Two tales of health insurance

Y’all, the flu SUCKS. It is the fucking worst. I’ve had it for three miserable days and I am tired of feeling awful and tired of staying in bed (also apologies if none of this makes sense. I’m not functioning very well lately). I went to work for an hour today before someone yelled at me and told me to go home, so back to bed it was. I’m also tired of, in my ample spare time laying in bed, trying not to worry about whether or not I’ll be good to get on a plane by Monday night. Remember that trip I mentioned in the last post? Yeah, I’m supposed to be spending next week in the Azores with my mom and sister, and I’m really hoping I’m better in time for that. But I’m also trying not to think (worry) about it.

On the bright side, though, I’m super glad I have my new Vitamix. Because right now I’m subsisting on smoothies and soup and tea. I’ve developed a nasty cough over the last 24 hours to go along with my horribly sore throat, so I’ve had two smoothies just today. I’m also really glad for the incredibly-on-sale dry soup mixes Mom has given me over the years since I’m slowly working my way through those. I’ll have to restock when I get better because now I know: if you’re gonna be out of commission for 4+ (please let me be so much better by Friday. Even tomorrow! But please by Friday) days, dried soup mixes are your friend.

So I’ve been idly and very slowly thinking as I’m laying in bed, avoiding paying $30 to go to urgent care just for the doctor to tell me what I already know (I guess I could also get a doctor’s note while I’m there because there’s something about needing one if you’re out for three or more days. Whatever, HR, the people who saw me today know I’m really fucking sick. I’m not burning through all my sick leave for the hell of it!). I should probably go tomorrow just to make sure I don’t also have a sinus infection and/or strep. Which is another of those super nasty things I’m particularly susceptible to, much like flu strains that weren’t covered by my flu shot last winter, ahem. Anyway, I’ve been thinking maybe I’d do a post on two health insurance-related things that have happened to me lately since, y’know, it seems timely.

A $140 lesson in adulting

The first thing that happened to me a few weeks ago is that I went to a specialist. And then I went back two months later for a follow-up appointment because that’s how these things work. I already mentioned in my intro post that I have excellent health insurance and at the moment am not paying anything for it, so I can’t really complain. But. While I was at the desk checking in and paying my $30 specialist copay, they informed me that actually I owed $140 from my last visit. I’d already paid $30 so they needed my credit card again to put the remaining $110 on it. I was already standing there so couldn’t really be like “no, what the fuck. I’m not paying this until I know I have to,” so I reluctantly paid it. There were tears in my eyes, I’m not even going to lie about that. $110 is a lot of money especially to have sprung on you out of the middle of nowhere.

The guy took me over to one of their accounting people who pulled up my profile and said according to the paperwork they’d gotten the claim back and that was the amount my insurance company had declined to pay. I, all full of righteous indignation, decided as soon as I got home I was going to call the insurance company and ask what was up because what the hell.

There, ahem, might have been tears during that phone call. I also had a million questions because I didn’t understand. Why did you refuse to pay that amount of money? Because I hadn’t yet hit my deductible so the insurance hadn’t started covering everything in full. That was the amount of money I owed for the visit according to some mysterious math formula that figures out how much someone pays when they haven’t hit their deductible yet (I made up the part about the mysterious math formula, by the way). Okay, well I’m $100 from hitting my deductible (I’ve had a LOT of doctors visits lately). So I pay $100 and then the $40 and all other future visits are now covered by my insurance in full? No. It’s already been counted toward my deductible and that would be double-counting it. I should’ve gotten an explanation of benefits in my portal after that visit that explains that I owe $140. No, the customer service rep could not explain why this was sprung on me by surprise. That was the doctor’s fault for not telling me I owed them money.

I hung up and started thinking about it some more (in between a few last tears). The thing is I had seen the $140 pop up and get counted towards my $1500 deductible even if it barely registered at the time. But silly me for thinking that somehow meant I didn’t have to pay it. I’m also blaming the doctor for this one and not telling me until I came back for my next appointment. Who decides they’re just gonna be owed money for two months instead of sending a bill? Not me, that’s for sure.

In summary, health insurance is confusing. Even when you think you’ve got it figured out, you probably don’t. Also surprise $140 bills are a SURE way to ruin your day, and that was a surprise expense right at the end of last month (so thankfully that’s not showing up on this month’s expense breakdown). Adulting is fun, yay!

LARCs and a better health insurance experience

The second thing is I guess gonna get political. But actually, fuck that noise because this shouldn’t be political. My having control over my body and my reproductive health is in no way, shape, or form actually a political issue. It’s just me saying that I don’t want and certainly can’t afford to have a kid at this moment in time, which by the way, is the responsible thing to do. I can’t afford a kid so I’m not going to have one until I can. I also don’t want to have children until I’m in a stable marriage that can handle the demands of kids, and frankly that ain’t happening anytime soon at the current rate. So I’ve given myself permission to not even start thinking about having kids until I’m 30, and in order to achieve that, yes, I’ve turned to the wonder that is birth control.

Up until a few months ago I’d happily taken the pill every day with the help of a “be responsible” alarm on my phone, and this situation worked for me. But I was increasingly worried that my access to a steady, uninterrupted supply of the birth control pill was going to be threatened at some point in the not-too-distant future, so I started looking up IUD options and other Long-Acting Reversible Contraceptives (LARCs). At this point my health insurance will still cover the full cost of a LARC (our fiscal year ends in a few months and I don’t know what our health insurance will look like in the new year. HR has hinted that our current company has been getting too expensive lately plus there’s the ever-present ??? status of the ACA) and hopefully the American healthcare system will be less of a clusterfuck in a few years when it’s time for a new LARC. Perhaps this is just wishful thinking, but a girl can dream.

Anyway, I’m a wimp, so I opted for a plastic implant in my arm instead of an IUD and having a doctor shove a plastic thing up into my uterus. No, thank you. I’ll spare you the details but suffice it to say, getting the damn thing put into my arm and the following week of healing was not fun. I spent a week at barre not using my arms a single bit but at least getting a killer lower-body workout in the process. I spared you the details, but here, have some fun/gruesome pictures:

Right after my pressure bandage came off 24 hours later.
One week later. Look at all that disgusting bruising!










About a week later I logged into my portal on my health insurance website to check on how I was doing towards my deductible and saw the following:

Jesus Christ, that was almost $1700 that I didn’t have to pay for. Thank you, employer-sponsored good health insurance! I suppose if it turns out I do live in a fantasy world and I do have to pay for my next LARC, I’ve got three years to save up for it. Better get started now…

Anyway, this post has been brought to you by flu delirium. I’m gonna do some more of that laying in bed thing and hoping I get so much better super quickly.

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