Friday, October 18, 2013

Medical Folderol & Wishes My Foot was Better so I Could Kick Some A$$



Well a bill came from Geisinger so I now know what my little excursion to the ER(then Urgent Card, then back to the ER)cost us.

We have an automatic $150 Copay every time we walk into an ER for treatment with our insurance plan.
And the bill for "Diagnostic Radiology"(2 ex-rays of my foot)was $548, "Pharmacy"(1 shot of Lovenox and 1 Coumadin pill)was $11.94 and "Emergency Services"(maybe the sonogram of my leg/ankle was included in this?..the ER staff's wages?.....the use of a gurney sitting in the hallway in the ER?...goodness only knows what this included!)was $1,420.

All totaled that bill came to $1,979.94 for my 9 ish hr. visit to the hospital.

Insurance paid $1,829.94 of the bill, leaving our payment at $150.
So with the copay we paid a total of $300 OOP for my ER/Urgent Care/ER Visit.

I thought our benefit was 90% for in hospital services but $150 isn't even 8% of the total charged on the bill.
Hhhmmmm.

Well the check is written and it's paid and done.  If they want an extra $50 +/- from me they can come after me.  lolz



And this all leads into talking about that this week and next are the "Open Enrollment" at Hubs works for next year's insurance plan.
I like to refer to it as "Open Season on Consumers" instead because I feel like Elmer Fudd when this time rolls around every year.




We've already started analyzing the costs/benefits of each of 5 plans we can choose from.
Oh what fun!! 8-))

Luckily for us, Hubs employer provides part of the cost of his healthcare so that is why we are limited to 5 choices.

I can't imagine having to pay the full shift of the coverage yourself and having to pick from all those supposed options on a state's mandated HealthCare Exchange.
That is, IF there are any options in your state, which doesn't seem to be the case in some states....not that anyone can get through the system yet because the websites are a clusterf*ck, but I digress......


We won't be going with our current plan, which is a local to this area of PA HMO, next year.
Mainly because we have a daughter in Louisiana who can't utilize any of the benefits where she lives as none of the practitioners or services are outside of Pennsylvania.  When she left home in May we had to purchase an additional insurance policy just to cover her.  It's an additional healthcare cost in our budget, and a bare bones policy and basically you can only use it if you are in dire medical need(and it has very high deductibles).  So luckily she has stayed relatively healthy the last 6 months, but she needs a policy that she can use for day to day problems or if she gets an infection and needs meds.

And thanks to our wonderful government and the ACA if we continue to keep her on the plan she is on(which her carrier WILL continue to provide for at least through 2014)she will be fined because it's not expensive/expansive enough.
Thank you Mr. Obama and those pinheads in Congress who passed this mess without reading it!!

I'd like to personally kick each and every one of you in the ass right now....but then again, I'd need medical again for my foot.



So now, even if the insurance we pay for currently is great for me(who is by far the largest consumer of healthcare presently in our family)we have to change our coverage, our doctors, and increase how much we pay out of pocket for our healthcare.  (If we were able to keep our same policy it would still go up a little bit but at least I wouldn't have to find all new healthcare providers.)

So option 5(our current policy)is out and we are left with 3 Consumer Directed plans offered by the same company(Cigna)and 1 HMO offered by Aetna.
I like the idea of going from our HMO to another HMO(this one is nationwide so daughter can actually use it!)but upon closer inspection it doesn't seem to be the best fit for us.

We'll run the numbers(benefits vs. OOP costs, co-pays, co-insurance and premiums)later this week using what we have spent this year on health issues to test which is the best financial option for us.

The 3 other choices, the Consumer Directeds, have in-network and out-of-network benefits, with the in-network benefits being higher of course.  So we have to sit down and list all the doctors, drugs and services I/we use and see what costs would be in-network and what is out-of-network.....then weight the possible costs against the costs to us in the national HMO for the same services and goods.

I swear you have to be an Einstein to get the best deal for yourself......

Sluggy


 

9 comments:

  1. My sister just got a bill today from geisenger also(did I spell that right). Best part is they apparently treated my 1 year old niece for an enlarged scrotum. Yeah I can't wait til they explain that tomorrow. And what did she actually go for? They thought she broke her little ankle

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    1. Hey! Ankles, Scrotums.....I often confuse those two.....lolz

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  2. "I swear you have to be an Einstein to get the best deal for yourself"-And that about sums it up. We get insurance through Den's work but it is increasing at an alarming rate and the coverage is constantly being cut. And I have to say the company that he works for tries really hard to get the best deal for the employees. We are just paying for something that we can't use.

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    1. Same here....paying for health coverage 2 of our 3 kids can't use.

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  3. Brutal.. :( Thanking my lucky stars i'm Canadian.

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  4. Last time I went to the ER, I think my total outlay was $150. Not bad for all I had done!

    I am really happy with my insurance coverage, but then, I work for a government agency and since they pay us in kibble, at least my insurance is decent!

    Peace <3
    Jay

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  5. Wow..super confusing healthcare system..I'm with Carla on this one.

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  6. Have you taken levaquin or anything related? Read about the long-lasting pain and damage it can do to a body.

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  7. When I retire next June I will have to pick a health care package - mind if I run them by you?!! Honestly, it all sounds Greek to me! I couldn't stand what you have to go through - change doctors?? We're lucky to find 1 that takes new patients around here. We certainly wouldn't be allowed to change to a new doctor if we already had one, no matter how crappy they were. For new people to the area it can take months and years before they can find a doctor willing to take them on!!

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