The (Im)Practical Side of Disease

I think I have pretty good health insurance.  I don’t know.  Changes under the ACA several years ago allowed our agency to be eligible for federal health care insurance plans even though technically I’m not a federal employee. Of course every year there are changes to the plan but overall, it seems like most have been beneficial. For example, I never had to pay much for prescriptions but now for many, I don’t pay anything. My doctor visit copays range between $30 – $40 depending on the specialty.

But all these different tests I’ve had to undergo this year was a real eye-opener, not only to the cost but to all the different deductibles within my plan. And to be honest, to this day, I haven’t looked at all that stuff closely. It’s too overwhelming. But thyroid ultrasounds, kidney ultrasounds, biopsies, echocardiograms, heart monitors… yeah, it all adds up. And after I would pay the bills from the hospital, I would often get a bill from the provider for the amount my insurance didn’t cover.

And those EPO shots… I have to pay $111.00 for every EPO shot I get.  And I was getting them every two weeks for quite a while. And most likely, I’ll need them for the rest of my life, although probably not as often. It was such a nice break when I would go six weeks without needing a shot!  So much money saved!

I kept waiting to get the statement from the last shot I got right before I left for Pittsburgh but it never came. I wasn’t concerned; it’s not like they would just forget about it. Then a few days ago I logged into my insurance website and found that I had (finally) met my deductible… I’ve paid out over $6000.00 so far this year. So I’m assuming no more copays for shots. GREAT!!

Shortly after that, I got a notification on my phone that I had a new statement from my insurance. I figured it was the $40 copay from the video visit I had with Dr. A a couple weeks ago. For whatever reason, they didn’t require I pay it at the time of the appointment.

I opened the notification on my phone.

You can imagine my surprise:
“You have a new statement. 
Your balance: $3527.46.
If you can’t pay this all at once, sign up to pay $587.91 per month.”

No joke… I just started laughing. I mean what else can you do.

Many years ago, I took a budgeting class which dramatically changed how I handle money. I’ve faithfully stuck by it since that day, rarely straying off course. It has served me well. Once all this medical stuff hit, I moved money around to start putting more each month in to my “healthcare fund.”  Smart thinkin’.  I’m also incredibly fortunate to have a good job and make a decent salary for the relatively low cost of living in New Mexico. So while this was a big shocker, I can afford to pay it. I’m probably NOT going to pay it all at once, and I’m probably not going to even pay the $500+ every month—I mean, I will still continue to have more medical expenses. It’s not like it all just stops.

For the moment, I’m not doing anything about it. I’m going to wait until I get the statement in the mail so I can see exactly what the heck it’s all for. Yes, I could get it off the internet but I’ll just wait. They’re going to mail it to me anyway. Then I’ll have to give them a call and see if this is all really accurate. During the prior approval process, the case manager in PA said that I shouldn’t have any outstanding costs, but of course, she doesn’t work for the insurance company. So we’ll see what they say.

But I can only imagine the stress of getting a bill like this and NOT having the means to cover it.  I know many people in this situation. Instead of just worrying about their health, they have the added burden of wondering how they are going to pay to stay alive.  They have to delay tests until they can afford them.  They have outrageous copays for their medications—to the point where they ration them because they have no other option.  And of course this just leads to further health complications, and it starts over again.  It’s nothing new. We all know the stories.

It’s all so broken.


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