Insurance is a Scam! – Blogging Away Debt

by Ashley

The title of this submit is a bit tongue-and-cheek. I need to begin proper off the bat by saying that we’re lucky to have fairly good medical insurance (a PPO) and a wholesome HSA to assist pay our out-of-pocket medical prices. That has not at all times been the case.

Background as a  Broke School Scholar

I keep in mind solely having catastrophic protection as a graduate scholar (no prescription protection). There was one time I obtained sick and once I went to select up the prescription my physician had prescribed, it price greater than I can afford. At this level, I can’t recall particulars (e.g., don’t know the sickness or prescription). What I’ll always remember, although, was standing within the foyer of Walgreens near-tears as a result of I couldn’t afford the medication to assist me get higher. I requested the pharmacist if I may fulfill a partial-prescription (the reply was “no.”). My pleasure wouldn’t let me name my mother to ask for assist (which she actually would have given). As an alternative, I left empty-handed.

Modifications in Protection

I’ve come a great distance from that broke faculty child. However how far, actually? After I known as just lately to schedule an annual well-woman verify with my OBGYN, I used to be knowledgeable that my OBGYN is not coated by my insurance coverage. I’d both must 1) pay out of pocket for the price of being seen AND the price of the routine pap-smear check, lab outcomes, and many others. or 2) discover a new OBGYN. What did I do? Possibility 3 – I’ve not scheduled an appointment. I do know even typing this how reckless that’s. However I LOVE my OBGYN. I don’t need one other! However I additionally don’t need to pay out-of-pocket. So I’m caught in limbo-land. Discover a new supplier? Or possibly wait till open enrollment and discover a new insurance coverage (however then what if my different docs are not coated?). I’m so aggravated with the insurance coverage firm – and sure, I’ve written to allow them to learn about my disappointment.

Being pregnant Protection

It takes me again, once more, to my broke grad scholar insurance coverage days. Perhaps I’m scarred from these experiences.

I had my twins once I was a graduate scholar on that crappy grad scholar insurance coverage. After I first sought care, I used to be planning on doing the all-natural route and, subsequently, I used to be seeing a midwife group.  I used to be 20-weeks pregnant once I found – WOW! – I used to be truly pregnant with twins. I used to be thrust into the “excessive threat being pregnant” class and not certified for the midwife group. I began seeing a health care provider who had been really useful by my midwife. The issue is I HATED the physician. A lot. He made me cry nearly each appointment. He was so harsh and impersonal and harped on all of the dangers and I used to be a first-time pregnant lady, residing removed from household and scared mindless. Why didn’t I swap suppliers? With my crappy insurance coverage, I used to be solely allowed to vary suppliers as soon as through the being pregnant. I had formally modified from the midwife group to the “imply” OBGYN and so I used to be caught. I used to be not allowed to vary once more. Your complete being pregnant from that time was actually powerful. And the beginning expertise was traumatic. I gained’t go into particulars, however I absolutely maintain resentment to the insurance coverage firm for “trapping” me in that state of affairs.

Trapped once more!?

I had an analogous “trapped” expertise just lately. Or, somewhat, my husband did. Final weekend, my husband ended up within the ER for belly ache – we had been nervous it was gallstones, as he’s had an assault earlier than. He was handled and launched with a ache prescription and directions to follow-up together with his PCP. Sadly, lots of our pharmacies have decreased hours over the previous 12 months or so. At this level, the closest 24-hour pharmacy, a CVS, is an efficient 30+ minutes away (in comparison with our most popular pharmacy, Walgreens, which is possibly a 5 minute drive away). My husband was launched in the midst of the evening, so the ER physician known as his ‘script into the closest 24-hour pharmacy, somewhat than our most popular pharmacy. We didn’t go to select it up that evening, as my husband simply needed to go dwelling and sleep.

The subsequent morning, I known as to substantiate that the prescription was prepared for pick-up. To my shock, I used to be instructed that the CVS pharmacy doesn’t take our insurance coverage and, subsequently, had not crammed the prescription. They really useful calling the hospital and having the prescription despatched to our close by Walgreens. I known as the hospital, however as a result of one of many prescriptions was for a narcotic, they may not switch it to a distinct pharmacy and the prescribing physician was not on-duty. I known as CVS again once more. “Appears like we’re going to must pay out of pocket for the prescription, however can y’all switch it to a CVS nearer to our home so we don’t must drive clear throughout city to select it up?” Nope. As a result of one of many prescriptions is a narcotic, there aren’t any transfers, even inside one other CVS retailer. We had been caught. At an out-of-network pharmacy, means throughout city.

So guess what. We drove all the way in which throughout city and paid out of pocket for the prescription.

What’s the purpose?

Right here’s the place I get right into a little bit of hyperbole due to course medical insurance is vital and had we paid out-of-pocket for all my husband’s scans and exams within the hospital, it could have been hundreds (or tens of hundreds????) of {dollars}. So I’m grateful for the protection.

However in the event you’ll indulge my petulance for a minute…what the heck is the purpose in paying for insurance coverage once they gained’t cowl our physician of selection, our pharmacy of selection, our prescription remedy, and many others?

I do know with 100% certainty I’ve used CVS prior to now. When was it dropped from our insurance coverage protection? And within the case of my OBGYN, why would the insurance coverage firm not inform clients that they’re dropping the supplier throughout open enrollment interval once I’d even have the chance to vary my well being plan?

It’s extremely irritating to pay massive bucks to a medical insurance firm that feels prefer it’s simply taking our cash and reducing corners, refusing to cowl care and prescriptions left and proper! And so I return to the title of this submit…..insurance coverage is a rip-off! I stated it.

I’ve been a loyal Blue Cross Blue Defend buyer since I obtained my first full-time job in 2015. However this prescription fiasco on high of the OBGYN downside is the straw that broke the camel’s again. When open enrollment comes round, I’m formally going to look into different suppliers.

Anybody have an organization you like that you just’d advocate?

It’s such a bummer as a result of I’ve a lot of specialists (urologist, nephrologist), so if I make a change to my medical insurance, I’ve to ensure my most popular docs are nonetheless coated. I don’t want a referral with my present medical insurance, and I need to be certain that it stays that means. Do all U.S. corporations simply sort of suck now? Is that simply what it’s? Do I’ve to discover a new OBGYN after lastly discovering somebody I like? *cue whiny face* I hate to assume others have handled these similar struggles, however one thing tells me this isn’t an uncommon state of affairs within the present American medical insurance local weather.

Hello, I’m Ashley! Arizonan on paper, Texan at coronary heart. Lover of operating, running a blog, and all issues cheeeeese. Late 30’s, married mom of two, working as a professor at a serious college within the southwest. Making an attempt to lastly (lastly!) repay that ridiculous 6-digit scholar mortgage debt!