I recently had to go through a round of physical therapy. A very specific kind of physical therapy that is not easy to come by...There's one person in my area who offers it. I needed it in order to be able to function on a daily basis. My physical therapist and I agreed that I would pay $25 up front at every session until we found out how much my health insurance would pay, then I would pay the difference later. After 8 sessions (and $200 later), I got the bill in the mail. My health insurance company paid a total of $144.63.
The remaining balance that I need to pay? $1383.90!
Here's the problem: If I would have paid out of pocket from the very beginning, it would have cost me $85 per session. That comes out to $680 total. With the amount I had already paid, I was expecting a bill that would be less than $480 - NOT $1383! With insurance, I'm being asked to pay $631.83 above and beyond what I would have paid out of pocket!
Considering the amount of money I have to pay every month for medications (one of them costs $240 for a one-month supply), doctor visits, lab tests, and the high insurance premiums so I could keep my doctors, a bill like this is a very big deal.
It's wrong.
I know that people have different opinions about health insurance, and I don't mean for this to be a controversial or political post by any means. But what happened to me is plain wrong. I'm trying to talk to the insurance company and the billing department to see what can be done, but this never should have happened in the first place. This is inexcusable. I feel like I'm being punished for having health insurance and taking care of myself. I'm not frivolously opting for treatments I don't need. I'm just trying to live.
The Lupus Foundation of America reports, "The average annual direct and indirect costs incurred by a person with lupus can exceed $21,000...A higher average annual cost of illness per person than those living with rheumatoid arthritis, heart disease, diabetes, hypertension or asthma." The burden of lupus goes beyond the physical struggles. The financial cost of having lupus is high. It is a heavy load, overwhelming at times. And bills that are significantly higher than what they should be just add to the weight.
Something needs to be done.
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Update: Since publishing this post and after months of phone calls and prayers, the billing office informed me that they discussed my situation with my physical therapist and decided to change my remaining balance to reflect what I would have owed if I paid out of pocket: $480! My opinions about health insurance still remain the same and I still think there is a problem that needs to be addressed. But I am thankful that my healthcare providers really do care. I am also thankful that there are people in billing offices that are willing to listen and go the extra mile. (Thank you, Sarah, for having my back even though you don't even know me!)
So what's the moral of the story? God answers prayer. Caring people exist in surprising places. And you don't have to be a victim when your health insurance company doesn't play fairly.
To learn more about lupus, check out the KNOW LUPUS Card Game. Every time you complete a level, $1 will be donated to lupus research!
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