Monday, January 26, 2009

Dividedwefail FAIL

Insurance fail. Or maybe it's Kate fail.

I about had a cow yesterday when sorting through the week's mail, I found bills for my surgery in early Dec - totally $4200?! What could this be?! I already paid $1100 at the surgeon's office beforehand. That's a fuckload of money right there. I mean this procedure is COVERED by insurance? $1100 sounds reasonable... pricey but doable -- and for my avid readers you already saw my rant about that bill...

Oh how I wish it were *just* $1100. (This of course on top of the $300 or so I'd paid already toward deductible.) Who would think my earlier blog rant about that only covered a small amount of the 'holy shit I'm going to become a dividedwefail commercial.'

"I had a job. In fact I HAD insurance coverage -- but the medical bills kept coming in."

Well FUCK. And eff my company for year by year making our plan shittier and shittier - but not really cheaper... and ironically they were touting how 'great' it would be for 09 since 'benefits weren't changing.'

So shock, disbelief, tears characterized Sunday. Seething anger began Monday morning.

Kate -- "But I have a max out of pocket each yr of $3500 -- I already satisfied my $1000 deductible and my co-insurance is only 30%!! And I already paid $1500 to healthcare in 08 - WTF?! "

Radiologist - "Call Aetna."

Surgeon's office "Before you call anesthesiologist ($800 bill opened Sunday) or St Mary's ($3400 bill opened Sunday) -- CALL AETNA"

Kate -- "Ok." so I call Aetna...

Astoundingly this poor woman was able to make me understand WTH was going on. Oh and by the way - 1 night in St Mary's (NOT counting surgeon's bill) -- $33K - HOLY SHIT. And w Terrible Teri to boot?!

Well apparently due to some strange LIFO type insurance payment scheme - or perhaps just really delayed billing from the surgeon's office, their claim was paid out last. Which means I should be getting a full refund of the $1100. Unfortunately that's bc I'll be LEGITIMATELY having to pay $4200 which satisfies my deductible and co-insurance max out of pocket for 08.


The only concession is that St Mary's allows you to take 10% off if you pay within 30 days - so you BET I'm gonna be racking up the rewards points w Chase as I pay that off to the tune of saving me over $300. Hoping all still goes well, my bonus in March will go COMPLETELY to medical bills and some 'we just bought a fucking house 6 mos ago' expenditures.

To add insult to injury, my fill -- that took all of about 15minutes (w 2hrs wait time) -- guess how much that cost?!

I'll give you a minute...

A 'negotiated' price of $3307. Negotiated apparenlty meaning that some pay MORE.

Which means I'm now smack dab into 09 with another bill coming soon from St Mary's for $1700 -- satisfying my 09 deductible at $1000 and already going another $600 into my max out of pocket of $3500 in 09.

So the moral of the story is 'multi-fold'

1. Insurance STINKS. PERIOD. Even if their bookkeeping was totally accurate - about which I am floored. The cost of healthcare is outrageous.
2. Put whatever you can in FSA. Worst case you end up with hundreds of dollars to blow at Walgreens EOY.
3. When in doubt, call and make them itemize upcoming expenses -- I figured my bandfills couldn't be that much since they *used* to do them in their office for a $50 co-pay. How WRONG was I?! Wish I'd done this and coulda padded FSA way more.
4. We'll never afford to get married. Great... fucking great... we haven't even ever taken a vacation together. And it's not due to spendorama - first it was moving to RIC and building up some $, then my 2nd back procedure, then buying a house - and now medical bills. DAMMIT - how at 29 do I feel like I'm telling the story of a 50yr old?

And as if that's not bad enough - of course BEFORE all this shit of the last week... I got my tax forms for all my accts. That includes my 401K - of which I lost $30K. Which was 30% of my total acct -- the acct that I started 8 years ago. How bout them apples? Thank GOD I'm not retiring anytime soon.

Oh yah and last Thursday we announced a loss - first time ever.

At least I still have a job (SO FAR) and a house to live in.

And if we elope, I can get on Rob's (also Aetna - eeks!) health insurance... it's the Aetna plan I had years ago - when I never even GOT a bill for my 1st back surgery.


Megan Van Fleet said...

So sorry to hear about all of this--that is way beyond suck. I hope that at least everything gets sorted out soon and it's clear what you're paying/paying for!

Hope to talk to you soon!

aimee spevak said...

Oh Kate, that's so awful! It's one thing to go into it knowing how pricey it'll be, but having this hit you after the fact totally sucks.

Just remember, 1) they can't keep charging you FOREVER. it's gotta end somewhere, right? and 2) when it does, you'll know that everything you've paid is an investment in yourself. You have made a bold and brave step for yourself, and that is worth any amount of money. :)

(I know that may be cold comfort when you are dishing out the cash, but in the long run it will prove true!)

Kate McHugh said...

Megan - it's all valid charges - like there's no more 'sorting out' - other than getting my refund of the $1100 overpayment. IN fact Aetna just sent me a check w the FULL FSA 09 based on the St Mary's fill charges...

Kate McHugh said...

Aimee - thank you for the supportive reminder :) IN the back of my head I did always think to assume the worst - but I surely didn't anticipate having to get a refund for charges NOR could I have imagined the horrid timing so that I ruin TWO years of budget/savings. It esp kills me bc of all the planning I did take the time to do and yet that I could have done more at least in planning FSA 09 stuff... and it just adds insult to injury w the whole 'finally a year where I will put my bonus savings away to fund a wedding' - plus the economy and losing $30K is all just icing... I am having that drama queen moment where I'm just annoyed that everything isn't working out the 'way it's supposed to' and stuff that other folks take for granted/haven't had to struggle through, I am. It's all envy really - I know - but I feel like I need a pity party for a few days and then will get back to it. I'm not stoked taht I may have to ask for money in order to make my ROTH IRA contribution this year... bc that involves Daddy Dan...

Kate McHugh said...
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