Monday, December 8, 2008

I’ll balance bill you

I’ve been neglecting my blog because in my spare time, I’ve been busy talking to two different insurance brokers, two insurance companies, and pestering three doctors and their secretaries. I’ve been trying to decipher the difference between HMO’s, PPO’s and POS’s, in-network vs out of network, and my favorite—balance billing. Stuff that many patients deal with at some point, although, I’ve not had to, until now when I want to go out-of-network using my POS. Basically my insurance company is poised as a gatekeeper, and THEY will decide if I want to go out of network. This makes me want to say that they are a bit (ok a lot) evil, but I haven’t heard the final outcome, so I’m being Zen about the whole thing.

I have a good ability to get to the bottom of things, but this is taking a toll on me. I consider myself a fairly intelligent person, but the loop holes and bureaucracy have left me deflated. On top of this, I have a deadline—Dec 15th. Because if my insurance doesn’t approve out-of-network care, I will need to buy a plan through my husband’s business by the 15th. This will involve switching my husband’s and in-law’s insurance (oh lord, help me) because they all get coverage through his business. I currently get my insurance through my employer (paid 100% by them). So, if I did go over with my husband, I would be forfeiting a huge benefit and then paying out of pocket for my share.

I’m hopeful, because the things that have worked out for me seem to do so at the very last minute. I’m also being peaceful because I’ve seen some pretty impossible stuff fall into place.

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