overtime I lost by them or my insurance. You would think if the massage therapy was anywhere near as common as you suggest....that would have been a prescription. My wife has dealt with a chronic pain issue so severe it has an estimated 40-60% suicide rate. You can imagine that it required a significant amount of high potency painkillers. Once her tolerance grew too high for regular doses to help...her doctor raised her prescription to beyond the upper limit for really any insurance....and he had to write a written confirmation and explanation every single month, or the insurance wouldn't cover it and the pharmacy wouldn't fill it. Even in that situation, I wasn't paying up front and hoping for reimbursement.
Even though I'm very confident your insurance doesn't actually cover massages the way you claim (and I looked, they possibly do around Chicago, Portland, and maybe even Seattle) even if I'm wrong about your specific plan....there's very little chance I'm wrong about the OP's circumstances. Nothing in it indicated any sort of health insurance, doctors, diagnosis, etc. It sounded entirely frivolous, indulgent, and in no way necessary let alone medically necessary or beneficial.
And in spite of any attempted slight on my character for not being able to "admit being wrong" I've admitted being wrong multiple times on this forum. My most recent time (that I recall anyway) involved a particularly heinous allegation of police brutality in Mississippi if I remember correctly. When the story came out....it was so bad that I thought it must have been wildly exaggerated or at least partly false just because it was only allegations made against the police department and no statements at all involving the perspective of the police department or anyone defending them in the case. As such, I said I was skeptical of the claims and wasn't willing to judge the police without any further details. A poster either remembered this or noticed when those details emerged later and I was asked what I thought after those details and facts came out. All I recall specifically was say "I was wrong" followed by why I was wrong, and how my views on the case changed now that I knew I was wrong. I don't like being proven wrong anymore than the next person but I simply stop posting or ignore those facts to keep arguing with people who are correct. I don't just admit to being wrong when proven so....I'll actually admit it and change my views if proven wrong over a relevant fact.