Thursday, September 23, 2021

Insurance. Bah...humbug.

Okay, the more I have to deal with the mess of the medical system down here, the angrier I become. The claim from my nutrition course at the hospital (which, for the record, I did virtually with 6 other people)* just came through. In order to even sign up for the class I had to give the registration lady my credit card information over the phone. And even though I had verified that my insurance covered the class 100% this lady insisted that wasn't true.

It would be the case if I had already met my deductible (which by some miracle I haven't) and my out-of-pocket maximum (haven't hit that yet, either, though I trust by the end of the year we will). However, since I haven't met either of those two requirements I was responsible to cover the cost of the class. 


Which, fine. 

I mean, it wasn't great timing to have to pay that fee because tuition had been due right around the same time (technically, my tuition has been waived as part of my compensation for working, but I was still responsible for paying fees, which are $$$), but we're solvent enough right now that while swallowing $420 for a stupid nutrition class wasn't fun, it didn't break the bank, either. 

But, as it turns insurance paid for that class in full

So, as I mentioned, the hospital has put my $420 into their "credit" account for me, which is really fine because I know we'll end up paying them much more than that amount, anyway. According to my hospital's estimated price index, we could be facing bills like the following:





LABOR HOURS $739.00 to $3,945.00

Naturally, these are just estimates and don't include what we've already paid our doctor. That's fine. Insurance will kick in 100% after we, you know, put down a couple grand. It's fine. And we're lucky to have insurance. I get that. 

But, like, here's the thing...
What if paying that $420 up front had been a financial burden to us? Then what? Because the lady on the phone wasn't going to listen to any sob story, let me tell you that. I don't really know what would have happened if I had refused to pay for the class but I imagine not taking the class would have raised all sorts of issues with my insurance company (since they require the class) and with my doctor (who seems really nice, but, like, in the past I've had doctors flat-out tell me that if I, as a mother with a history of preterm labor, refuse their advice to take progesterone (which was just a very expensive fad, turns out) that they would refuse to treat me and I could just walk right back out the door). 

But, really, what if I could not have paid? Would they not allow me to take the class even though my insurance was planning on covering the cost (and they could have verified that fact if they had actually taken the time to do so...which I don't think they did...). 

So, anyway. It's fine. We paid for the class that we didn't have to pay for, which we'll just consider a deposit for our hospital bill. And we pay a monthly insurance premium. And we pay everything out of pocket until a certain dollar amount (in the hundreds). And then we pay 20% thereafter until we hit an even higher dollar amount (in the thousands). And then our insurance should cover everything...that they deem necessary...and which has been pre-approved...but we might be required to pay for things upfront before our insurance is billed...just for kicks and giggles.

I've been working to do my hospital pre-registration and doing legwork to get my impending delivery pre-approved (so much paperwork) and I's a bit of a joke. 

Then my brother says, "Yeah, we could have paid $150 to have a private room, but we've had this shared room all to ourselves the whole time, so I'm glad we didn't do that! But other than that [paying nothing] we've paid $15 in parking fees..." it kind of makes my blood boil. 

(According to Investopedia, "U.S. federal income tax brackets range from 10% to 37% for individuals. In Canada, the range is 15% to 33%. In the U.S., the lowest tax bracket for the tax year ending 2019 is 10% for an individual earning $9,700 and jumps to 22% for those earning $39,476. The corresponding bottom Canadian bracket stays at 15% until $47,630," so don't hit me with the "but the taxes" argument. The taxes are comparable; the benefits of taxation are not (which is one reason I suspect American don't like taxes in the first place)).

So, wish me luck as I try to get my new breast pump through my insurance (to be fair, my brother had to pay for that out of pocket while my insurance covers the cost at 100%) because I left my beloved breast pump behind when we an idiot...because we weren't going to have any more babies.

I have obtained (read: quickly scribbled down while they rattled the information off over the phone, since the information isn't available online) a list of acceptable vendors from my insurance, as well as a list of acceptable models. But the insurance company can't be sure what models the vendors may carry or whether they'll service my zip code. So I get to call them all to see if the stars align. 

Because that's fun! 

And exactly how I want to spend my time!

I mean, it's not like I pay hundreds of dollars a month for my insurance company to actually do stuff (I've had several people explain this to me before: we pay the insurance company not to do stuff. Ideally you don't use insurance at all,'s just a backup plan should your body happen to fail you. And I'm are always having issues, so...are you sure you guys have thought this whole "health insurance" thing through?!).

Anyway, wish me luck...

* That's $2520 in fees the hospital collected for a single (1) nurse to spend three hours going over a very boring powerpoint presentation with us. Nice.

1 comment:

  1. How much did Nancy get paid for the hours spent making sure the providers and insurance company play nice and jumping through all the artificial hoops? And how much are my providers paying how many people to play nice with how many insurance companies? It's enough to give me high blood pressure! Oh wait, that's another office visit...