4/16/2007

Never mind that feeling....

Man. Catching a break? Not in 2007 for me it seems. Received word that the way the King's health provider has to bill the broken arm...we are on the hook for over $500. For a freaking office visit.

You know...I used to drink the Kool-Aid of Consumerism in Healthcare. But here is how I see it now....

Because of my consumerism training (via Humana!), I took the King to a physician’s office rather than to the ER. Even waited two days to do so, as I had him evaluated by his pediatrician before I went to a specialist. The pediatrician advised that I wait two days, as she wasn’t clear as to whether or not their was a fracture. I paid my specialist’s copay to the Pediatric Ortho and felt good about being a good steward of my healthcare dollars by avoiding the ER.

During this same period of time...you know the story about the Cadet....so I won't rehash. In this case, since he was at military school, he was taken to the ER to start the process. That..I couldn’t avoid. Luckily…since it was an emergency, it is covered as “in-network benefit” and subject to the usual copays and deductibles. I kinda felt bad about having to use an ER..but with him so far away..I knew I had to bite the bullet.

Then the bills came in. (Which is where I learned about consumerism at its best!). For the Cadet, I am on the hook for $425 total for the ER. That is a $150 copay, and then deductible for all the remaining services (including casting, etc). For the King..I am on the hook for $525 + my specialist copay…because if you take a fracture to a Doctor’s office…it is billed as surgery (even if the doctor only look at the xray and said..yup..it is broken, we will cast it and no surgery is involved), and surgery is subject to deductible, co-insurance, and copays for the office visit. So…what did I learn? Skip the Doctor and head to the ER - which is the antithesis of what consumer-driven healthcare teaches you.

Sad but true. Sigh. The Health Insurance industry has a long way to go. (Oh..and did I mention that EVERYTHING the Cadet has had done up north including physical therapy, etc. is considered out of network short of the ER visit?? Ka-freaking-ching......oh well..I didn't need to eat this month anyhow).


So forget that feeling that something good was going to happen...it seems that Bad Karma 2007 is still hanging around. Sigh.

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