floatingleaf | the Dark Lord of United States healthcare system defeats me :(

So, wanna hear something funny? I got my new glasses so that I wouldn't lose the money in my Flexible Spending Account, right? Well, it turns out that the eye exam itself might cost me much more than what I paid for the glasses. I just assumed I had nothing to worry about, because my employer offers a good vision plan that covers pretty much everything. Which is perfectly true. Except I didn't pick my optometrist through our vision plan. I picked him through the regular medical plan, which is run by a whole another insurance company. It just never occurred to me that they are not one and the same. I mean, I did know that at some point, I just completely forgot about it. I have never used the vision plan before. So when I went to see the optometrist, I just automatically showed them my regular medical insurance card. And when I opened my work email yesterday, there was a message from the insurance company letting me know that the 'amount billed' for the service was - and make sure to swallow before you read on, in case you're eating or drinking something - $1,375, and that it was all categorized as 'patient responsibility'. I kid you not. ONE THOUSAND THREE HUNDRED SEVENTY FIVE. FOR A SINGLE DOCTOR'S VISIT. After staring at it, blinking stupidly, for about 15 minutes, I called the doctor's office to make sure I wasn't hallucinating. They told me promptly to ignore anything that comes from the insurance company, because it's not what they are going to bill me - it's what the insurance company is going to bill THEM. This just momentarily stunned me into silence, because I felt like a complete moron, not having the slightest idea what was going on. First of all, WHY would the insurance company bill the doctor's office? Isn't it supposed to be the other way round?... And, second of all, regardless of who's paying whom - HOW CAN A SINGLE EYE EXAM POSSIBLY COST THAT MUCH??? I still don't know the answer to that, despite having spent a sizeable chunk of an hour on the phone with the insurance company last night. All I do know is that my medical plan does NOT cover any vision-related expenses at all, and that the optometrist I saw is NOT in the vision plan network. I can still contact the vision plan company and ask them if they could cover at least part of my bill when I get it - or I can tell the doctor's office to bill them directly and see what happens. I don't know at this point how much they will actually bill me - I am assuming it's not going to be the entire amount mentioned above, since they told me to ignore it, but it still could be a few hundred... and there is no telling how much the vision plan company might be willing to cover (since the doctor is not in their network). I do have $700 in my Health Savings Account, though, so hopefully whatever I have to pay out of my own pocket will not exceed that. Still... the whole thing nearly gave me a heart attack, and I can't believe it never crossed my mind that I was choosing the doctor through the wrong network. *sigh* The United States healthcare system is a mind-boggling, scary monster to me, and I'm sure I will never figure it out. Nowhere else in the world is it nearly as complicated. And in order to fully appreciate the irony of the situation, please bear in mind that the ONLY reason I came up with the idea to get the new glasses in the first place was because I had misunderstood my medical plan and ended up with some benefit money that couldn't be used for anything else. Had I been aware at the beginning of last year that my Flexible Spending Account would only be good for either dental or vision, I wouldn't have opened one at all, because I had just fixed my teeth in 2007, and my old pair of glasses is still in pretty good shape. And this whole shitty situation would never have happened. And yes, I do try to carefully read all the information pertaining to any benefits I sign up for - it's just that you can't possibly remember it all at any given time, and I've had so much other stuff occupying my mind throughout 2008, I just somehow let this one slip through. With possibly disastrous results. Again, appreciate the irony: having to pay a few hundred bucks for something I didn't actually need is the LAST thing I should be doing in my current financial situation. So it figures this is exactly what would happen to me. Just to punish me for overlooking the small print somewhere along the way.:/ This is the kind of stuff that makes me feel I can't deal with real life sometimes. That there are some powerful dark forces out there to get me, and the only measure of peace I can have is my little fantasy world, where evil things like bureaucracy, finances or other mundane concerns simply do not exist. It is very tempting to get lost in that little world for long periods of time... at least until RL steps in again and whacks me over the head with gusto. But each time that happens, I just want to crawl deeper into my secret hiding place. Even though I know I will be dragged out of there kicking and screaming sooner or later... *sigh*

Flat | Top-Level Comments Only

Oh, dear. This is so mind-boggling to me that I can hardly wrap my mind around it. Such a huge sum just for a simple eye-examination? That is plain and simple robbery, regardless of whom is paying it. And I wonder, too, that in such a situation, when they have patients who may be forced to pay it on their own, they do not tell them of the costs in advance. Down here, the treatments that are not covered by insurance have to be chosen in an extra form by a patient, and each has a price attached. But I still have resolved to look for another doctor, since the women doctor I currently have is much more eager at selling those extra services not covered by insurance, than at doing the normal ones that are covered.

