Monthly Archives: September 2013
Warning: the incident described herein happened before implementation of the Affordable Care Act and the author has absolutely no idea if it will help others in similar circumstances. She hopes so but highly doubts it.
Contrary to what their names imply, health care providers do not exist to give health care and health insurance companies do not exist to offer health insurance.
They exist primarily to make the rest of us crazy, with the added benefit of giving the people who work in those industries something to laugh at.
How do I know? I’m one of the rest of us.
I’m at the age when doing the things I used to be able to do – like exercise – is unwise. That’s because I foolishly believe my doctor’s advice that exercise is better for me than sitting on a couch drinking beer and eating doughnuts, which – unlike exercise – has never sent me to the hospital for x-rays and physical therapy.
Which is why I’m now crazy.
Because I ended up with a bill. And learned that physical therapists charge more than K Street lawyers.
I opened it up and learned they charge $519 for a 30 minute session which basically involved insulting my knees, telling me I’m an out-of-shape weakling, and snickering while watching me walk.
They then told me to go home. And come back in two weeks.
Foolishly believing that, because I had health insurance, the charges for therapy would be reasonable, I completed two more sessions.
All three sessions involved the same process. They asked me how I felt. The snickered as they tested my strength. They asked me to demonstrate the assigned exercises. They gave me new ones. They sent me home.
Then I got the first bill.
Keep in mind that no one, no one, could tell me how much my therapy would cost, I just had to promise I would pay, no matter how much it was. That may be why they think they can charge anything they like. And do, including $519 for some guy who’s not even a doctor to tell me my knees point in the wrong direction.
Of course, that’s not what I have to pay. I only have to pay the contracted rate of $368.49. For just one visit. The insurance company doesn’t pay any of it. That’s because we pay thousands of dollars for a top-rated policy.
Under a top-rated policy, after paying thousands of dollars in premiums every year, we get to pay thousands of dollars in out-of-pocket expenses every year until we satisfy the patient obligation. Then, if we suffer a catastrophic illness on December 31st, the insurance company pays all the bills. Until January 1st. When the patient obligation starts all over again.
Of course, I happen to think that $519 (or even $368.49) is a ridiculous amount to charge someone just to ridicule them. Especially when the treatment doesn’t improve things. Which may be intentional. After all, this insures a continued revenue stream.
I, of course, called the health care provider to complain. A staffer, after telling me they can’t tell people what the therapy will cost before giving the therapy, said the manager would call me back to discuss my concerns. I foolishly believed this.
After never hearing from the manager (who may not actually exist), I called my insurance company (foolishly thinking I could find a less expensive option) because their “Explanation of Benefits” or “EOB” (commonly called Form #Abandon Hope All Ye Who Enter Here) says to “call us to estimate treatment costs or to compare cost and quality of in-network health care professionals and facilities.”
The staffer immediately told me they didn’t know the prices and I’d have to call the health care provider to find out.
This is why I’m now crazy. Or would be but I don’t know if I can afford it because nobody will tell me what it would cost.