Deductible | You Just have to Laugh….

I’m back…..and boy do I have a story for you!

I try so hard to let you all know the important things going on in caregiving both legally and practically. It’s so difficult for us to stay abreast of all this crazy, complex information. And yet, I too, fall prey to the insidious actions of those who would undermine all of us.

I did the one thing, the one thing I tell all of you not to do. Okay, I didn’t actually do it, but I sat side-by-side with my husband and watched him do the ONE THING I TELL ALL OF YOU NOT TO DO.

Here’s the tale:

My husband was having a routine colonoscopy. He hates that I share personal information, but in this case, it’s critical that you know exactly that. For your protection, he’s allowing me to reveal he has routine medical care. Yes, he’s that great.

The day before the procedure, my husband gets a call from the hospital. They tell him that they have called our insurance and he will have to pay a $1,190 co-pay. Yes, that is One Thousand One hundred Ninety Dollars.

This seemed really odd to me. Routine care is always covered. But I will admit that even with relatively good health insurance, we have been paying larger and larger sums every year for co-pays, deductibles, and God-forbid, out-of-network costs.

Since the hospital said they checked with our insurance and this would be our co-pay, we took the checkbook to the hospital.

Now, I bitched about this to anyone who would listen.

“Can you believe this? Almost $1200 for a CO-PAY for a ROUTINE COLONOSCOPY? No wonder people get cancer! No wonder they won’t get routine tests! That’s a mortgage payment for lots of people! That’s a car payment! Hell, that’s a mortgage payment AND a car payment for most people!

I was hopping mad. We are fortunate that we could pay, but it’s not without a big “OUCH.” I also know that there are many, many people who absolutely cannot afford $1200 out of nowhere for a ROUTINE PREVENTATIVE MEDICAL PROCEDURE. Yes, I’m yelling. Yes, I’m using exclamation points. I was pissed.

When we got to the hospital, the clerk asked how much did we want to put down on our colonoscopy. Like it was a car, a house, or some nice furniture. Because they were not taking him back there for those great drugs until we made some kind of a downpayment. For God’s sake. We just don’t want cancer….which clearly we probably wouldn’t be able to pay for either.

But I sat there, speechless, as my husband wrote a check for $1,190.

And then I got the EOB. That ‘s the Explanation of Benefits. I read every one, just to make sure our medical bills were processed and to see how much of a bill I can expect.

Guess what? The EOB for my husband’s colonoscopy showed that it was a routine procedure and we did not owe anything. Not because we owed a co-pay or a deductible that we paid in advance…but because WE DIDN’T OWE ANYTHING.

Yep. We called the hospital and the billing department said: “Oh, that’s just an estimate that they give you, they don’t really know what you will owe. We will return all your money. But you need to wait at least two weeks.”

My husband is the calm one in this house. Thank God, because they would only discuss this with him. If I had a crowbar, a siren, or a hammer that phone call would have gone so very differently.