Dec 28, 2010

Medical Insurance and a Real Mommy Moment

This has nothing to do with crafts, or recipes or venting about Walmart-just a Real Mommy Moment from my life.
Three days before Christmas I received a medical bill from the Doctors office for $488.00.  That's right $488.00 after taking my little pumpkin in for her 1 year well baby visit.  Before this I don't think I ever paid a cent for a well baby visit except the office co-pay.  The word shocked does not describe how I felt; dumbfounded is maybe a better word to use.  My heart instantly sank realizing that $488.00 was not something that we could come up with.  I looked over the bill-my insurance had covered the visit to the office, one immunization and the basic "look in her ears, eyes, nose and measure her" stuff.  The other immunizations that she received were not covered, nor was the administration of said immunizations.  WHAT IN THE WORLD!!!! I called the insurance company.  I had already done that you see-before I even took her in for the appointment.  I called to ask if the well baby visit was covered.  I was told it was-I was wondering if the new health care law would cover the visit but the lady told me that the health care law didn't matter in my case because I had insurance and this insurance covered all of the visit.  So when I called this time wondering what on earth was going on I was told that my insurance does cover all of the well baby visit but not all of the immunizations.  So let me get this straight- as part of the well baby visit I am to get my baby immunized (well I choose to) and I am told by the nurse what immunizations my baby is to receive.  Doesn't that sound like part of a well baby visit??? Part of  a well baby visit that is "100 % covered by my insurance?"  So I said, "my health care rep. said that our insurance is to cover all of a well baby visit and that 100% of immunizations are covered up to age 19."  She said, "yes we do cover all immunizations up to age 19 but we don't cover all of them."  HUH???? Does that make sense to any one else?  So pretty much the lady I talked to the first time should have informed me that yes my insurance does cover all of a well baby visit and 100% of immunizations but it will not cover all immunizations.  But she did not-hence my $488.00 lesson in how to make sure you ask every question possible in case the lovely person you are talking to fails to truly inform you about your health insurance.  I called my doctors office and asked about the bill.  I was told there that actually what happened in the office was that the nurse who does the shots checks to see what insurance the patient has and then makes sure that she does not give a $200.00 shot to someone who is not covered.  In my case she did look to see what insurance I had but their computer still showed my former insurance (one that covered these kinds of things) and so she proceeded to administer the shots when had she known they weren't covered she wouldn't have and would have sent me to the health department where I could have got them for like $15.00.  So the office claimed a great deal of the responsibility.  I said, in sobbing tears, that had I known the shots were not covered I would have never had them done there and I explained that I was under the impression that my insurance did cover everything.  The billing department lady was extremely sympathetic as I said, "now I have a $500.00 Doctors bill and no way to pay for it."  In the end, the Doctor-bless him, said that the clinic would eat the costs and that I was only responsible for administration of the immunizations-$186.00 as opposed to $500.00.  It is still more than I would ever choose to pay for a routine visit to the Doctor but it is a blessing to my little family.  So here's the thing-as a parent you always tell yourself that you would do anything for your kid-you want them to be healthy and strong and there is no limit to what you would pay to make sure they always stay that way.  And then you hit a financial road block and you are counting every penny and suddenly you find yourself thinking, "should I take her to the Doctor and pay the $35.00 co-pay just to see the doctor let alone what ever else she might need, or can we wait it out and see if she gets better on her own?" I hate it-I hate having to question whether or not I should get my children the medical help that they need, but we simply cannot afford to take them to the doctor every time they are sick.  How do I know though if she is going to get better on her own-I don't-I just pray she will.  And then there are the times when you feel guilty with this miserable little girl coughing and hacking and decide you had better take her in and what are you told-"there is nothing we can do-you will just have to wait for her to get over it-oh and by the way don't forget to pay your $35.00 for my totally useless advice."  I don't know-just saying that I hate it.  I wish we had endless money so that I never had to worry and I could afford the best Doctors whenever I desired.  I wish I had some magical power that made me able to tell exactly what is wrong with my kids every time.  I wish I had some way to make a $488.00 bill disappear.  It's one expensive life lesson.
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  1. I won't even get started on insurance companies! I am so sorry this happened to you! Just awful but I definitely will be more aware!

  2. Glad I live in Canada. I may not have a family doctor but I would hate to be face will bills like these. (Love you Blog)

  3. I went through the same thing a couple of years ago with Kylie and her shots. Mine was a little different, as I knew I had a set amount that would cover well care child visits. I just didn't know that the cost of the shots were going to take me over that amount. Needless to say that is why I take my kids to the Health Department for all their shots and even well care check up now. The costs are a lot more reasonable and I get the same information. We still go to the regular doctor for sickness issues, just not well care stuff. Sorry this happened. I know that it is the pits and insurance companies never seem to give you the same story when you call them.

  4. That is horrible! I'm glad the Medical Center helped you out a bit, kinda. Wow.

  5. I think you need to take the next step and complain to some sort of government agency that the insurance company misinformed you. And complain, in writing, to the insurance company. Nobody should have to go through what you did. And make sure the doctor's office knows what insurance you have. My experience is that they ask every single time any of us visits them what insurance we have, so they should shoulder some blame for not checking on that. But, do remember to inform the doctor every time your insurance changes.


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