Last time I saw my doctor, my exit bill was $385, and my stress level went up and my bank account got another dent in it. Why is that? I called my insurance company (Blue Cross/Blue Shield), and after making my way through umpteen decision trees which required me to push “this” or “that” or “other”, it turned out that none of the options applied, and I just had to listen to the computer-version of elevator music for an interminable time; I was periodically reassurred by a prerecorded voice that “your call is important to us”, and the nice lady encouraged me not to hang up! I wonder if they do marketing research on the types of music which are the least likely to agitate a person, but not put the person to sleep?
So a person identifying herself as a coverage specialist came on the line. I had to take a few deep breaths, because whatever music they had been playing had gotten me agitated (or was it the lady that kept reassuring me that my call was important that did it?). At any rate, I asked the lady why my doctor had to get $385 from me before they would let me out the door?
She said, “Oh, I’m sure I can help you with that, Ma’am”. She proceeded to get policy numbers, group numbers, last 4 of my social, zip code, my mom’s maiden name, and my first pet’s name, before putting me on hold for another 5 minutes or so (yes, with that same maddening music.) On returning to the phone, the lady said, no, the annual deductible had been met; it was the CO-INSURANCE !!!
I assurred her I didn’t have any “co-insurance”, because that’s what they used to call another insurance policy which was also billed, as in the case of a spouse’s insurance. I could hear her taking a deeper-than-usual breath, before she explained that “co-insurance” is “like another deductible that you must pay out of pocket”. However, she assurred me that mine was only $2000/annually, (and I reminded her that I had already met my $2500/annual deductible for the year).
No matter. With deductible ($2500) + co-insurance ($2000) + ongoing co-pays (20%), I still had to get significantly poorer before I hit the “stop-loss” on covered services, and they quit locking me into my doctor’s office until I paid. My stop-loss was somewhere around $20000, it seems. I’m glad they have that stop-loss thing. Because on top of the 50% to 85% premium increases which my insurance company has been jacking me for annually, I still have a lot more money to cough up before I can just recklessly and wantonly see the doctor & ask for unnecessary tests just for the fun of it ! (Look for more details on premium increases in a later post!)
Last but not least, I decided to slow my meltdown, & turned on the radio. That was a mistake. The nice radio man was talking about the non-profit insurance company that many of you will recognize: Blue Shield. (Hey! That’s mine!!) The CEO is subsisting on just $4.6 million/annually in salary. And that’s a non-profit. (Look for more on this in later posts.)
Does this explain anything about the rising cost of healthcare?!