Okay, that said, I recently read a comment on a good friend's Facebook page that really set me off. The friend was legitimately venting about an uncovered service on her insurance policy, and I had complete sympathy for her (I understood the rationale behind the exclusion, though I disagree with it). However, another friend of hers made a comment on said thread to the effect that all health insurance sucks and it is completely worthless and a huge racket. To which, I pretty much lost it, and left a very snarky and sarcastic reply comment for which I am still not the least bit sorry. Granted, I was still really sick with bronchitis at the time, and overstressed from work, and the show, and wedding planning and I recognize that I wasn't in the most forgiving frame of mind. Still, I'm not at all sorry about saying what I did.
It just really gets me how little people understand what insurance is supposed to be. I do, however, understand why they seem to think that a health insurance policy needs to cover every possible test, service and treatment with up front first-dollar coverage -- this is what our state and federal governments have forced the industry into doing. But seriously, no one expects their car insurance policy to cover every oil change and maintenance service for free. So why do we all expect that up front with our health insurance policy? I really don't get it.
The other thing people really don't seem to get is how much work insurance companies work to get really amazing discounts from doctors, drug companies, and medical equipment/device providers. Seriously, it is huge. In fact, they will often do it for providers that aren't even in their network. Just so that their members don't have to shell out huge sums of dough. Does that sound like something an evil, greedy, money-grubbing corporation only concerned with profit and lining the pockets of their CEO would do?
[Fact: Last year when Brian had his sinus surgery done by an out-of-network provider, his insurance company did, in fact, negotiate discounts and got the total surgery cost down to less than half of billed charges.]
In going over my statements of benefits for my diagnosis and treatment of Sleep Apnea, I was once again reminded of how much my insurance does not suck, and how grateful I am to have it. Even though having to do so has caused me to reach my rather large medical deductible. That too is a good thing, as any other services I get this year (including the recent Urgent Care visit) will now be covered at 80% by my insurance, in addition to the aforementioned discounts. Silver lining, I suppose, to being unpleasantly sick for far too large a portion of this year?
A few non-hypothetical examples of how my insurance has made this a much less financially painful experience for me:
- Initial visit and consultation with Sleep Specialist: Billed $370, Discount $134.25 -- I paid $235.75
- Follow up visits with Sleep Specialist: Billed $165, Discount $63.64 -- I paid $101.36 (each)
- At-Home Sleep Study: Billed $600, Discount $283.94 -- I paid $316.06
- CPAP machine: Billed $2,052, Discount $1,599.57, portion paid by insurance after meeting deductible $157.59 -- I pay $294.84
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