succumbing to peer pressure

Wednesday, January 02, 2008

Health Insurance

I realize it's far from novel to lament the state of healthcare and health insurance in this country, but holy crap! I am an intelligent, mathematically ept individual, who is fortunate enough to have really good insurance, and I still can't figure this shit out! The summary of my benefits states that as long as I stay 'in network' (easy enough to do, since I'm a student, with student insurance, who visits the student health center) anything beyond a healthy check-up costs $25 co-pay + 20% of the negotiated price. It's that negotiated word that's pesky. Now, I know I shouldn't complain, since in the end it's saving me money, but still, criminy, these bills are so full of gobbledygook it's absolutely no wonder that people pay incorrect amounts all the damn time!

Ok, so I've been working out this business with my hip*, so back in October I had a consult with a specialist that cost $190. Except that it didn't really cost $190, because even though that's the charge, the negotiated price includes a $57.47 'credit.' So subtract that off, then subtract off my $25 co-pay, then multiply by 20%, then add that to $25, and that's what I owe for that one visit. Except during that same visit I also had $236 worth of x-rays. Now, my deductible is $100, but for some random reason my x-rays are costing me $94.21 and my insurance company is picking up the rest. Again, I know I sound like an ass complaining that I've been saved $5.79, but it's just all so random that it can't possibly be a legitimate accounting of my bill. Don't even get me started on my physical therapy bill, where for one visit I was charged $38.63 and for the exact same visit two weeks later I was charged $43.80. It's the fact that they're just so clearly making shit up that drives me insane. And it's precisely the people making shit up, and sitting on the phone with people like me to confirm that the bill is even vaguely legitimate, who are eating up a huge, unnecessary chunk of our healthcare dollars in this country.

*speaking of my hip, I'll be having a giant needle inserted into it, along with some contrast dye, early tomorrow morning, so if you've got a second to spare, send me some pain-free thoughts, would ya?


Anonymous Anonymous said...

Don't even get me started. My otherwise decent student health plan doesn't cover non-emergency room illnesses between December 22 and Jan 2 because they are on vacation and can't pre-approve doctor's visits. And approval post-appointment would apparently kill them. Add one for Germany...

6:54 PM  
Anonymous Anonymous said...

Oh, and to make you smile: Neil Patrick Harris has found love (I hope the link works).

6:57 PM  

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