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A couple of months ago, I had what seemed like the bad burrito from hell.  Okay, it was really a taco (I don’t eat wheat) and I actually made it myself.  But you know what I mean.  We’ve all been there.  You feel the gurgling and suddenly have the overwhelming need to set up camp in the bathroom until the storm passes.

Except the storm kept getting worse and worse.  At one point, I was lying on the tiny bathroom floor, fetal position, in a literal puddle of sweat.  Not pretty, I know, but hey, reality isn’t always pretty either.  Keep in mind that I have had two 9-pound babies without any pain meds.  My threshold is high, but this was more painful than childbirth.  At one point, I’m not sure if I fell asleep from exhaustion or passed out.

So, being a moron, I waited it out until morning.  I called Mom to see if I was just being a wuss, and was told in no uncertain terms to get my butt to the hospital – now.  I don’t care how old you are, you don’t argue with your mom when she tells you to seek emergency services.  So I went.

Let me say now that, if you live in the metropolitan Las Vegas area, you should go to one of the St Rose emergency rooms.  I have yet to hear anything bad about their chain of hospitals ever, and this was no exception.  Wait time was maybe 5 minutes, certainly not long enough for me to even finish the paperwork.  The staff was intelligent and friendly, which mirrors a prior visit when my son flipped his bike and stopped the fall with his face.  Great hospitals.  They fixed me up, didn’t give me any flack about not eating wheat, let me go home 4 hours later and now I feel great.

But now, 2 months later, I get my insurance company’s Explanation of Benefits.  It’s the paper your insurance company sends out to remind you to be grateful and keep making your payments.  It says right on there on the top, “THIS IS NOT A BILL” in big capital letters.  I guess that avoids some of the angry calls, but probably not all of them.  I’m sure many people are too distracted by the big number down at the bottom, which in my case was…

$14,148.00

Wow.

Don’t get me wrong – I’m not saying that’s too high or unreasonable or whatever.  Frankly, I’m not so sure I wouldn’t have died or at least been a pretty serious internal wreck if they hadn’t helped me out.  How much is your life worth?  But what bugs me is the column just to the right of “Amount Billed”.  It’s labeled “Amount Allowed” and it’s the part of the bill my insurance company says it’s willing to pay.  Add those numbers up and it only comes to $2,574.00.  And the hospital basically says “Close enough!”

The problem I have is that I would need to pay more than $14k and my insurance company only has to pay 18% of that.  I would be willing to bet they have significantly more in their bank account than I do, but even that’s not the point.  Shouldn’t the price be the same no matter who is paying?  I mean, it just seems wrong that I pay insurance premiums for years, rarely using my benefits, and then if I can’t afford insurance anymore, I would have to pay more than the insurance company does.  And don’t get me wrong – insurance is expensive if you can’t get it through your employer.

So I guess the lessons of the day are

1)Stay healthy

2)Pay your insurance premiums

3)Listen to your mom

4)Life isn’t fair

It’s #4 that I always have trouble accepting, and I really don’t see that changing any time soon.

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2 thoughts on “Well, Well

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