Still, it is mind boggling that two different insurance companies are covering different medical plans run by the same employer, and can leave you in such a situation. And the cost of that eye exam is - I have no words.

I hope the best for you, and that you will have to pay only a part. *HUGS*

Edited 2009-01-04 12:13 (UTC)

in such a situation, when they have patients who may be forced to pay it on their own, they do not tell them of the costs in advance

That's the part where the predatory nature of the American healthcare system becomes most apparent. Healthcare institutions here are just as capitalist as the biggest industrial corporations. They operate for profit. They don't care where the money comes from - whether it's from a patient's pocket or from an insurance company - as long as they get it. And if they always gave proper warning about the price of the service, they wouldn't be making half as much money, would they? :/

it is mind boggling that two different insurance companies are covering different medical plans run by the same employer

Actually, we have three different insurance companies covering our health benefits. Dental plan is also run by a separate company. But I was always well aware of that, because I've had plenty of dental treatments before. It's just that I've never been to an eye doctor since I moved to this country, and I simply forgot that this was a whole another thing as well. *sigh*

i believe you completely that you do read things carefully; it just really IS that miserable to try to wade through all of this miserable detail. you must have been sick to your stomach when you opened that bill. GAH. if you're not in the mood for this, i apologize, and i certainly don't want to minimize your distress... but sometimes it helps me to remember that it's 'only' money. it's fixable. it's not your health, it's not a death in your family. you can and will get past this. but again, you know that i don't want to brush it off for you - - it sucks! *hugs hard*

you must have been sick to your stomach when you opened that bill

Yeah. Well, it wasn't exactly a bill - it was an online statement of sorts, and since the doctor's office said not to worry about it, I'm hoping they're not planning on billing me anywhere close to that amount. Still... just trying to figure out how they could possibly come up with this much gives me a headache.

it's 'only' money. it's fixable

I know. I'm just really annoyed at myself when I think that the whole mess could have been easily avoided. It's almost as if I didn't have enough problems already and went out looking for more.:/

I am so sorry to hear about this. :(
*hugs* I am crossing my fingers that the other bill is smaller, and that your "real" vision plan insurance company will pay some of the bill.

Not a very good way to start a new year, is it? Especially if you've been planning to reduce your expenses.:(

I'm not sure I even want to wear my new glasses after this. *sigh*

ARGH! Our health care system is confusing to almost everyone, myself included. One must pay careful attention to each and every detail, or else. *soothes you*

What optometrist charges that much for an examination? That is insane! I pay out of pocket for my vision care since K's company doesn't carry coverage. My OD has been my provider for close to 20 years and he's good but expensive. That said, I've never received a bill that high, ever, not even including new glasses or contacts. Simply outrageous, my friend. I hope you fight those charges. Seriously. Good luck!

Good god! $1,375!! I would have had a coronary attack! Yes, our healthcare system is a maze of bureaucracy set to confuse and red tape the average American.

All those little loopholes...pick a doctor through this provider and not that one...thats how they ensnare you. Sometimes I think the whole thing is a joke...but then again, your lucky enough to have health insurance.

Im sorry you got swindled into thinking everything was okay...you know if you have an HR Department they may be able to assist you with healthcare questions.

Oh, I also looked up Good and it doesnt seem to be playing in Chicago area :(

*hugs you*
^V^

Well, I'm waiting for them to send me an actual bill before I try to figure out what to do next. Hopefully it won't be anywhere close to the abovementioned amount. *crosses fingers*

I also looked up Good and it doesnt seem to be playing in Chicago area :(

Yeah, I've been checking too, and it doesn't come up. Looks like we have to wait for the DVD. *pouts*

the Dark Lord of United States healthcare system defeats me :(

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