The Procrastination ended on July 11th.
Call #1: Freedom Life Insurance….my health insurance people.
I knew that I could somehow upgrade my insurance if I needed to, like if something terrible happened. It took about 10 minutes on hold but this is what I found out:
It depends on the surgery. I didn’t say specifically what surgery I was getting to this customer service person because I wanted the options. Her question was how much it is going to cost. I didn’t know.
Option 1: Upgrade to next tier of coverage. $750/ month covers like $5k in outpatient surgery after $5k deductible.
Option 2: Premier Med: Covers 100% of outpatient surgery (minus anesthesia, but maybe some? Unclear here) and brings monthly premium to about $1300/ a month and can only be used for 6 months.
Obviously, option 2 is what I wanted but that’s almost as much as my rent. And where in my budget could I come up with an additional $900 a month? So I needed to find out what the hospital could do for me.
Call #2: Northwestern Financial Counseling
The first step was to give all my insurance info to them and they would call me back with what was covered and what wasn’t. They were super nice. Sounds great. United Healthcare Premier Choice. Take a look.
Call #3: Northwestern calls back.
My coverage is zero. Zilch. Nada. Not covered.
Fuck.
So what happens now, I ask. I am to be transferred to a self-pay representative. Have to leave a message.
Call #4: Northwestern Self-Pay:
This is the guy who tells you how much stuff costs.
My surgery costs $57,725
Because I don’t have coverage, I get a discount: $40,402
AND BECAUSE I HAVE INSURANCE BUT NOT THE GOOD INSURANCE, THEY NEED THE FULL AMOUNT 2 DAYS BEFORE THE SURGERY.
I ask if he’s joking.
He is not.
I ask him if there is a payment plan.
There is not.
I ask if I didn’t have any insurance what would happen then?
Not his area of expertise and since that isn’t the case not worth exploring.
I’m crying at this point. I’m shocked. As I keep telling everyone, anything over $500 is monopoly money to me. I can’t afford it. I am bowled over by how much it costs for sure, but 40k and 57k are essentially the same amount to me. Completely unattainable.
I ask him what I’m supposed to do.
He says, “Call your doctor’s office? I don’t know. See if they can code the procedure differently?” His lack of affect and disinterest felt like someone had smashed the heel of their hand into my solar plexus.
Call #5: Mollie. my Thithy
Scream and cry at my sister
Call #6-8: You Know Who You Are
Scream and cry at my friends
Call #9: Dr. Hansen’s (Breast Surgeon) Office
Call and ask for Felicia, the nurse who walked me through the steps in the office.
Left a message.
Call #10: Felicia, Nurse
She is horrified at everything I tell her. And surprised. And has no power to do anything and doesn’t control the coding. Suggests I call Insurance Navigation office.
Call #11-12: Insurance Navigation Office
Only tells you if Northwestern accepts your insurance. Transfers me to Financial Counseling. Where I have been before to talk about whether I’m covered or not. Transferred back to self-pay. This call takes 57 minutes, I have to tell my story 4 times, and we get disconnected once. Zero help.
Call #13: Insurance Broker Eric
I decided to forgive him for trying to sell me life insurance. I explain the situation with all the numbers. He tells me that upgrading the insurance to Premier Med can be done only for the time it’s needed so I don’t have to do all 6 months and then we can get a regular major medical plan during open enrollment in November for Jan 1, 2023. Even with the $3k deductible and some incidentals not covered and the $2600 for let’s call it two months of coverage, it is probably the way to go.
Call #14 My Health Insurance Upgrade Team
Hi, I’m getting surgery and need the big insurance you all offer. How do I do that?
When is your surgery?
August 22nd.
Oh, just call us next month and we can set it up.
Are you sure?
Yeah, I can’t even it book it that far out. Just call back in the middle of August.
Um. Sounds suss but ok.
Call #15: Mollie, my Thithy.
My sister and I concoct a plan where I borrow some money to pay for the upgraded insurance. (See the blog about how I hate asking for help out soon.)
It took 2 days and many tears and this still seems unfinished. Now it’s coming up on the middle of August so the next chapter will be about upgrading so stay tuned!!
Alternate title: How many ways is healthcare, this country, and the people in it, really f*ing broken. (It's about the same as the number of licks I would surmise.)
This makes me so so angry