Friday, October 16, 2009

Explanation of Benefits

Let me just start by saying that I will look at EOB (the form the insurance company sends to say what they were billed by your doctor and what they paid, and also, what you might still owe) to see if/what we owe after insurance does its thing.

Usually, it's just a tiny bit (the co-pay) that is still owed.

But I look, to make sure, and sometimes, I am intrigued by what was billed vs. what was paid (and that my provider accepts as full-payment and "will not bill" me for the balance). It's a percentage (usually around 50). Is that what I would be expected to pay if I didn't have great (through the Other Half's employer) insurance? Holy cannoli!

For the first three weeks of radiation treatment, the bill was over $21,000! And there are 4 weeks left to be billed.

Who can afford to get sick?

You know where this is going, don't you?

Others are debating it far more competently than I can, so I won't, but good grief! I will just say that, though some of us ::coff::me::coff:: consider basic health care a right, not everyone does.

Did I mention that the bill is only for 3 weeks of just radiation? No surgery, no doctor visits, no mammograms, no biopsy, no MRI, no CT, no second surgery, no placement or removal of catheter (nor the cost of the device). Did I mention that it's just for the first 3 weeks?

Holy crap!

Coming tomorrow: knitting content, perhaps.

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// posted by Ann @ 10/16/2009 04:07:00 PM
Comments:
Some day I'll tell you what I pay for my Blue Shield insurance. We are self employed, no help of any kind.
No wonder so many people don't have insurance. This subject makes me froth at the mouth.
# posted by Blogger Kathy F : 4:34 PM
 
I get those statements, too, for my lowly chiropractic care; nothing as high in cost as yours, but I've had the same reaction when I see what they "allow" (pay" vs what he charges.

I'm not sure how the guy stays in business, myself!

And I know I could never afford it on my own, but my insurance isn't "great" like yours, so I'd be bankrupt just paying my portion of the costs for your treatment. And folks wonder why there's a push for socialized medicine.
# posted by Anonymous Beth in MN : 5:51 PM
 
My emergency appendectomy and one week in the hospital was $25,000 six or seven years ago. My portion = $200. I hate my job but I love the benefits. Hope the rest of your treatments pass uneventfully.
# posted by Blogger bittenbyknittin : 6:33 PM
 
Eep. Terrifying. And still the fighting about health care. I don't understand.
# posted by Anonymous Anonymous : 6:54 PM
 
there are 2 things that i feel need to be dealt with specifically with healthcare: pre-existing conditions, and young adult insurance.

3 of my 4 children have pre-existing conditions. my oldest has health insurance, but it doesn't pay anything on what she needs treatment for the most, because it's a pre-existing condition.

also, the thought of my youngest going off our insurance is terrifying. he has asperger's, and his medication alone would bankrupt us without insurance. his medication costs more than i bring home in amonth even with insurance, the copay on his meds is $160 a month. he's 15, and i feel like we're rushing headlong into adulthood, and aplace where i can't protect him a ny more, and most entry-level jobs have horrific insurance (my eldest works for McDonalds, hence the horrible insurance). having him be able to stay on our insurance until he can get insurance that will REALLY take care of him would alleviate a lot of those worries (and no, idon't know if he'd qualify for medicare/SSI. don't want to if we don't have to)

the really crappy part? he was on hubbie's insurance until july 1, and we STILL don't know how much we owe on his therapy bill. sometimes it feels like bad insurance is almost worse than none. (i went back to work, and my job lets you get on the insurance on the 1st day of the following month of your employment, which meant i started on may 26, and had insurance on june 1)

i'll shut up now, lol.
# posted by Blogger dragon knitter : 11:37 PM
 
Hearing this it certainly good that here in the UK we don't pay
Prayers for your treatment
Hugs Janice
# posted by Blogger Searchfamilies : 12:17 AM
 
Hello Ann;
I just came across your blog as I was surfing thru some knitting blogs. As I was reading I says to myself this sounds familiar - so back tracking to your August posts. Yup definately sounds familiar right down to the diagnosis - me too! That was way back in 1990, I too had lumpectomy with radiation. Did have a reoccurance in 1996 so went ahead with mastectomy & Tamoxifen. It's been clean sailing since then. My oncologist told me if you're going to have breast cancer the type we have is the one to have. Hang in there - if I can beat it so can you.
Jane in Canada
# posted by Anonymous Anonymous : 4:30 PM
 
the whole subject of the health care system in this country just makes me see RED! I've been dealing with surgeries and basically no insurance all summer long. Just wish that our congress critters would GET it.
# posted by Blogger Bev : 10:22 AM
 
I know many people are afraid of the idea of socialized medicine, but for my biopsy, surgery (including hospital stay) and radiation treatments, I did not pay one penny. I thank God every time I think of it that if I had to get sick, I live here and not in the U.S. anymore. Less than a month after my diagnosis, I underwent surgery, and I received excellent care every step of the way.
# posted by Blogger AmyS : 12:13 PM
 
For the Naysayers to public health in the US, please turn the congressman's head to Australia. We currently have bad waiting lists & this is causing a political headache (more of wasted govt money than anything else), however, overall, medical procedures are available for all. Plus, we have health insurance to help pay the difference in costs.
BTW - our economy is doing fine, thanks very much. :-D
# posted by Anonymous NannaPeter : 1:23 AM
 
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