GeoffM

It was the authorization department that gave three different prices. None of which actually matched what the policy document stated (I only discovered that recently).

Speedwell

Nothing personal, but they routinely check for child abuse. I had a friend whose son got in quite a pitched battle with another boy at school, including a nice obvious black eye. She tried cleaning him up a bit before she brought him in to be checked out, and some idiot evidently thought she was trying to cover for something. Until they checked with the school, they were eyeing her with a certain amount of obvious suspicion.

Yorkieabroad

The Childrens Counsellor turned out to be a lady who followed the doctor around translating the doctor speak into language a 4 year old would understand. My 11 year old pretty soon got sick of it, and very politely told her "Its OK - I know what the doctors talking about"! Good boy - there's an extra grand or so for your college fund

We also came across a new form of anaesthetic yesterday - he was told he would be on a morphine drip, would have 4 or 5 local injections but they would start with "digital anaesthetic". I'd never heard of that, but thought busted hand - "digital" - must be something to do with fingers. But no, we found that having been fired as the childrens counselor, the same lady was reincarnated as a "digital anaesthetist". In another age she may have been called a book stand. Basically, she stood there with an ipad and held it at the correct angle so he could play Minecraft with his left hand while they worked on his right hand! Silly though it sounds, I have to admit it worked pretty well in distracting him from what else was going on - he didn't even realize when they put the IV line in, or any of the injections, or any of the subsequent work. He was totally engrossed in his game. I do wonder what the bill for that little role will be though....

Speedwell

Hilarious, good for your son! I suppose the iPad was the "digital anesthesia". Priceless.

Jerseygirl

Hope it wasn't anything too nasty. Good luck little Yorkie.

Yorkieabroad

Sorry for dragging this OT.

Getting back on topic (or at least close to), my insurance experience yesterday:

1) At our renewal we took out an accidental injury rider - additional $50 a month to pay the first 1000 of any ER visits, no max number of visits per year). Given our very high deductible (now 11900!!!!!!!!!!!!!!!!!!), and looking at our last 5 years history, this would have paid for itself in 4 of the 5 years, so we took it. That was in March, and I've called 4 times to ask where the written confirmaiton was - they've taken the payments, but no paperwork was forthcoming. Yesterday when I called Humana before I took the chap to ER, they denied we had that coverage. Over an hour on the phone, and they finally agreed that we did indeed have the coverage.

2) At the ER check in - "are you in Network with Humana?"...."Oh yeah sugar, we're good with everyone" How reassuring.

3) We only saw 2 doctors, 1 nurse and the "Childrens counselor/digital anaesthetist". One doctor confirmed they were In Network. One doctor didn't know, so suggested checking at the front desk, ditto for the nurse, and the Childrens Counsellor looked confused and asked if I'd like a coloring book. So I checked with the same lady at the front desk - "I told you honey, we're all good with Humana here, just chill and look after your baby". Err, Okay....

4) As I left, I asked if they could give me an idea of the bill - no, that'll go to my insurance company in 7-10 business days. Presumably it takes that long to count how many tissues and rubber gloves they used, not to mention whether my son blew their download limit on Minecraft....

I'm guessing we blew through our deductible yesterday, so now we've got to get all our "bad health" stuff in in the next 6 months to get our VFM before the decuctible resets. I'm thinking a heart attack next month will give me enough recovery time to go skiing and break a few legs at Thanksgiving, and I'm going to kick it all off with a visit to a little "hole in the wall" Indian tomorrow and see if we can get a family discount on food poisoning

lansbury

Bet you've paid for the iPad

Yorkieabroad

iPads all round more like.....

penguinbar

My insurance used to cover orthotics but it no longer does. One of my customers is an office manager for a podiatrist. She said most insurance companies will not cover orthotics anymore.

sir_eccles

As everyone is an expert on this stuff and I am currently reviewing my insurance perhaps I can get some input.

Currently:

Group plan through BCBSIL (BluePrint PPO)
Me+spouse+sprog (1yr old)
Premium $1075 pm (actually $1597 but the company chips in)
$1500 deductible
100/80 coinsurance
$0 max out of pocket
(in network numbers)

Ok, it's good coverage but pricey. So I'm wondering what the local BCBSAZ offers (my office is headquartered in IL before you ask).

Individual plan through BCBSAZ (Blue Optimum Plus)
Me+spouse+sprog (1 yr old)
Premium $790 pm (preferred rate so may go up when we actually apply)
$1000 deductible
80/20 coinsurance
$2500 max out of pocket
(in network numbers)

I could opt for a $3000 deductible and only pay $541 a month.

I think office copays are a little more $30 instead of $20 and Rx start at $15/40 not $10/20 woohoo. What else am I missing apart from the extra cash I might have in my pocket each month?

Giantaxe

Never get an individual policy if you have a group plan available. You're just too vulnerable with the former to pre-existing condition exclusions, policy increases and getting dumped altogether if you get sick. Things ought to change once the ACA comes into force, but I certainly wouldn't jump to an individual policy until the dust is settled.

sir_eccles

That's a good point, but on the assumption that the group plan might not be available and I had to change policy. What are your thoughts?

Bob

80/20 is a bit rough....if it were just you, probably doable, but with a sprog, they're prone to fall over, get a fever, all kinds of illnesses when hanging out with other people.

scrubbedexpat099

http://www.denverpost.com/breakingne...ce=rsshomemiss

An interesting article comparing actual rates with chargemaster rates.

I had not heard this term before, seems appropriate.