How different our lives are when we really know what is deeply important to us, and keeping that picture in mind, we manage ourselves each day to be and to do what really matters most.--Stephen Covey

Monday, October 17, 2011

Bullied by the Health Insurance

Happy Monday!

Okay, it may not be the best day of the week, but I have always hated Wednesdays more than Mondays because by Wednesday I am always tired and just "done" with the week and want it to be Friday. It's the middle of the week... need I say more? I like Mondays (I can all see you now, "WHAT!?") because you are getting back into the grind of things, there is that "newness" of the week and the day feeling. It's almost like that feeling that you get for the first day of school. Okay, maybe I'm the only one that feels that way about Mondays. And I loved going back to school. But either way you feel about Monday, Happy Monday :)

This week is going to be hard. BUT, I'm starting it off with positivity because I know it's going to be difficult. This Friday my mom is having her second breast cancer surgery for her second diagnosis of breast cancer. She's having a full double mastectomy and is having spacers put in so that she can have falsies put in later. There is a good explanation here. I leave on Wednesday to go to be with her. It was 1)cheaper this way; and 2)I'll be able to spend some time with her before the surgery (ya know, because she's going to be so drugged up). I won't really get the chance to take care of her because I'm coming home the following Tuesday and she will probably be in the hospital for a couple days, but I'll be there for support. I wish that Jake was coming with me because I could use the support, but I also know that he'll be at home waiting for me will be extra supportive when I get home.

I'm currently in the process of scheduling my own surgery to have my little toxic thyroid nodule removed along with a tonsillectomy. Can I tell you that insurance companies = the devil?? And that they are bullies?? First off, let me back up a little and tell you about my mom's experience with them--for her to have her breast cancer surgery they are requiring her to pay her deductible ($700) along with her (I'm assuming) out-of-pocket expense ($2,000) before/at surgery. She never got to get in touch with the surgeon to see if they would do the surgery without her paying them upfront and arrange a payment plan because my uncle is going to help her out with the expenses, but here's the thing, my mom freaking has cancer. Stress does not help cancer. Let's go ahead and add on more stress by telling her that she may not be able to have a surgery because she has to pay ahead of time. I am telling you right now, the medical system in this country is ridiculous. ::shakes head:: My mom is a teacher in a very poor neighborhood and let's just face it, teachers in this country don't get paid enough as it is. She's paying off prior debt of raising 3 kids on nothing after her first diagnosis and going back to school and is paying off student debt that she accrued for going back to school so she wouldn't have to make minimum wage and struggle all the time. And she still struggles.

Anyway, it makes me mad that my mom had to freak out about that. That there was a possibility that she would not have been able to get this surgery (that could save her life) because of money. Ridiculous. My own story is just dealing with a pre-existing condition clause because I did not have health insurance the 12-months prior to being added to Jake's insurance. I haven't had steady health insurance since I was under 18. I've been a full-time student (undergrad and grad) and then it just wasn't in the budget to have private insurance, so I just went without. And luckily I never got sick. Or if I did, it was when I was in school and would go to the health clinic at school or Jake and I just sucked it up and I went to the doctor. But, here I am, fighting with the health insurance company every.step.of.the.way right now because they have to review every.single.doctors.visit. And I haven't been able to schedule my surgery because the scheduler at my ENT's office isn't sure about getting surgery when I have this pre-exisiting condition clause because I may have to pay for things. I told her that I would be willing to fight for everything and that I have never been seen or treated for anything associated with my thyroid. If the insurance company doesn't pay for something with my surgery--I will appeal it. I will fight. They are being bullies and that makes me so angry. I am waiting to hear from the scheduler today regarding it all as she was going to talk to the billing/insurance person and get some suggestions/advice on moving forward. Honestly, I just want to schedule the surgery and get it done and over with so I can work on feeling better and being healthy again.

It is all just so stressful. Which is why I am making the choice of today being a good day. I need to stay positive. I will get through this.

It is all in God's hands.


  1. I love Mondays TOO, for exactly the same reasons!

  2. Liz, I'm right there with you on the health insurance thing. I've paid them every month for almost 2 years and have a $500 deductible. So, why is it then that I have to pay Northside $1700+, the anesthesiologists $700, and the doctor $600+? And I haven't even received Blake's bill yet - grr! Hoping that you don't have to deal with all that crap! Even with insurance, you have to whip out soo much money. Maybe I should quit my job and get medicaid so I don't have to pay anything!? You and your mom will be in my prayers this week. Hope the insurance company figures it out - definitely get it approved before you do it. NOT worth having to pay for it out of pocket!

  3. I'm sorry Brooke!! I really feel like there is no point in having health insurance if you are still going to have to pay out of pocket for all this stuff... I mean, isn't the point of having medical insurance so that you don't have to pay for all these expensive medical procedures.

    I would get mine approved ahead of time but they said they won't do that because they'll review it after the claims are made... seriously!? Why should anyone have to go into debt to have a child or take care of their health???


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