September 10, 2008

It’s a love/hate thing

Posted in Uncategorized tagged , , , at 1:00 pm by sillydreamer

I want to start by saying that I am extremely thankful that I have health insurance.  I remember the early days when the girls were little and we didn’t have it for a time so I know how that feels and I don’t take having it for granted.  So while I am thankful to have it, I get very frustrated at the system and it’s not easy to place blame.  Do I blame the Dr.’s for the outrageous price of health care, do I blame the insurance companies for the run around they give trying to get out of paying, do I blame the lawyers who file the friviolous lawsuits that drive those costs up or do I blame office workers who have defrauded the insurance companies out of millions?  Are we all sharing this blame?  In one way or another, we are all paying for it.

Here’s my rant this morning.  My oldest daughter is required to have a physical to participate in drill team.  The school offers this one day a year for free but rather than stand in the hot gym for a few hours, I decide that it’s worth my copay of $15 to just go in to the Dr’s office.   Thankfully since I have insurance, that’s all I have to pay and that’s worth it to me.

I got the statement from my insurance company yesterday and couldn’t believe my eyes.  I assume a physical for school would be billed the same as a regular office visit.  I think that runs about $65 in my Dr’s office.  They don’t do any blood work or any other type of lab screening.  Basically, he asks her some questions about rapid breathing or heart beat, makes her bend down and touch her toes a couple of times and feels around on her abdomen.  Pretty basic stuff, right?  It’s actually less time with her than if she were sick.  Don’t get me wrong, I like our doctor so this rant isn’t about him personally.  Just imagine my surprise when I see that this visit is actually $170!!!!  After the “discount” given because he is a participating provider, his office billed my insurance $95 and then I made the $15 copay.  Isn’t that insane?????? 

Like most issues, I know what the problem is, I’m just clueless as to how to go about fixing it.  Apparently so do those in charge because the problem isn’t getting better, it’s getting worse.   We’ve been very blessed to not have had anything very serious come up health related but the few trips we’ve made to the emergency room have usually resulted in lots of correspondence with the insurance company, convincing them to pay what they owe.   Several years ago my oldest daughter was turning cartwheels on the front lawn and landed on her elbow which resulted in an ER trip.  I had to write in detail what exactly happened and where before they would pay.  Of course they were hoping that this happened on someone else’s property so they could sue the homeowner’s insurance for payment but in the end, they had to pay.  It’s all about passing the buck with insurance companies these days.  I think most people don’t want to sue others but sometimes our own insurance companies give us no choice. 

And that’s my rant for the day, done without a Diet Coke no less!  Off to the kitchen to crack one open and get this day started right!  🙂

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4 Comments »

  1. tasithoughts said,

    Our litigious society has resulted in all these convuluted regulations and laws that has created a health insurance system that is burdensome and becoming more expensive by the minute. We all need to keep ranting until it is completely overhauled. Rant on!

  2. So did you pay the difference in the end? Healthcare in the US is so crucial and it must be annoying to have to fight for what you are entitled to.

  3. sillydreamer said,

    Tasithoughts, thanks for stopping by and leaving a comment.

    Hi Magik! No, all I was responsible for was the $15 copay, it just pains me that they can charge that much. I’m sure most people with insurance have the mind set that if all we are paying is the co-pay then it’s ok but it’s not ok. I know….who am I to say what a doctor can charge but I just think of all the people without insurance. Any trip to the ER, at least in my experience, is at least $1,000. We had a visit almost a year ago that totaled $7,000! Of course we weren’t responsible for nearly that much thanks to insurance but $7,000???? It’s craziness!

  4. Susan said,

    It makes me cringe too. Like you, we had no insurance when the girls were tiny so I really appreicate having it now.

    I have to agree that they charge outrageous fees, even if it doesn’t directly affect me. It also really bothers me that our insurance company can negotiate to pay a smaller amount when those without insurance, the ones that really need the break, still have to pay the full fee. Ugh.


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