Lamesurance


[Graphic courtesy of Ms. Crafty - thank you! I'd explain what it means, but it's a long story. A select few will understand its meaning in relation to this post. For the rest, just enjoy the cute, lumbering blue whale that can't seem to not bash itself in the head repeatedly.]

So, I know my story is nothing compared to what many people are dealing with, but I thought it was worth mentioning as another example of how "regular folks" are affected by the lack of affordable coverage for basic care.

Some would say I'm far from regular, but I disagree. I get lots of fiber.

When we got back from Canaduh I signed up for a basic plan from a provider, the name of which rhymes with Flue Yield of Palifornia. Seemed like a good plan that would let me see a doctor if I needed to but not cost a fortune every month. My premium is about $135/month and the deductible is $2,900 per year.

I saw the Caribbean Gyno for an annual exam and had no co-pay. That was cool. The doc wrote me two referrals, one for a mammogram (haven't had one in three years) and an ultrasound to look at one of my ovaries, the one that explodes like a super nova every few months.

She was very helpful, explaining when to schedule the ultrasound during my cycle to ensure the best results and said I could likely get both tests scheduled on the same day. I went away happy to have such a proactive doctor helping me out with my Lady Parts.

Later that week I got everything scheduled - same day, perfectly timed - and felt great about getting that taken care of. Neither test is pleasant, but I was actually excited to find out what might be going on with the ovary. If that thing blows up again, I'm going to take it out myself.

The day before my appointments I got a cryptic phone message from someone at USCF. I called back the next morning and spoke to a friendly guy who explained to me that because my deductible is $2,900, they'd be charging me $700 for the mammogram and $1,500 for the ultrasound.

I thanked him very much for the information and told him I'd be canceling my appointments for the day. I forgot about that big ol' deductible... When my annual exam was covered, I guess I didn't realize the tests the doctor had ordered wouldn't be. Actually, I don't know if my annual exam IS covered... I might get a bill for that at some point.

If I were working full-time or more consistently, I could probably afford $2,200 for standard tests or just buy a better plan that covers them.

The silly thing is, if there is something wrong that requires major care down the road, the insurance company will likely pay out way more $$ than they would if the problem was found (and fixed) much earlier. i.e., If they covered the tests I need now, they'd probably save money in the long run.

But hey, as someone recently said, health insurance is not a right - you get what you can afford. If all I can afford is a plan that prevents bankruptcy, then that's what I get. But I'm paying $135/month, and all that buys me is one annual doctor's appointment and $10 generic drugs? Really?

I would love to see health insurance reform that makes the entire process completely transparent. I want price lists posted on doctors' websites like you'd see for auto mechanics. I would love to see independent audits that keep everyone honest.

The goal now is to work harder at making good money so I can afford the kind of coverage I want. The American way, right? While I'm busting my ass to afford a better plan, Flue Yield of Palifornia will clear another 8 Billion - BILLION - dollars (or more) this year. Billion with a B.