Medical Setbacks (of the Financial and the Personal Variety!)

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How do people without medical coverage manage it?  I guess the real answer is they don’t.

Over the past few months, I’ve managed to accrue close to $1700 in sudden out of pocket medical expenses.  I’m going to have to set up a payment plan for some of it.

First, the boy faceplanted on the basement floor.  He busted his glasses and hit his face very hard on the concrete.  Seemed reasonably OK, but several hours later he was mentioning stars and a headache and some flashing lights.  Straight to the emergency room we went!  An MRI later, we walked out knowing he had a slight concussion, but nothing more serious than that.  About a month later, got the bill.  It was around $1800.  The insurance, Anthem Blue Cross Blue Shield, paid for the doctor’s exam and the initial fee to step in the emergency room — but not a penny for the $1400 MRI.  I don’t mind paying my part, but I’m not sure how they can justify paying nothing for an MRI when a head injury pretty much automatically dictates one.  Who knows, maybe the hospital took advantage of my ignorance on the matter.

Afterwards, I’ve found myself facing some interesting medical issues of the female variety.  Things are still uncomfortably in process, but so far I’ve gotten a look at the “real” bill versus what my insurance company gets to settle for.  Some procedures are being billed for $500, but the company settles with the doctors for about $160.  How does your average Jane with no insurance company rep to lobby for her pay out of pocket for that?!  I’m not even done yet, haven’t gotten my latest lab bills or procedure bills, and I’m in it for about $200 already.  Not bad, for sure, compared to what it could be.

My health insurance is just as tenuous as my job.  If that contract doesn’t renew in March, I may lose my health insurance by the end of May.  I’ve done without it before for years, but it’s not a risk I like to take.  I should probably check into private health insurance and see what the cost would be and then think about just switching to that so it isn’t linked to my employment.

I won’t flog the old arguments and statistics about the United States and sickness, missed days of work, expenses related to medical costs and our general decline in health as a country.  That’s all been done to death.  I have done my best to get to the point where I have access to insurance, especially for my son.  I try to be reasonably healthy.  I try to eat right, cook most of our meals from scratch, etc.  But sometimes prevention isn’t possible.

Sometimes things just happen.  Even with insurance coverage.  What then, for those of us on a glamorous little budget?  What then?

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3 responses »

  1. The arbitrariness of what insurance companies will pay for and not pay for is infuriating. I remember how annoying Blue Cross could be, back when that was my provider. It’s also infuriating to know that what medical providers say they charge is nothing like what they really do charge.

    When I had an HSA with an outrageous deductible (might be worth looking into, BTW), I discovered that many doctors will negotiate their prices WAY down when they think you’re paying in cash. And with the HSA’s high deductible, that’s more often the case than not.

    The gynecologist made routine exams very affordable when I agreed to pay out of pocket. It saves her a lot of money not to have to do battle with insurance companies to be paid for routine billing.

    If you’re young and reasonably healthy, it might be worth looking in to buying your own insurance policy. For some people, HSAs are a great plan: you get to put money into savings tax-free, and if you don’t get sick much, your medical bills don’t cost much. I think newer HSAs now do cover routine preventive exams. And if you’ve got your own coverage, at least that’s one thing you don’t have to worry about if your contract fails to renew.

    Writer’s Guild and a few other trade groups offer group insurance to members. I think you can get group insurance through MLA, too.

  2. Well, I thought I was reasonably healthy. But after getting sidelined with a fast track to dealing with possible cervical cancer, I’m not so sure anymore! I’ll know more soon, but I may have a sight more difficult time getting independent insurance than I first imagined. 😦

  3. BTW, the other day I read that consumers should appeal EVERY denial of claim. Apparently a large number of appeals are granted, enough to make it worth asking. Anthem is notorious for denying claims, so…make some noise.

    Well, if you’ve caught it early, at least cervical cancer can be treated successfully.

    Under Obamacare, I think insurers are not allowed to discriminate against you on the basis of “pre-existing conditions.”

    I found the MSA I had burdensome because I had no medical conditions but still was having to shovel $1500 a year into a savings account that didn’t cover the deductible (it would take two years to accrue enough to cover the entire deductible). If it looks like you’re going to go through a period of expensive medical bills, a different type of policy may be better, unless you can find one that will cover 100% of your bills after you meet the deductible (mine did).

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