Wednesday, November 18, 2009

Health Care Reform?

My health insurance pays for 4 doctor's visits a year, with a $20 co-pay for each. After those 4 visits, I'm supposed to pay the whole cost (until I meet my deductible, which will never happen).

In February, I had a routine physical. In April, I had a lady-parts annual exam. In June I went to a dermatologist for a mole-check (also routine for someone with fair skin and a family history of skin cancer). And in October I had my annual eye exam.

My calculations are that since I don't need a physical every year, I should have one "free" doctor's visit each year, in case I get sick, except the years when I get a physical. Also, if I space them out strategically (like going for an annual exam every 15 months), I might be able to work in physical without sacrificing my "free" appointment.

By the way, I had an issue with my eye exam. I went to my eye doctor in CA, the one who knows me and asks about my life and treats my parents and is listed in one of the many optometrist listings on my insurance website. But when I got there her assistant said they don't take my insurance, and so I have to pay up front and send in the claim to be reimbursed. I called my insurance company, whose representative said I was using the wrong online listing, and I probably wouldn't be reimbursed, but that it would be subject to my deductible. So I sent the claim in, along with a letter explaining the situation, and how miffed I was. I also sent the whole packet to my state and federal representatives, just so they know how dumb health insurance is. (I don't by any means think this is the worst the insurance company could do. One of my greatest fears is that I will get cancer and my health insurance will drop my coverage. And I said so in the letter.) By the time I got back to CT, there was a check waiting for me. Surprise! My insurance company had reimbursed me all but the $20 co-pay. I also got a letter from Lieberman about how dedicated he is to health care reform, but not the public option. Douchebag.

Anyway, that's not the point. This is the point: After my October eye exam, I had to go until February without needing to see the doctor, but then I got sick. I went to the doctor, paid my $20 co-pay got my prescription, and got better. I expected to get a bill from the doctor saying my insurance wouldn't pay the rest of the bill (since it was my 5th visit in a year).

Instead, I got a check for $20 from a different doctor. WTF? They say I overpaid. They didn't say who or when, or for what, just, "Here's $20." Whatever. I'm not asking questions. I'm just cashing the check.

No comments:

Post a Comment