Have Insurance? Doesn't Matter.

I realize that some people who have read my story and have seen the donations page may be asking: "Why would I donate? They have insurance." Fair enough question.

Deductibles

Yes, we do have insurance. Another view may be that we don't have insurance until our initial deductible is met... can you say $7,000? And then there is an out-of-pocket amount ($10k? $15k?) that has to be met before the coverage pays all expenses, up to a certain amount of course.

Insurance Coverage

Yes, we do have insurance. Another view may be that we have coverage that pays pennies on the dollar. How about an example of a recent statement from a provider during my initial emergency hospitalization? (keep in mind this is just for one of the tests during my week-long hospitalization)

Description: Pathology Test
$714.42 - Total Bill
$ 29.40 - Insurance Payment from Blue Cross
$685.02 - Amount Due

Here's an image of the full bill. And here's an image of the bill zoomed. Thanks for the $29.40 payment Blue Cross.

Work would be a Blessing

When the time comes for my surgery, I'll be unable to work for several weeks. As much as 8-12 weeks. The prospect of being out of work that long has me worried for my home and family.

Does Insurance Really Matter?

My experience with insurance companies in the past has been nothing short of a battle. They want to deny every charge. We have to call and fight for coverage. They want to spend their time finding payment loopholes. We want to spend our time returning to life.

We pay tens of thousands of dollars into insurance for decades. And when the time comes when we have to use the insurance for ourselves, the insurance companies look at us like they don't even know us.

I'm beginning to see first-hand why our President is demanding for health-care reform. This is nothing short of a nightmare.

The Golden Ticket

I will say this much: Insurance is like a Golden Ticket to get into a hospital. If you have insurance, you're admitted through the V.I.P. lane. Doesn't matter if the insurance company will actually pay as long as you have that little card with a group number.

Thanks for listening.

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Comments

Sadi O.
Sadi O. United States
9/26/2010 12:04:27 PM Permalink

I KNOOOOOW

Jessica
Jessica United States
9/27/2010 9:07:01 AM Permalink

Hey, if you need help with the insurance crud after your surgery, let me know.  Insurance crud is what I do so I can at least try to help.
Hang in there!

kindler
kindler United States
9/27/2010 10:04:16 AM Permalink

Thanks Jessica - we may just forward all our mail to you Laughing

Peggie
Peggie United States
9/28/2010 10:07:14 PM Permalink

If the medical provider accepts insurance, don't they also have to accept the authorized payment amount as the full amount (except for a deductible). That's always how my Blue Cross worked.

IE: Hospital billed $8,000 for something, my insurance authorized $880.00. Hospital gets $880.00, I owe nothing if I've met my deductible.

Sadi O.
Sadi O. United States
9/29/2010 1:53:15 PM Permalink

It's looking a lot clearer to me now.

I've called BCBS and finally got to speak to a kind person. But most of all we have our Super Hero Advocate Jen Katz!
She is helping me with everything and she's helping understand it all a bit more.
We should be ok as long as we keep our eye on everything and we have Jen to strong arm them when needed.

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