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health insurance woes  
dooce's recent mamba with health insurance reminded me that i've never written about one of my biggest passions in life - hating health insurance. i didn't have to hate health insurance until i moved to NC in 1999 when i got a job with the state and was covered under the state employee's health plan run by blue cross blue shield (BCBS) of NC. they claim it costs $273 a month to cover an employee. to add a spouse and child would cost something like $450 a month. it's the worst health coverage in the world. no dental, no vision, high yearly deductibles and what they ultimate cover is next to nothing. whenever i went to the doctor for a well check-up, inevitably, about a month later i'd get a slew of bills from the doc's office and from lab corp (if there was blood drawn) for stuff the insurance wouldn't cover or would only cover very little. the whole "reasonable and customary charges" ploy or whatever they call it. whatever it means when some guy without a medical degree sits in an office and decides how much a pap smear should cost. i once got a freaky looking mole removed and because it wasn't "routine" and apparently, blue cross and blue shield would rather i wait until it morphed into skin cancer and i had to have my shoulder removed, since they only paid like $30 of the $250 bill. thankfully i timed ella's birth just right so i met my detuctible for the year and while that was good, craig and i still paid about $2500 out of the $6000 it costs to have a baby. the state plan didn't include dental so for about 17 bucks a month you could get a dental plan that basically covered only cleanings every six months. i got slammed one time with huge bills after having a silver filling removed and replace with a white filling. apparently, depending on the tooth, it's considered cosmetic to have the white filling and i've should've called ahead with the TOOTH NUMBER to find out if they'd cover the cost. just before i left the state plan, the dental plan instituted a new $50 yearly deductible so basically i was paying $254 for two cleanings that cost $102 a piece. you're smart girls and boys. you can do that math.

craig's company is rather small and although they have a great health insurance plan for their employees that includes dental and vision and craig never has to pay extra for any visits, if he wanted to add ella and i, it would cost $600 a month. it's true. now, granted, if we went out and got the same coverage independantly, it would cost that same amount but back in the day you only had to pay like 50 bucks to cover your family through your company - at least that's how it was for my family and that's how it is for my dad now (he works for a pharmaceutical company so they HAVE to have decent insurance). as it stands, we pay $148 a month for me and $130 for ella with individual policies through BCBS. the policy for ella is pretty good as for children they cover everything. she goes to the doctor for shots every two months and a visit could easily cost $300 but everything is paid for. now, in my case, i have a very high detuctible because otherwise, my premium would be $250 plus a month so a recent visit to the gyno for a check-up is going to result in a slew of bills not paid by BCBS. i got my cholesterol done and the bill from lab corp was $82 and BCBS only paid 8 bucks. EIGHT bucks. because apparently BCBS knows some voodoo lady downtown that will swing a chicken over your head for 8 bucks and tell you if your cholesterol is high or low (mine's low - shouldn't i be rewarded for that?). funnily enough, my premium was $130 last month but went up to $148 with the new year because, according to the person i talked to on the phone, "the rising costs of healthcare". you bastard, you ARE the rising costs of health care. basically, my policy means that if i get hit by a car or get diagnosed with some sort of horrible disease, i can meet my deductible of $5000 and everything else will get paid for.

so, who do i complain to? if i get pissed and cancel my policy, it doesn't help anything. should doctor's lower their costs? i don't know. i thought it was pretty reasonable what my ob charged to DELIVER A HUMAN FROM MY LOINS. for chrissake's, am i supposed to shop around for whatever dirty knifed surgeon has set up shop in back of wal-mart to get a mole removed? i've been lucky because i'm fairly healthy and have really great doctors. ones that suggest alternate therapy besides medication or ones that have nurses that will take a phone call without me having to go in for an office visit. i can't imagine being really really sick with crappy insurance. i guess we all can move to canada or france or get jobs at health insurance companies...

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post #504
bio: lisa may
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1/11/2006
10:15

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