Tuesday, March 10, 2009

Quick, Before My Righteous Indignation Fades

The amazing thing is: we are some of the lucky ones. We have health insurance. We pay over $500 a month ($6,000 a year) to cover Elan and me on Mikhail's plan through his employer. I would consider our coverage to be middle-of-the-road. It's not anywhere near as good as - say - a teacher's. But it's not just-in-case-you-get-hit-by-a-train either. 

However, in the last few months, our little family of three has endured a run of bad luck health-wise. Maladies include: head colds too numerous to count, 2 cases of conjunctivitis (pink eye), 3 cases of chronic nasty cough, 1 sprained chest wall muscle from said cough, 2 standard stomach bugs, 1 case of undetermined gastrointestinal illness, 1 broken finger (Mikhail's, from soccer), 1 Staph infection in eyelid (also Mikhail's, also from soccer), 1 other kind of infection of eyelid (this time Elan), runny and congested noses that never end, and so on and so forth. And that is just since January.

Thankfully, these are all minor illnesses, par for the course of a toddler-containing household. However, you wouldn't know that from looking at the stack of medical bills currently residing on my desk. This morning I spent an hour on the phone with a very nice lady from Blue Cross who explained very patiently to me that, yes, it is true that our health insurance is total @(#*$! Actually, she put it much more diplomatically than that. It was more like - yes, ma'am, it is true that your health insurance does not cover the following:
  • routine vaccinations for children under the age of 7, until you've met your deductible (in our case, $500 per year PER PERSON) and then only partly after that;
  • routine annual physical exams and associated tests (such as general bloodwork, pap smears and mammograms for women), performed by your doctor, unless you go to a special clinic which no one ever mentioned before, and even then it still costs extra; and
  • routine prenatal care (for the next time I am pregnant), until we've spent that pesky $500 per year.
Nice Lady and I did not even get to talking about Mikhail's broken finger issues, X-rays and physical therapy appointments that will likely blow right past his $500 deductible (then we'll only have to pay 35% of the ridiculousness... WHEW! WHAT A RELIEF!). I can't even hazard a guess for what the finger will end up costing us. Could be $700. FOR A FINGER! ON HIS LEFT HAND! AND IT'S NOT EVEN A BIG ONE! But it is his left ring finger. Meaning his wedding ring has been sitting in a little dish in the bathroom medicine cabinet while we wait for the swelling and bruising to go down and see if the digit will allow itself to be straightened back to the point that the ring will once again fit. 

[By the way, the reason Nice Lady and I didn't talk about Mikhail? Because he hadn't signed a special paper that allowed me, his wife & Payer Of All Bills, to ask questions about his insurance benefits, even though I'm on his plan and receive the exact same benefits. May I just say: Oy!]

But of course we're going to do the X-rays and the physical therapy. Of course I'll get on the phone once said piece of paper is mailed and signed and sent back and put into the system and advocate as best I can, and then we'll suck it up and pay the outrageous bills. And while I sign the checks, I'll glance at the cost that it would have been had we not been some of the lucky ones who have a job that provides our family health insurance, and I'll be grateful.

Just like of course we will not allow our health insurance company's disincentives to vaccinating our child to influence our decision about whether or not to vaccinate him. But that is because we can afford to pay approximately $40 out of pocket PER SHOT (and if you don't know how many shots kids get, keep reading). If we simply didn't have the money, as so many in our country don't at this time, well then, I guess he wouldn't get the shot. Or maybe he just wouldn't eat quite as much. At a time when so many parents are choosing not to immunize their children because of vaccine safety concerns, do we really need to be providing yet another disincentive?

I'm going to do some quick math here for when Mikhail and I decide to procreate again. According to the CDC's standard vaccination schedule, a child receives 24 shots in his or her first 12 months (18 pokes if you do combo vaccines). That means Mikhail and I will likely spend about $1000 out of pocket to vaccinate our next child IN THE FIRST YEAR! Better hope we don't have twins. This of course does not include office visit co-pays ($35 per visit, well or sick) or any other tests, medications, or illnesses. And it doesn't include the cost of my pregnancy, a number which gives me symptoms-resembling-morning-sickness just to contemplate. 

This is the part that makes me completely crazy: insurance companies penalizing people for trying to be proactive about their health and the health of their children. CAUSE IT'S SO MUCH CHEAPER TO TREAT A CASE OF THE MEASLES!

Nice Lady from Blue Cross asked if there was anything else she could do for me. I said, "I don't suppose fixing our nation's completely broken health care system is in your job description, is it?" She laughed. And agreed with me.

After Nice Lady and I hung up, I congratulated myself on maintaining my sense of humor. Then I turned my attention to today's mail. And there, lurking in the pile, was a bill from a lab in Southern California that had been forwarded to my new Berkeley mailing address. For a test done when I was pregnant. With my son. Who is now two years old. I called the lab and talked to a very not-nice man. When I questioned why I was getting a bill from SEPTEMBER 2006 now, in March 2009, he told me they had been trying to reach me all this time and it's my fault for not providing my correct insurance information TWO AND A HALF YEARS AGO. I will spare you the rest of the details. Suffice it to say that Not Nice Man and I went back and forth for quite a while. He would not listen to my explanations that I had only moved six months ago, and that I had never, in the two years I lived in San Diego after this test was performed, received any mail from this lab at all. He was sure he was right. And I was sure he was a total @$$&%*#. Finally, I agreed to try to find my then-insurance card from two and a half years ago. Cause most people keep those lying around. Forever.

Oh well. While I comb through my old files, I'll just keep being thankful that we're some of the lucky ones.

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