Insurance Woes

When you are planning for major surgery your mind tends to race a mile a minute.  Can I get the time off work?  Will we be able to pay all of our bills while I’m out of work?  Who is going to clean the house?  Who is going to cook?  Who is going to watch Charlie and who will feed the dogs?  Did I remember to fill all of my prescriptions?  All of these thoughts can turn a girl into a big ball of stress.  When you add the extra stress of dealing with insurance companies, hospitals and doctor’s offices, then that big ball of stress turns into big giant asteroid of stress about to crash into my world.

Let me start off by counting my blessings.  I am thankful that I have a job and I am thankful that I have insurance provided through that job, even though I am shelling out $400 per month for a premium and still have to meet a $2,500 deductible and $4,000 out of pocket max before anything is covered at 100%.  My company provides us with an HSA account and deposits half of our deductible into it for us.  This year, they switched from depositing all of the money on January 1^st to splitting it out into four payments throughout the year.  So instead of having half of my deductible at the time of my surgery I will only have $312.

I decided to be proactive and call the hospital in November to see if they are willing to set up a payment plan for me.  The woman, Nellie, was very helpful but informed me that her boss cannot make any decision until after the first of the year.  Being the OCD girl that I am and needing to have everything planned out before my surgery, I started to think of different ways to have my deductible covered.  I asked my benefits manager at work if there is any way for them to disburse all of my HSA funds in January.  I’ve worked for the company for over 5 years, so hopefully they would work with me.  I was told they would not do that. 

Next, I called my insurance company.  All preventative services are supposed to be covered at 100%.  My BRCAnalysis test was covered 100% and so was my mammogram.  Since my BRCAnalysis came back positive and I am having preventative surgery, you would think that it would be covered 100% as preventative.  Right?  Wrong.  Not only did the girl in customer service tell me it wasn’t covered as preventative (but will be covered after I reach my deductible) she pretty much told me “Well, this is your choice to have it done.  If we covered it 100% then anybody would have this surgery done.”  I then went on my tangent about how having a BRCA mutation means I have an 87% chance of getting breast cancer and how she should be more informed before making such rude comments.  I hung up on her.  Then I felt bad for hanging up.  So I called back and talked to another woman who was much kinder and understanding.

Today, I decided to call the hospital again to see if there has been any progress made on whether or not they will work out a payment plan with me or not.  Hey, it’s January 2^nd, surely they’ve been working on this since the strike of midnight on January 1^st!  Nellie told me that she was about to call me and has been working on my case since this morning, but she isn’t sure if her boss is going to approve a payment plan or not.  She will call me back later this week.  I’m four weeks away from surgery date and I want to know now!

I need to have options.  I e-mailed my benefits manager at work and told her that the hospital wants the deductible up front and if there is any way for them to escalate my request to have my HSA funds disbursed this month I would greatly appreciate it.

I must be patient.  If it is meant to be, it will be.  Sometimes I need to just learn to put things in God’s hands and pray that everything will turn out the way it is supposed to.  And breathe.  Just breathe.